Back in range 🕺🏼👏

[Regenallotment]

Feels like a minor triumph.

I’ve been over range for some time.

Symptoms weren’t noticeable at first, bit hot (I’m always a bit sweaty), bit unstoppable, bundles of energy, motivation and drive. Bit achey but that’s common for me, recovery after a busy was quicker than before, bounced out of bed in the mornings, quite loose bowels (not unusual for me), steady weight loss of previous 6 months continued at 1kg a month. Appetite healthy and felt quite hungry. Chronic ankle pain vanished, as did headaches. Periods lighter. hR raised to 70s resting and HRV dropped to 20s-30s. Basal temperature no noticeable difference held steady at 36.2.

April 2023 on 125mcg T4 5mcg T3 Test after splitting previous T3 dose in two, last dose 8 hours before blood test, T4 24 hours.

FT4 27.7 (12-22)

FT3 6.8 (3.1-6.8)

Reduction was overseen my prescriber, advice here was 25mcg might be too much. I went with my gut feel at the time that I needed to continue T3 and significantly drop T4 down.

July 2023 on 100mcg T4 5mcg T3 alternate days. Test after 24 hours of BOTH T4 and T3 doses.

FT4 27.5 (12-22)

FT3 10.5 (3.1-6.8)

Reduction again overseen by my prescriber. I was more keen to drop T3 and T4 this time. We discussed 2.5mcg T3 daily, advice repeated often here is take the same dose daily but but my blood test showed FT3 at 10.5 after 24 hours so plenty in the system. Did 4 weeks like this. Feeling fewer symptoms.

August 2023 on 75mcg T4 and slow tapering of 5mcg T3 to nothing 4 days before test. NHS test via GP so I was keen to get FT4 in range to maintain prescription. Last Levo dose was 28 hours before this test and test was earliest available 10.15 appointment.

FT4 20.4 (12-22)

After this test I have remained on 75mcg T4 daily, no T3 and feel pretty steady so far.

Note: I am unlikely to get FT3 in this round as NHS test despite GP requesting due to over replacement symptoms.

I will repeat in 6 weeks privately to include FT3 and adjust from there.

GP has also tested all vits, bloods, liver, kidney, proteins, serums, lipids, iGA igG, (zinc, selenium also requested not sure they’ll do those), faecal tests too. The works.

Just thought I’d share that, there a few of us over range and we’ve been comparing symptoms, I feel we don’t discuss over range results as often as under. Not really looking for advice, I’m happy with where I am and feel good.

happy bank holiday weekend folks, I hope you all win your duck races, county fair scone competitions or whatever your Bank Holiday thing is 🌱

[HealthStarDust]

Super well done. I agree, there isn’t enough on over medicated as much as under medicated. And, it’s heartening to read someone’s positive experience of removing T3 as the removal of this is also under discussed.

I hope you continue to feel well.

[Regenallotment Ambassador in reply to HealthStarDust]

Thanks HSD, yes I agree with you there 🌱

[greygoose]

Maybe there isn't much discussion about over-medication because it's somewhat rare. Most people are under-medicated.

And most people are fighting to get T3, not to give it up.

[Buddy195 Administrator]

I too have experienced symptoms of over medication and that’s why I only ever increase (or decrease) super slowly. We all have different’sweet spots’ where we feel well. I’m so glad your adverse symptoms have eased Regenallotment 🦋

[SlowDragon Administrator]

Well done

Retest again in 6-8 weeks

This may be the dose you need to be on but this “over medicated “ phase could have been a Hashimoto’s flare and you might need to increase a bit in coming months

[Regenallotment Ambassador in reply to SlowDragon]

Thank you as always for the reassurance, yes I’ll definitely do that 🌱

[FoggyThinker]

Love a good news story! I think we need to know all sides of getting ourselves well, no such thing as being too well-informed whatever our GPs may think. First day on Adrenal Cortex Extract for me; I've concluded I have a false good FT3 reading on only 1 grain NDT and my cortisol came back low all day so I'm hoping that I can share a good news story soonish, too. Wish me luck please? And I hope it continues going well for you too 🤞🌼 🦋

[Regenallotment Ambassador in reply to FoggyThinker]

Excellent work finding out more about yourself, it’s empowering isn’t it. Thank you for the encouragement, and yes Good Luck 🤞🍀🧧☺️

[HealthStarDust in reply to FoggyThinker]

Good luck!

[TiggerMe Ambassador]

Excellent news 🤗

It goes to show that you have done a great job improving all the basics and tackling deficiencies that sneak up on us hypo's and the need to keep monitoring and be ready for these things to improve overall function and so the tweaking continues 🙃

What a great insight you now have to zoning in on optimising your dosing A⭐ pupil 🤩

Like  greygoose says most of us are more often than not kept below optimal with restrictive prescribing and hoops to jump through, wouldn't it be great if we could all experiment and get to know what the highs and lows feel like to find our optimal 😏

The great thing about this site is that it often gives people the confidence to try things, it isn't all about increasing to find wellness

[Hidden]

Well done Regen! The pendulum swings. Metabolic cascades must have happened, maybe the added T3 has done its thing and can now bog off? Glad you are feeling well, really hope it sustains for you ❤️

[HealthStarDust in reply to Hidden]

I like the idea that a short course of T3 has done its job!

[Hidden in reply to HealthStarDust]

An endo once told me that sometimes T3 only needs to be temporarily used, but I’ve never seen it in anyone other than Regen!

[Tythrop]

So glad you are feeling in controll .Good news makes us happy .Thanks

[SarahJane1471]

🙌great news

[DippyDame]

Sounds promising.

Your T4 to T3 conversion looked fine?

Who suggested that you add T3...it's not the panacea of all ills!

In most cases before adding T3 we usually raise levo dose until FT4 is about 75% through the ref range

At the same time we optimise essential nutrients.

healthunlocked.com/thyroidu...

If that fails, then time to add a little T3

On 25mcg you were undermedicated and your low vit D would be affecting your thyroid function

A Hashi's flair may have caused a temp hormone rise

After this test (08/23)I have remained on 75mcg T4 daily, no T3 and feel pretty steady so far.

Perhaps this proves that increasing your original tiny dose of 25mcg was the solution from the start

Wait and see how you feel after 6/8 weeks on a steady dose of 75mcg levo before coming to any conclusions

Well done for reaching this stage.

Happy that you feel well now...hope it continues.

[Regenallotment Ambassador in reply to DippyDame]

Your T4 to T3 conversion looked fine?

It wasn’t before starting T3. I also remained symptomatic. On 125mcg T4 alone my FT3 was 29% through range. The % through range FT3 actually went down after increasing 100mcg Levo only to 125 mcg Levo only.

Who suggested that you add T3...it's not the panacea of all ills!

With my FT3 at 29% through range with FT4 up above 75% through range it was the logical next step discussed here on the forum, from my own reading and with the pharmacist prescriber. It was a considered decision after seeking advice, and optimising all vitamins, diet and lifestyle.

Oh and I have the DIO1 & 2 gene mutation along with MTHFR so felt that may cause my poor conversion.

Not sure what you mean about increasing my 25mcg tiny dose or it being the solution from the start. I was on 25mcg when first diagnosed, I immediately put on 10kg despite a home grown home cooked diet and lifetime of verging on orthorexic about food, and was very unwell at the time. I’ve worked hard to get to this point.

Are you suggesting I didn’t need the T3?

I don’t agree because at the point I was first prescribed T3 I was still symptomatic despite optimal vitamins, but low ferritin. I didn’t experience any ‘rush or whoosh’ but gradually felt the fog lift and the aches recede over a matter of weeks. As I said at the top, I didn’t initially even realise I was over replaced. The feeling was familiar, it’s how I felt during most of my younger years. I expect that is a typical Hashi observation.

Whether it’s the ferritin fix or the T3 metabolic cascade, or a Hashi Flare who knows I’m just glad my heart is beating a little slower, I didn’t need beta blockers and I haven’t lost my Levo prescription. 🌱

[DippyDame in reply to Regenallotment]

You asked, so if I may I'll clarify my comments.

I based my comments about your conversion status on your early post, while you were still on 25mcg T4

FT4. 15.1 (12-22) 31% through ref range

FT3. 4.4 (3.1 - 6.8) 35.14% ditto

This shows undermedication, not poor conversion

Poor conversion shows as high FT4 with low FT3 which is not evidenced here

You say conversion wasn't good before starting T3....T3 doesn't affect conversion, it is the consequence of good T4 to T3 conversion

I'd suggest you remained symtomatic at that point because you were undermedicated....the symptoms you list are those of undermedication.

Not sure what you mean about increasing my 25mcg tiny dose or it being the solution from the start.

I replied

Perhaps this ( the fact that you now appear to be doing well on 75mcg T4) proves that increasing your original tiny dose of 25mcg was the solution from the start.

In other words, the solution to your problem from the start .....without a need for T3.

I don’t agree (that I didn't need T3) because at the point I was first prescribed T3 I was still symptomatic despite optimal vitamins, but low ferritin.

Maybe, but what was your levo dose when you added T3 and how did your FT4 result compare with your FT3?

Are you suggesting I didn’t need the T3?

That is what I'm suggesting based on your labs when only 25mcg T4 had been added.

Once T3 is added labs can't be used to calculate conversion

...And now you seem happy on an increased T4 dose without T3.

I expect that is a typical Hashi observation.

I did point out that your raised labs were likely the result o a Hashi's flare rather than over replacement

I have the DIO2 mutation.

If heterozygous it may not affect conversion greatly, butresearch proves that a homozygous polymorphism has greater impact on conversion.

I’m just glad my heart is beating a little slower

The heart needs a lot of T3 and raising your T4 dose will, by conversion, have raised your FT3 level so helping your cardiac function.

There is no reason why you should lose your levo prescription

You will be aware that your thyroid hormone levels will fluctuate as a result if Hashi's.

A gluten free diet is recommended for Hashi's

The main thing is that you now feel better, I hope that continues.

[Regenallotment Ambassador in reply to DippyDame]

Ah ok so you seem to have mixed old results with new, my FT3 % through range didn’t change much on 50mcg, 75 mcg, 100mcg always around the 30% mark and on 125mcg it was 29%.

I’ve been all that way up the T4 doses THEN added T3 after optimising vitamins

I’ve been gluten free for 12 months. Have a dairy allergy and lactose intolerance.

[DippyDame in reply to Regenallotment]

Sorry, but no....I haven't mixed up any results.

The results I referred to were from your Medichecks test a year ago and the ones I used to establish your conversion

Just noticed that SlowDragon commented in that post...

Shows good conversion but inadequate dose.

Your labs have certainly become skewed but hopefully on a steady dose things will now begin to improve and stabilise.

You've had a challenging time.

Take care

[Regenallotment Ambassador in reply to DippyDame]

What do you make of 125mcg T4 and FT3 at 29% through range?

Are you saying that because at starter dose of 25mcg my conversion was as would be expected that I shouldn’t assume conversion was my issue at 125mcg 4 titrations and almost a year later when it was at 29%?

[Hidden in reply to Regenallotment]

Regen - I aspire to be as meticulous, dedicated and considered as you! You followed every thread of advice given and have done loads of the boring lifestyle changes that many don’t commit to.

With FT3 at 29% through range on a full replacement dose with lingering symptoms, T3 is a completely reasonable decision, whether you got endorsement from outside sources or whether you just made the decision on your own.

Your wellness is hard won and carefully procured! 🏆

[DippyDame in reply to Regenallotment]

Something certainly happened along the way to alter your FT3 but what did that isn't clear....and not necessarily poor conversion, though that may have been a consequence rather than a cause.

chriskresser.com/low-t3-syn...

[Beau55]

so glad you are starting to feel better regen ☺️ I just wanted to say I think you made the right decision in trialling some t3 in your treatment, i certainly would have based on your results!

The one thing I’m really, really questioning looking at your results and story is whether low cortisol is affecting things..

I know everyone is different but I can’t fathom how an additional 5mcg of t3 could have pushed your results so high! I have seen so many instances where the blood results go high from a very normal dose and it always seems to point to cortisol issues, perhaps this could explain things and give you a new area to explore as you get back on track?

Did you have any low cortisol symptoms during raises?

You are so meticulous, I am sure this has been suggested before but just thought I would add incase it hasn’t x

[Regenallotment Ambassador in reply to Beau55]

Thanks Beau it’s very much appreciated, I’ve learned and am still learning so much when people pitch in ideas.

I have followed others looking at cortisol and wondered about it, but when I look at the symptoms mine is possibly high /normal just now rather than low. I do agree though it may have been low in the past, I dragged myself around my teenage years etc. I won’t dismiss it. I have found the adrenal cocktail folks mentioned here very effective when I’ve overdone things and given myself a bit of PEM or have a full day ahead and don’t want the 3pm slump (which I haven’t had while over replaced) and recent blood tests put potassium and sodium in the lower half of their ranges so one to watch perhaps now I’m on a lower dose.

thanks again 🌱

[Hidden in reply to Regenallotment]

I think that Beau55 is right that your FT3 going so high on such a small dose of T3 is suspicious 🤨 I’d also say that before I got my adrenal insufficiency diagnosis I cross referenced all my low and high cortisol symptoms on the rt3-adrenals website and I got 69% high cortisol symptoms and 70% low - I feel worried that symptoms are too similar to be much of a steer ☹️ If you into issues down the line you can always do the Regenerus saliva panel to check it out x

[Regenallotment Ambassador in reply to Hidden]

Yes I looked at that too after TiggerMe shared the link the other day. I will watch and wait. Thanks for your thoughts, all really helpful 🌱

[GlowCoach Administrator]

Just to say that I am watching your progress with interest. I have no answers as to why your results have gone so high on a fairly small amount of T3 and future tests will hopefully be revealing. Fingers and everything else crossed for you.

[HealthStarDust]

Hello. Just checking in. How are you doing since all this?

[Regenallotment Ambassador]

Tests early Sept showed T4 and T3 back in range. Still had frequent palpitations.

Did 4 weeks of 75mcg T4 only, added 2.5 mcg daily of T3 as I ache without it.

Got a bit constipated

Did 4 weeks of 75/100 and 2.5mcg didn’t change much

On week 2 of 75 and 2x2.5mcg T3 and that seems better. GP said to play around with adding 100mcg T4 on different days so that’s the next twiddle.

I may need to go back to heme from Vegan Biglycinate though… or alternate, I’ll see what the test says.

no more testing till December, feel pretty good, working full time, sleep well, diet is sorted. Just have the occasional dip when I overdo it. 🌱

[HealthStarDust]

May I ask how you got on? Did you have to resume the T3 since the above post?

[Regenallotment Ambassador in reply to HealthStarDust]

Eventually I became more hypo again with symptoms around the end of January.

Yes went back on T3 Thybon Henning 10mcg, but stayed on 75mcg Aristo, can’t remember when probably some time in the Autumn, tried 75/15 and I didn’t post my last test results but both FT4 and FT3 were low in range. Vitamins steady but ferritin lower. That was about 3 weeks ago so I’ve gone 100/ 15 and might need to drop back to 100/10 we shall see, I’ll give it another 3 weeks. I’ve upped the three arrows Heme for 2-3 a week to 4 and I think that’s helped too. I have energy but conk out quite quickly. Was trying some weights but can’t manage much yet, building up slow, I’ve gone from 5 mins to 15 mins, tried 3 times a week and needed naps 😴🤣 so tried 2 and this week will do 1. 🌱

[HealthStarDust in reply to Regenallotment]

Thank you for sharing.

I wondered if it was possible for someone to stop taking T3 altogether once they started it.

I hope it worked out for you.

[Regenallotment Ambassador in reply to HealthStarDust]

Yes I think someone can if they manage to get on top of conversion. 👍

How are things with you, did you get down to your sweet spot again ok?

[HealthStarDust in reply to Regenallotment]

🙂‍↕️ I wish!

I am determined to give levo the best chance possible and trialing different brands currently (I seem to experience horrible symptoms depending on both dose and brands). Failing that, I have some hormone tests to complete before approaching private endocrinologist. No doubt I’ll (eventually) have an NHS one too.

The reason I am determined to give levo the best chance possible is as I’d rather not have the bureaucratic debacles that come with T3 and NDT, particularly for an eventual successful pregnancy.

[Regenallotment Ambassador in reply to HealthStarDust]

Good for you, yes I saw the other post about brands. Not sure I can offer much other than I know within half an hour of taking one whether I can tolerate it. But that’s a lactose thing.

Fingers crossed for you 🤞