I’m currently on Liothyronine only 40mcg daily. My endocrinologist sent me for a blood test 3 weeks ago and I got a letter from her today saying that my T3 is high indicating I am overactive. She never supplied me with any figures on this letter so I have no idea what my levels are now. She has suggested that I take 20mcg of Liothyronine 4 times a week and 30mcg the other 3 days. I feel mostly ok, I am able to exercise every day with no pain but I have constant pins and needles in both feet since January. I also still haven’t lost the extra weight I put on when I got diagnosed.
For the last 3 weeks I have constantly been itching. I have tried 5 different antihistamines and none of them have made any difference. Would this itching be a symptom of overactive thyroid?
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ScriptMaz
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How long before the blood test did you take your T3 and what dose was it?
Recommended timing for T3 pre test is 8-12 hours. Too soon will result in a false high and too longer time space will result in a false low.
Suggest you get hold of these results as 40mcg T3 is a failry lowish dose for T3 monotherapy. Either that or do your own test. Stop any biotin containing supplement for 4-7 days maximum before the testand split your dose the day before so that you take 1/4 to 1/3 8-12hrs before the test.
T3 is an immediately acting hormone so its not advisable to alternate the dose. Its better to take the same dose each day.
Have you tested key vitamins and now supplementing them to optimal?
What supplements are you taking?
Low B12 often causes pins and needles.
Until you see your results its hard to know if you are under or over replaced.
I took my T3 at 7.30 and the test was 15.30 so 8 hours. I mentioned to the endocrinologist in May about my feet and she increased my dosage from 30 to 40 mcg a day. I take NAC, which I read on Dr Isabella Wentz Facebook page was good for Hashimoto’s. I also take a vitamin B complex. I am also on Hydrocortisone 10mg and 5mg as I have low cortisol levels. My main worry just now is this constant itching which I read now could be connected to having an overactive thyroid
I’m a creature of habit so haven’t changed anything recently. I got the vitamins from Hey Nutrients so it’s Ashwagandha and vitamins B1,B2,B3,B6 and B12. When I got the test I was taking VitD but I’ve ran out now.
The Hey Nutrients supplement is a pretty low dose at only 100% RDA of B12, it doesnt contain folate either. The supplements we recommend here contain over 16,000% RDA which is the kind of dose you probably need. Ive attached a label from something we often suggest - Thorne Basic B so that you can see the quantities of vitamin that you would benefit from. Compare other supplements to this and dont buy anything thats lower in dose.
Ideally you really need to test your levels now to see if B12 really is the issue causing pins & needles, also to test other levels.
As soon as you stop taking a supplement then your levels will begin to drop. Most people need a minimum of 3,000iu of vit D.
B complex suggestions: Slightly cheaper options with inactive B6:
Oh. You take multi B vitamins. I think your biotin has given a false high result for your FT3. You must not take liothyroinine within 18 hours of blood test and it should be a fasting test and early morning . For biotin you need to stop taking all B12 vitamins for at least a week 2 weeks if you can. B12 is the only one that doesn't appear to Interfere with thyroid blood tests. :/ I recommend that you don't change your dose that much. Possibly 40 for 4 days a week and 30 for 3 days a week. If you make the dose too low it could cause other symptoms. Possibly tell them you had only just took your meds and made a mistake and ask to redo the load rests in 3 month's time. Arrange for blood test to be done early in the morning around 8.30am. :/
I didn’t start on the B supplements till after the blood test. It was the endocrinologist that scheduled the blood test so you would think she’d know better
It does seem to be hailed as a cure all 🤷♀️but it can behave differently for instance in some it will raise cortisol but for others lower it, which can be a major issue for us Hypo's 😵💫 buyer beware adaptogens need close monitoring too!!... I've never found a combi worth buying
In my view, the word "overactive" in relation to thyroid means one thing: When your thyroid is producing too much thyroid hormone.
It does not EVER mean over-medicated.
There are words, like "thyrotoxic", to refer to the state of having too much thyroid hormone and suffering the effects of that.
I often use the word/phrase "heavy-handed" regarding dose changes - often made by doctors.
A 50% reduction four days a week - and a mere 25% reduction the other three!!!
I'd call dropping to 30 every day pretty heavy-handed. No, I'd call it beyond heavy-handed. But I'd liken this double-step reduction to dropping a fully-loaded weight-lifting bar onto your big toe.
And the near-universal advice here is never to alternate dose with liothyronine. With its short half-life, doing that ensures you will be heading straight for a roller-coaster.
Even more ridiculous, with four of one dose and three of another, you are going head-on to having two successive days of 20 - which will make it even more pronounced.
You must, really and truly this is essential, get your blood test results. Including the lab's reference intervals (ranges).
Thanks. I’m going to phone the endocrinologist next week and get an explanation as to why I need to lower the dosage. I don’t like doing things just because the doctor says. I need to know why and how it will improve my symptoms
It's only likely to make your symptoms a lot worse. That doctor has not advised you from a basis of actual experience or knowledge. That's a very strange thing to tell someone on Tt3 only to do. The maximum reduction should be 5mcg a day, better just to reduce by 2.5mcg a day and see that how feels.
The only symptom I had before I was diagnosed was unexplained weight gain. Since I started on medication I’ve felt far worse and put more weight on. Levothyroxine was the worst and caused me so many issues. At least with Liothyronine the only issue was the pins and needles in my feet. And now the constant itching which I’ve read could be Hives and thyroid related
I have itching sometimes. My forearms especially and especially at night. But I think it might be either low T3 or HRT for me. Not sure which. It comes and goes a bit. My skin is very dry thanks to both hypothyroidism and menopause. I find I can ease it by washing in cool water and then slathering the worst parts in moisuriser.
For someone on T3 only, you are likely suffering from too little T3 per day. Reducing it further is crazy. I'd be asking why she wants to do this, which blood test result made her want to try it? If she says low TSH then "remind" her that patients on T3 only will have drastic reductions in TSH and that it is not considered a reliable measure for assessing treatment. Rather you need to have Free T3 tested and work from that.
I did a quick search for "T3 only" on the ThyroidpatientsCanada blog (which has a wealth of accurate thyroid information on it) and it threw up a list of articles you might find helpful. But certainly trawl through that site. The author is T3 only herself and she understands the process better than any doctor I've heard about here in the UK.
The letter from the endocrinologist said that my T3 is too high but didn’t say what the number is and I’m pretty sure that it’s never been checked before as they only ever test TSH and T4. I feel like the doctors only ever look at numbers and not on how the patient is feeling
Also, by changing my search on the ThyroidPatientsCanada web site to "T3 Monotherapy" I got another set of useful articles for you. I was particularly looking for the "wheelchair" article.
I’m on low level hydrocortisone. It’s just to bring me up to my natural levels. I’m waiting on an appointment to check if this is caused by my adrenal glands or my pituitary gland. The weight gain was mainly from the levothyroxine. I put on a stone and a half from that. I’ve now levelled out and not put on anymore since. I just can’t shift this extra even though I eat healthy and exercise every day
I think even a low dose of steroids will cause weight gain initially. Once stable the weight should also stabilize but I would think you wil find it difficult to lose any.
It hasn’t caused any weight gain. I’ve been taking them for a couple of months and my weight is still the same. I exercise every single day and my shape has changed for the better but the weight is exact same
I’m scheduled for a blood test on Tuesday because of the itching I’ve had constantly for over 3 weeks now. I don’t know what exactly they’re testing but I will ask the phlebotomist when she’s doing it. I will also ask the gp for printouts of my last few blood tests to see what the endocrinologist has seen to make her decide to reduce my dose. Sometimes I think they’re making it up as they go along. I’ve seen 4 doctors in the past few weeks and none of them can explain what this rash is or why the 5 different antihistamines have not worked
I don’t know if that’s available in Scotland. Last year I had to put in writing a request to my GP to get a print out of my results. I’m going to do it again once I’ve had my blood test on Tuesday
I am a creature of habit so nothing has changed. The only thing I’ve done different and it was only highlighted during a chat with someone else on this is that I’ve finished my course of iron tablets about the same time as the itch started. I will be going for a blood test tomorrow to see if anything shows up
I haven’t changed anything. As I’ve said I’m a creature of habit so I use all the same products I’ve been using for years and I’m not adventurous when it comes to food
Have you rechecked the ingredients of all meds and foods.
With costs going up all the time fillers are being changed. Food ingredients are changed.
I had a reaction quite recently to a hair conditioner. On reading the small print and speaking to the manufacturer, the oil has been altered with the addition of a small amount of mustard seed oil.
This is a cruciferae. I have no enzyme to oxidise sulphur and I itch ++, then my skin bleeds.
There was no indication on the bottle, but a tiny ‘brassica’ ingredient that wasn’t on the old bottle.
You say you are not in England. Where are you?
I’m in U.K. but I got my T3 in 1984 from an Italian doctor, a friend of my GP. I have learnt over the yrs to resist any changes. I had a hosp test only 3 wks ago. I was not told to fast etc for any. The T3 came out too high, but since I have no thyroid on CT they now ignore it.
But my B12 was non existent and Vit D very low. So I’ll add them.
I don’t eat much processed food so I’m not sure that’s what’s causing it. Anything I put on my skin I check because it’s super sensitive due to my vitiligo. I very rarely change anything so if it works I stick by it.
Does anyone else find it scary that these Endos are prescribing T3 and dont seem to have the first idea how it works and patients are having to turn to forums like this to get put right?
It is scary - Endo was happy to prescribe t3 but he gave it as a single 20mcg tablet to be taken in the morning. With the info from this group chose to start with 5 in the morning then after bld tests at 6 weeks, increased this to twice a day. Then 3x a day - 6,11 and 4 pm each day. Taking 150mcg levo at 10pm. Recently fatigue had returned so increased the 11am dose to 10mcg. This has now suppressed the TSH which the Endo didn't like but has left things as they are as symptom free although I still can lose any weight.
The 2 symptoms I have are hives and pins and needles in feet. So by that logic then I should be getting an increase in my meds, not a decrease. I feel like the doctors are making it up as they go along. If the endocrinologist thinks I’m now overactive then maybe I should stop taking meds completely. I’m not going to do that but I may use that as an argument when I speak to her
I asked the doctor about that and he said my B12 levels are fine. I asked about it needing to be optimal and they just fobbed me off. They also said supplements do nothing to help. I take Ashwagandha and vitamin B complex, NAC
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)
Post discussing how biotin can affect test results
I don’t have any just now as I need to put it in writing each time I request my blood test results. Once I have this blood test on Tuesday I will request them so that I can research all the results properly
First of all, please don't reduce your dose by that much! 2.5 mcg t3 is the max you can start with a d see. But first, ask for your blood results.Itching can be a sign of overmedication, but equally can be a sign of undermedication. Better check results and if you decide to move dose upwards or downwards, move only by 2.5 mcg max.
Christ, what is wrong with these doctors, chopping changing doses like it is sweets.
Tingling in the hands and feet is a symptom of hypothyroidism. In my case it stopped as soon as I started taking T3. It's incomprehensible that the doctor doesn't want to give you the results of your blood tests. The doctor is not in your skin, he can't know how you feel. All you have to do is carry out tests and take small amounts of T3 every 3/4 hours and a dose of T3 and T4 at bedtime. Never exceed 10 mcg of T3 at a time. You should stay on the same dose for 15 days, then increase or decrease the dose depending on the support. Temperature and pulse should be adequate and symptoms should disappear. This will tell you whether you are indeed suffering from hypothyroidism.
I can’t take Levothyroxine. When I was on it the last time it affected all my joints to the point I struggled to function properly and couldn’t walk without being in agony. This is the reason I’m on T3 only. I’ve told both the endocrinologist and my gp about the issue with my feet but their reaction at the time was to increase the T3 which has made no difference
If you've taken too much T4, you should try a low dose, but if it doesn't work, T4 is not essential. As for T3, be careful with the dosage; you can feel very unwell with a large dose. I took 12.5 mcg of T3 every 4 hours and I was so sick I couldn't do anything. Now I take 6.25 mcg every 3 hours and I feel great. You have to try it out
I won’t ever take levothyroxine again. I’m on 40mcg of Liothyronine and I have no side effects. My only issues currently are the pins and needles, inability to lose weight and the Hives. All things I can cope with
If you take 40 mcg a day in a single dose, it's normal for it to make you ill. I take 1/4 tablet every 3 hours with food, i.e. 6.25 mcg per dose. That's how I feel. And your endocrinologist seems to know nothing about it. You don't vary the amount of hormones, the same amount has to be taken every day.
That’s the thing. Whether I took it in separate doses or one dose it made no difference. I take it at the same time every morning with water and an hour before any food as I’ve heard it affects the absorption. My endocrinologist said she has only once before switched someone from levothyroxine to liothyronine
Really. This contradicts everything I’ve ever read about thyroid medication. I was always told on an empty stomach and an hour before any food or caffeine
Hi - I’m on levothyroxine and had 6 months of itching and spots. The GP was of no help (prescribed high dose steroids after which the spots came back) and antihistamines which didn’t work. I was referred to a dermatologist who told me that research shows that patients can develop a severe itchy rash if iron or vitamin D levels are low. The dermatologist tested and my iron and vitamin D levels were both deficient. I was amazed find that my regular blood screening with the GP didn’t include screening for these important elements. I’m now on high dose supplements. However, I have been urging my GP to investigate why I’m not absorbing iron and vitamin D appropriately. I’ve been tested for coeliac disease and had faeces screening (for bleeding in the gut which thankfully was negative) I’m still awaiting the results re coeliac but in the meantime I’ve cut out gluten and feel so much better.
Thanks for that information. I wonder if the blood test I’m getting on Tuesday will check those vitamin levels. I will take note and mention this to my gp
It’s interesting you mention iron levels. I never put this together but I finished my course of iron tablets just before this itch started. I must mention it to the doctor.
I’m getting a blood test on Tuesday and they’ll check that. I’m only on Liothyronine and low level hydrocortisone so surely it can’t be that but we’ll see
i noticed itching started when I changed from levo to lio, its faily minor but always in the same place on my hands, for me just temporary and no biggie but it might suggest there is something to Lio or the filler that can do this.
i have no science basis for saying this but i have often found when I get symtpoms which I believe to relate to thyroid or hormone replace a subtle change of dose for a temporary period changes something. its like my body gets stuck on sometihng and a little agitation puts me on a different path. in my last thyroid inflammation i got myopathy in area of my right knee and got inflammation from it, just would subside for months, i reduced t3 for a few days and literally just disappeared, got back up to my usual dose and it never came back. observation could be absolute rubbish of course.
agree with all other comments, would push back heavily such a drastic change on medication on one test result, i would want more data and a risk based conversation with them. of course many GPs/ endo innhs hate patients who are curious or push back.
not sure if stated above but if you have hashimoto or similar thyroid condition then swinging from hyper through hypo (including time euthyroid) can be a part of the condition. i think it is well covered by admins on here but I read thyroid for dummies recenelty as was well covered there too.
the whole reason I switched from t4 to privately sourced t3 is so that I can adjust my presciption when i get large dumps on thyroxine into my body as this was chronically aggravating my sleep problems.
Thanks for the feedback. I’ve been on lio since November and apart from the feet issue I’ve had no side effects. This itching is only in the last 4 weeks and just after I finished my course of iron tablets so I’m thinking that could be the issue. I didn’t even think about it till someone on this forum mentioned it.
I’m going to phone my endocrinologist just now to find out the reasons why my lio has been reduced
That’s the thing. The only recent change was finishing my course of iron tablets. I’ve already mentioned to the doctor so she’s getting my iron levels checked now
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Possibly tell them you had only just took your meds and made a mistake and ask to redo the load rests in 3 month's time. Arrange for blood test to be done early in the morning around 8.30am. :/ 
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