T3 and cortisol issues?

[Knittergirl3]

hello, I could really use some help piecing my mess together. I’ll try to be brief but that may be difficult because there’s a lot to unpack.

2009 thyroidectomy for large goiter and hashimotos

Lived comfortably on 150/175 mcgs of Levo until perimenopause. Around that time i developed severe anxiety. My thyroid levels on 175 mcgs ft4 110% of range ft3 36% of range TSH .01 my dr at the time added an antidepressant and I pushed through for another few years. New doctor thought I would feel better with my levels balanced so my roller coaster ride with t3 began. I’ve literally tried everything and every combo you can imagine. I’m either hypo or hyper feeling.

I’ve been 5 years trying and ready to give up. I haven’t had a life in so long. T3 has always been difficult for me to tolerate. I drives my anxiety BUT once I get my ft3 to a decent level my anxiety vanishes.

In the past I’ve tolerated up 12.5 mcgs of t3 and I feel good for a few months but then I crash for various reasons - my ft4 goes too low, lower back pain, sleep issues etc. It feels like T3 just turns on me, so I would reset and build up my dose again. BUT lately, this has gotten to be impossible. I don’t know if it’s age (55) or my body is just worn out, or low vit levels, but this last crash has been terrible and I’m really scared. I need some t3 but cannot tolerate it. The past year or so has been dreadful and the last 3 months have been beyond my worst nightmares.

I’ll put pics of my cortisol saliva and my last reliable labs that I had when this most recent set back started. My dose at the time was 94.5/7.5 (May 2024). I was struggling to maintain the 7.5 of t3 but was functional and my anxiety was somewhat manageable then in a matter of a week or so anxiety exploded with panic attacks and I couldn’t tolerate my T3. I’ve been in a free fall ever since; changing meds, doses etc. bad I know. But desperation has made me crazy to fix this mess to my own detriment. Upon the encouragement of my dr I even tried t4 only, huge disaster on 75 mcgs of Tirosint, added depression to the anxiety party!

So currently I am back on 94.5 mcgs of levoxyl and trying to add T3. Even 1.25 mcgs of t3 taken with food gives me symptoms. Increased anxiety, tight chest, woozy/off balance, emotional etc. I’ve been trying to take 1.25 four times a day but after a few days I feel fried. Oh also, I’ve had early morning waking (3-4 am) for the past year or so.

I do have low B12 and just started injections yesterday. My iron I will attach. It’s weird because my ferritin isn’t bad but my actual iron labs are low.

Everything my naturopath gave me to take for my adrenals just made me feel worse. I feel stuck but I need to increase my t3. Do I push through despite symptoms? I’d feel better if I could get a 2.5 mcg dose in. These 1.25 doses don’t bring me up at all.

Also my symptoms are all over the place. I’m not fatigued and don’t feel sleepy and this puzzles me if I have low cortisol. Wouldn’t I be tired? Nothing hurts. I brisk walk twice a day, about 4 miles total. My motivation is in the gutter because of depression and anxiety I think. Loose BM’s when I try to take more T3.

Also, I had a blood morning cortisol test a while ago and it showed upper range but normal cortisol.

Any thoughts or input would be so appreciated. I’ve lost so much trying to find balance with T3.

thank you

[Knittergirl3]

labs 94.5/7.5

Labs

[Knittergirl3 in reply to Knittergirl3]

Iron labs

Iron

[Knittergirl3 in reply to Knittergirl3]

Ferritin

Lab

[Knittergirl3]

My pathetic B12 that my (then Dr) thought was fine. 🙄

B12

[greygoose]

Yes, your cortisol is very low - so is your DHEA, so there's obviously a problem with your adrenals. So, what is your doctor planning to do about that? He should be doing something, even if it's just referring you to an endo who can investigate further.

I’m not fatigued and don’t feel sleepy and this puzzles me if I have low cortisol. Wouldn’t I be tired?

Not necessarily, no. If it's been that low for a long time could be that your body has adapted.

It’s weird because my ferritin isn’t bad but my actual iron labs are low.

Not as weird as all that. It happens. But your ferritin isn't exactly good - it's not even mid-range. So, some iron supplements could be in order.

[Knittergirl3 in reply to greygoose]

My MD hasn’t done anything about my cortisol because my blood result was normal. My naturopath ordered the saliva test and she said it wasn’t terrible but that it needed some work. Like I said in my post, every supplement she had me try for my adrenals just made me feel worse so we gave up. I thought my DHEA is in the desired range in my saliva test?

I’m getting iron labs drawn again in two weeks by my dr so hopefully get some new info then.

With my cortisol levels where they are now do you think it’s possible to increase my T3 and hopefully see improvement?

[greygoose in reply to Knittergirl3]

What supplements did she have you try? One has to be very careful because some that you think are going to raise cortisol can actually lower it.

I don't know if increasing your T3 will raise your cortisol. It's possible, but it doesn't work for everyone.

[Knittergirl3 in reply to greygoose]

This! Exactly! Everything she gave me had contradictions to that. First was ashwagandha and that was big no. It made me feel terrible. Another supplement was a blend that had ashwagandha and other things in it. Then she started me on zinc and magnesium which I read on Paul’s site both decreases cortisol. So it’s been a confusing journey and we (I) have kinda given up. I’m doing adrenal cocktails, eating a lot of high vitamin C foods and hoping that getting out of this hypo ditch I’ve been in for awhile now will improve the situation. I’m trying to very slowly raise my T3 but stall out at 5 mcgs and I guess I just need to push through.

[greygoose in reply to Knittergirl3]

OK, so she doesn't really know what she's doing, does she.

Adrenals need lots of salt, vit C - never mind the high vit C foods, try taking vit C supplements, you're probably not getting enough from food - lot's of B vits and good protein. Try having a high protein breakfast as soon as you get up - eggs and cheese, etc. And try to go to bed and get up at the same time every day. That helps, too, a regular routine.

[Knittergirl3 in reply to greygoose]

Nope she sure doesn’t. So I’ve lost all faith in her and a lot money.

Thanks for the tips. I really appreciate all your input.

[greygoose in reply to Knittergirl3]

You're welcome.

[Knittergirl3 in reply to greygoose]

greygoose In regard to my iron labs being low but ferritin not terrible - you said it is not weird. I’ve been thinking about this and wondering, is this a common occurrence in people with genuinely low iron? Could you elaborate further on your comment I pasted below?

Thanks again for your thoughts.

It’s weird because my ferritin isn’t bad but my actual iron labs are low.

Not as weird as all that. It happens. But your ferritin isn't exactly good - it's not even mid-range. So, some iron supplements could be in order.

[greygoose in reply to Knittergirl3]

No, I'm afraid I can't. I don't know a lot about iron, just that it's not uncommon for serum iron to be low but ferritin higher. And vice versa. If you want further information on iron, I suggest you write a new post asking about it, or do a search on here for posts that deal with iron.

[TiggerMe Ambassador in reply to Knittergirl3]

Your ferritin might be higher due to inflammation or infection, sometimes you'll see raised CRP tie in with this, so it isn't particularly accurate which is why we need a full iron panel to get the whole picture

[SlowDragon Administrator]

in order to tolerate T3 it’s common to need GOOD vitamin levels

No vitamin D result

With serum B12 result below 500, (Or active B12 below 70) recommended to be taking a separate B12 supplement

A week later add a separate vitamin B Complex 

Then once your serum B12 is over 500 (or Active B12 level has reached 70), you may be able to reduce then stop the B12 and just carry on with the B Complex.

If Vegetarian or vegan likely to need ongoing separate B12 few times a week

Highly effective B12 drops

natureprovides.com/products...

Or

B12 sublingual lozenges

uk.iherb.com/pr/jarrow-form...

cytoplan.co.uk/shop-by-prod...

B12 range in U.K. is too wide

Interesting that in this research B12 below 400 is considered inadequate

healthunlocked.com/thyroidu...

Low folate

supplementing a good quality daily vitamin B complex, one with folate in (not folic acid)

This can help keep all B vitamins in balance and will help improve B12 levels too

Difference between folate and folic acid

healthline.com/nutrition/fo...

B vitamins best taken after breakfast

Igennus B complex popular option. Nice small tablets. Most people only find they need one per day. But a few people find it’s not high enough dose

Post discussing different B complex

healthunlocked.com/thyroidu...

Thorne Basic B recommended vitamin B complex that contains folate, but they are large capsules. (You can tip powder out if can’t swallow capsule) Thorne can be difficult to find at reasonable price, should be around £20-£25. iherb.com often have in stock. Or try ebay

IMPORTANT......If you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 5-7 days before ALL BLOOD TESTS , as biotin can falsely affect test results

endo.confex.com/endo/2016en...

endocrinenews.endocrine.org...

In week before blood test, when you stop vitamin B complex, you might want to consider taking a separate folate supplement (eg Jarrow methyl folate 400mcg) and continue separate B12

Post discussing how biotin can affect test results

healthunlocked.com/thyroidu...

helvella.blogspot.com/p/hel...

Have you had CRP tested - test for inflammation. High CRP will raise ferritin levels

[Knittergirl3 in reply to SlowDragon]

Thank you for all the info. Yes, my dr tested my CRP and SED rate and i don’t have inflammation.

[Knittergirl3 in reply to SlowDragon]

I got a B12 shot 2 days ago. And will get another in 10 days. I’d love to take a B complex and I’ve tried over the years but they are always too stimulating for me and increase my anxiety. I can’t do any methyl B’s those are the worst for me. I know that I have the MTHFR hetero but I’m not sure what means in regard to supplementing B vitamins.

Can you recommend a gentle B complex?

[FallingInReverse in reply to Knittergirl3]

Best B post ever:

healthunlocked.com/thyroidu...

[radd in reply to Knittergirl3]

Knittergirl3

Some of us can’t tolerate methylated forms as become over stimulated.

This is because it’s not just down to MTHFR mutations but others using the same pathways. For example COMPT impairments can speed up or slow down activity and this plays an important role in utilising the sex and stress hormones that come its way. These issues are often compounded by hypothyroidism instigating deficiencies in essential methyl-cofactors: B vits, zinc, magnesium, etc

Interesting you couldn’t tolerate Ashwagandha but it is nightshade. Have you ever had thyroid antibodies tested?

[Knittergirl3 in reply to radd]

Yes my antibodies were only 14 last checked. That is kind of where they usually stay since I had my thyroidectomy years ago.

[radd in reply to Knittergirl3]

Oh, I haven’t read your history.

I love Ashwagandha as used it successfully for several years.

There’s a huge amount of credible research on it but it can be a tricky supplement. Interesting article here … naturalendocrinesolutions.c...