i have Hashimotos and have been on t4 only for the past 15 years. I started feeling more tired over the past few years. I wanted to try t3. An endocrinologist put me on 137mcg of t4 and 10 mcg of t3. My original t4 only dosage was 145mcg.
When t3 was added, I immediately started to feel more focused and have energy all day. I havent felt this way in years.
Ive been in it now since 3 weeks and i have been having some chest pains anxiety like, feel my heart beating quickly, i also lost some weight and i am hungry a lot. I also have headaches. I dont want to give up on the t3 and want to give it a chance. Is it possible that the doctor didnt reduce my t4 enough? And i am having hyperthyroid symptoms now. Any thoughts?
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DApali
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If you are hypothyroid it's not physically possible to become hyperthyroid but you can suffer symptoms of over or wrong medication which is possibly what has happened.
It would help us to help you if you could offer some background details about your thyroid journey as well as any lab results you have
What were your FT4 and FT3 lab results like before this endo changed your dose? Do you have a copy? I'm assuming he did test before changing your medication!
Your endo has made 2 big changes at once and your body isn't liking this.
If your labs showed high FT4 that should have been reduced first before adding T3 maybe a week later.....difficult to be sure without lab results.
You are legally entitled to request copies of results from your surgery.
Starting with 10mcg T3 is too much, it needs to be added slowly to allow the system to adjust to what is a powerful hormone..
Adding T3 also naturally reduces TSH and FT4 so not usually an immediate need to reduce T4....though your T4 dose of 145mcg may be on the high side. Difficult to say without lab results because we are all different.
A starting dose of 2.5mcg T3 would have been a more gentle start to be raised to 5mcg after 2 weeks, then 7.5mcg after the next 2 weeks and finally after a further 2 weeks to 10mcg.
I'd be inclined to test after a further 6 weeks on 10mcgT3 plus your T4 dose of 137mcg.....or less
The results will show your thyroid hormone status and will point the way forward re hormone doses
Also important to optimise vit D, vit B12, folate and ferritin to support thyroid function
I have been taking Vitamin D, Zinc, Magnesium, B Complex, Gaba, Ashwagandha, Myo inositol over the past 7 months.
In 2018 i was on anti depressants for a few years, after i lost my mother and then I stopped in 2023. I also had covid twice. After i stoped the anti depressants in Summer 2023 i went to my GP some months after to say I was feeling very tired. she upped my T4 dosage. This past winter 2023 was not easy i was struggling with brain fog and fatigue. I did realize that maybe i am on a too high t4 dosage i am not sure. I live in germany and i still cannot find a competent Endocrinologist. I started to educate myself more on my condition Hashimotos and what changes i could make in my life style. In January 2024, i stopped eating gluten, i also lift weights 3x a week and have a healthy well balanced diet and started on Supplements. I also have good sleep. I did a bit better. I was still on T4 only.
I finally got an appointment with an Endocrinologist and he did the last test on July. He then put me now on the t3 10 mcg and reduced t4 by only a bit from 145mcg to 137mcg three weeks ago. I asked for an immediate appointment again with him on Monday. This morning i only took the t4 and did not take the t3.
Though im super energetic the heart palpatation, nervousness and headache have scared me and therefore did not take the t3 this morning.
Also is reverse t3 something i should be concerned about?
I am 32 years old and i am on a journey to figure out what is the best way to medicate myself and feel energetic enough throughout the day.
Try to ask your Dr to run labs on your Iron/Ferritin levels too. And some of us don't do well with Synthroid. I was on Synthroid and it caused me to have palpitations anxiety and other side affects. Best wishes for better days ahead.
I went today again to my endocrinologist.. i mentioned to him my symptoms. He also took my blood pressure which was 143/83 which was high. Should i be worried?
He decided to reduce my T4 to 125mcg and T3 continuing 10mcg. He said in germany there are not3 less than the 10mcg pill. I asked if i can divid the t3 and take it over two times 2x 5mcg.
I got home now and i dont feel i was correctly advised by him. I am thinking to take the 125mcg t4 and only 5mcg t3 in the morning and no other dose.
Unfortunately. taking T3 can involve trial and error....it can be beneficial to take T3 in small doses until the body adjusts to it.....you can divide the tablets using a pill cutter or a craft knife
From January 2024
Ft4 1,34ng/dl Reference 0,90-1,70
Ft3 2,2 pg/ml Reference 2,2-4,4
These labs do not suggest overmedication....but we need current results
Welcome to the group. If you could complete your profile it helps members understand your thyroid journey so far and be able to advise you better. Click on your image icon to start. Fill out the free text box at the top.
What were your blood results before you started T3? If FT4 was high in range then dropping 25mcgs is a good idea.
Its recommended to start T3 SLOWLY in 5mcg increments, some start with 2.5mcgs. Take 5mcgs for a few weeks, assess how you feel and if all is well then add a further 5mcgs and retest in 6-8 weeks.
Starting at 10mcgs might have been too much for your system all at once.
Possibly you may not have reduced Levo by enough. 137mcgs Levo is a fairly high amount to take in a combination with T3, most need 100-125mcgs.
When starting T3 its essential to ensure that all key vitamins are at OPTIMAL levels otherwise your body might find it hard to use this immediate acting hormone and intolerance/hyper symptoms can result.
When hypo we get low stomach acid which means we cannot absorb vitamins well from our food, regardless of a great diet. For thyroid hormone to work well we need OPTIMAL levels of vitamins.
Have you recently or could you ask your GP to test levels of ferritin, folate, B12 & D3? Private tests are available, see link for companies offering private blood tests & discount codes, some offer a blood draw service at an extra cost. thyroiduk.org/testing/priva...
There is also a new company offering walk in& mail order blood tests in London, Kent, Sussex & Surrey areas. Check to see if there is a blood test company near you. onedaytests.com/products/ul...
Only do private tests on a Monday or Tuesday to avoid postal delays.
It's ideal if you can always get the same brand of levo at every prescription. You can do this by getting GP to write the brand you prefer in the first line of the prescription. Many people find that different brands are not interchangeable.
Do you do tests as per the protocol recommended here? Recommended blood test protocol: Test at 9am (or as close as possible), fasting, last levo dose 24hrs before the blood draw, last T3 dose 8-12 hours before blood draw & no biotin containing supplements for 3-7 days (Biotin can interfere with thyroid blood results as it is used in the testing process).
Testing like this gives consistency in your results and will show stable blood levels of hormone and highest TSH which varies throughout the day. Taking Levo/T3 just prior to blood draw can show a falsely elevated result and your GP/Endo might change your dose incorrectly as a result.
I have been taking Vitamin D, Zinc, Magnesium, B Complex, Gaba, Ashwagandha, Myo inositol over the past 7 months.
In 2019 i was on anti depressants for a few years, after i lost my mother and then I stopped in 2023. I also had covid twice. After i stoped the anti depressants in Summer 2023 i went to my GP some months after to say I was feeling very tired. she upped my T4 dosage. This past winter 2023 was not easy i was struggling with brain fog and fatigue. I did realize that maybe i am on a too high t4 dosage i am not sure. I live in germany and i still cannot find a competent Endocrinologist. I started to educate myself more on my condition Hashimotos and what changes i could make in my life style. In January 2024, i stopped eating gluten, i also lift weights 3x a week and have a healthy well balanced diet and started on Supplements. I also have good sleep. I did a bit better. I was still on T4 only.
I finally got an appointment with an Endocrinologist and he did the last test on July. He then put me now on the t3 10 mcg and reduced t4 by only a bit from 145mcg to 137mcg three weeks ago. I asked for an immediate appointment again with him on Monday. This morning i only took the t4 and did not take the t3.
Though im super energetic the heart palpatation, nervousness and headache have scared me and therefore did not take the t3 this morning.
Is reverse t3 something to be concerned about?
I am 32 years old and i am on a journey to figure out what is the best way to medicate myself and feel energetic enough throughout the day.
Reverse T3 has gone out of fashion as tere are so many thing that can affect it and only 1 of them is thyroid. To check conversion you just need to look at your FT4 level compared to your FT3 level.
In July your FT4 was only 62% of range so you probably didnt need to drop it at all.
On a combi dose people generally aim for 70% through range for both FT4 & FT3. WE use a calculator to work out the percentage through range: thyroid.chingkerrs.online/
I would restart the T3 at either 2.5mcgs or 5mcgs and give it a few weeks until symptoms settle down.
Your vitamins are generally good but ferritin is letting you down a little.
Ferritin should be around 90 - 100 for best use of thyroid hormone. Suggest increasing iron rich foods in diet and eating them often. Chicken livers, pate, red meat etc
I went today again to my endocrinologist.. i mentioned to him my symptoms. He also took my blood pressure which was 143/83 which was high. Should i be worried..?
He decided to reduce my T4 to 125mcg and T3 continuing 10mcg. He said in germany there are not3 less than the 10mcg pill. I asked if i can divid the t3 and take it over two times 2x 5mcg.
I got home now and i dont feel i was correctly advised by him. I am thinking to take the 125mcg t4 and only 5mcg t3 in the morning and no other dose.
I will stop the t3 now for a few days so i come down a bit before i start again.. Do you have any thoughts?
From what symptoms you are describing it sounds like over medication. Try firstly to reduce the T4 slightly. I get really hungry when my medication has gone too high. T3 converts food to energy amongst other positive factors.
I’m on T4 and T3. I found reducing my T4 rather than T3 helped me. I take 68mcg liquid levothyroxine and 10mcg T3. I split both T4 and T3 throughout the day also. I believe this helps reducing spikes. The symptoms you describe are over medication
I have recently started the same combo therapy journey as you. I was on 125mcg level before but was not feeling g well so requested a trial of T4/T3 combo.My endo started me at 100mcg T4 and 10mcg T3 twice a day. (Yes, big wallop of T3).
After a few days I experienced the same palpitations etc. as you but only when I went to bed and lay down. I persevered for a week more but it did not settle so stopped taking the 2nd T3 tablet and they stopped .
Before next review I upped the dose to what I was told to take initially so the blood tests would reflect initial prescription. T4 was around 19 (12-22) and T3, not surprising out the top of range).
I was changed to 75mcg T4 and 10mcg T3 twice a day next, but still palpitatey. I tried splitting one of the 10s, so having 10 + 5 T3 which still felt too much T3 to me. However some of my old hypo symptoms started to reappear (tired, listless, hair shed).
After discussion with endoI suggested 100mcg T4 and 10mcg T3 seemed to be the my sweet spot. That's where I sit now albeit 5mcg T3 twice a day and feel much better now than on T4 alone.
In conclusion, I think you have too much T3 in your mix as others have said.
Make sure you say very clearly to your consultant that you are having palpitations and heart thumping, odd rhythm which is concerning you and not the vague "I don't feel quite well, heart beating a bit mych" (which was my mistake at first review).
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