Could increased anxiety be too much T3?

[Girlslovescifi]

4 weeks ago, the endo reduced my levo from 100mcg/75mcg on alternate days to 75mcg. At the same time, she increased my t3 from 15mcg daily to 20mcg. Think she wanted to see my tsh increase because it was under range. Anyway, I’m on holiday atm and my anxiety is terrible and I’m shaky and emotional. Just wondering if it could be the change. I was initially put on 100mcg Levo & 20mcg t3 when I came off NDT, but another endo reduced the t3 to 15mcg and said it was making my anxiety worse. I don’t get it.

[Buddy195 Administrator]

I have to increase thyroid medication super slowly as this always affects my anxiety levels. With Levo, I increase by 12.5 mcg alternate days at first (until tolerated) then add 12.5 daily. With Liothyronine, I add 2.5mcg only- & find a pill cutter useful. Some of us are more like a tortoise than a hare!

Another thought…..Has your Liothyronine brand changed at all Girlslovescifi? My anxiety spiked when my GP swapped my brands (from Morningside to Roma) & this resolved when original brand reissued.

[Girlslovescifi in reply to Buddy195]

I make sure I stay on the same Levo brand. Maybe reducing Levo and increasing t3 was all too much.

[SlowDragon Administrator]

Last Ft4 result

FT4: 15.3 pmol/l (Range 7.8 - 18)

Ft4 73.53% through range

Can’t see most recent Ft3 result

Ferritin on low side

What are vitamin D, folate and B12 levels

[Girlslovescifi in reply to SlowDragon]

Serum free triiodothyronine level 5.52 pmol/L [3.5 - 6.8] That was 11th April. Can’t recall if I followed the correct protocol or the surgery’s advice that time.

[SlowDragon Administrator in reply to Girlslovescifi]

What was TSH

Likely to reduce further on higher dose T3

Do you split your T3 as 3 doses per day

[Girlslovescifi in reply to SlowDragon]

Serum TSH level < 0.05 mIU/L [0.2 - 4.3]; I split it into 2 doses. I found 3 difficult to manage with eating and taking supplements.

[SlowDragon Administrator in reply to Girlslovescifi]

So the day before test did you split in 3 with last 5mcg dose between 8-12 hours before test

[Girlslovescifi in reply to SlowDragon]

That’s what I can’t remember. Sorry. I normally would but that test may have been one where I followed the message from the surgery that said I should take the t3 2-4 hours before the test.

[Girlslovescifi]

but previous tests where I’ve tried to follow the protocols, the t3 levels have always been upper quarter or at the top of the range.

[DippyDame]

Is your vit B12 optimal? Low B12 can cause anxiety

Only one thing should be changed at a time your " tired" system had to cope with less T4 and more T3 in one volley!

TSH is not a reliable marker and why she thought of increasing your TSH by raising T3 is a mystery......increasing T3 lowers TSH!. I need high dose T3-only and my TSH is on the floor

These medics appear to be using a " pick and mix" method of dosing rather than one based on robust analysis of your lab results.....I don't get it either !

Very difficult to comment without knowing the lab results this GP based her changes on. Did she have an FT3 result

How did you feel on your previous dose?

It sounds as if this new dose isn't suiting you.... as you already suspect

Ideally you need to remain on a steady dose for 6/8 weeks then have a full thyroid test to include....

TSH, FT4, FT3, vit D, vit B12, folate, ferritin and thyroid antibodies TPO and Tg

OR at the absolute minimum....TSH FT4 and FT3

FT3 is the most important result followed by FT4....relying on TSH is just asking for trouble..it measures the total amount of thyroid hormone in the serum but gives no indication of the level of each hormone ( FT4 and FT3) For accurate analysis we need both Frees.

If you make no progress with your GP/ endo then you could test privately

thyroiduk.org/help-and-supp...

Please post any labs you have, also, you are legally entitled to request copies of results from your surgery office....not the GP

Just a few thoughts, hope something resonates.

[Girlslovescifi in reply to DippyDame]

Thank you. T3 has always been in the upper most quarter or top of range. She lowered my Levo to try and raise the tsh. I think that’s what she said. None of it makes sense. They keep fiddling with my dose. I certainly don’t feel better on this dose, if anxiety is anything to go by. I was on 100mcg Levo daily with 15mcg t3 and they reduced it to 75/100 Levo on alternate days, then put it back up to 100 daily, then back to 100/75 and now it’s 75.

[DippyDame in reply to Girlslovescifi]

They sound clueless!

Change your dose...get you out the door for a few more weeks!

If they are relying on TSH they/ you will continue to struggle...see my earlier reply

Can you remember which dose you felt better on?

Do you have a copy of your diagnostic / first test results which shows the state of your thyroid function before medication?

[Girlslovescifi in reply to DippyDame]

No, I don’t have that result. It was years ago.

[DippyDame in reply to Girlslovescifi]

I got mine fairly recently...test was in 2000!

[tattybogle]

lowering levo from 87.5 to 75mcg to try to raise TSH ... Yes that should raise TSH .

..... but raising T3 dose by 5mcg at the same time ??

TSH obviously won't rise if they remove 12.5 mcg T4 and add 5mcg T3, because the overall dose is now HIGHER,, so the effect on TSH will be to lower it .

T3 is about 3 or 4 times a 'strong' in it's effect as T4 is .. so 'in effect' they removed 12.5mcg and added 15 or 20 mcg.

......has the person making these dose changes got a maths 'o' level ?

i think you should check.

[Girlslovescifi in reply to tattybogle]

I get so disillusioned with the endos.

[SlowDragon Administrator in reply to Girlslovescifi]

You need to take control and TELL them what dose you’re going to take

Which brand of levothyroxine are you using

Do you always get same brand

ALWAYS test as advised on here

And retest vitamin levels after any dose reduction

[Girlslovescifi in reply to SlowDragon]

I always get Mercury Pharma. They don’t test vitamin levels very often, which means I’ll have to pay to get them done.

[SlowDragon Administrator in reply to Girlslovescifi]

Test vitamin D twice year

Test folate, B12 and ferritin at least annually

But if reducing dose levothyroxine or T3 keep an eye on vitamin levels

Get GP/endo to Test cholesterol and GFR (kidney function) annually

Low GFR or High cholesterol suggests under medicated for thyroid

[Girlslovescifi in reply to SlowDragon]

thank you

[arTistapple]

I just read on the Canadian website that taking milk thistle can help if our T3 feels like a bit much, re:symptoms. I have ordered some in case it happens to me when I start taking T3 again. I have used Milk Thistle in the past for digestive issues and it is ‘listed’ as one of those capable of blocking ur thyroid meds.

[Girlslovescifi in reply to arTistapple]

Thanks for the tip.

[tattybogle in reply to Girlslovescifi]

i think helvella has some more info about Milk thistle ... it has some funny effects on thyroid hormone , but i can 't remeber what exactly ,, do plenty of research first .

[Girlslovescifi in reply to tattybogle]

Thanks. I always do my research.