Hi everyone, looking for some advice, I’m very confused, and getting desperate. Sorry this is long.
Bloods 2 weeks ago, taking 100 mcg T4 and 20-25 mcg T3 (10x2) (24 hrs since last T4, ~15 hrs since T3) —
T4: 12 (11–24). T3: 4.3 (3.6–6.5). TSH: fully suppressed. Has been for years.
Little back story: used to take a lot more T3 than this (50), same dose for 7 years, but it never had much effect on me. Back in July I suddenly started getting really bad palpitations, it was like all the T3 in my system suddenly started working out of nowhere. Came off my meds almost completely to recover and worked slowly up to 100 mcg T4 & 20 mcg T3.
Fast forward to 4 weeks ago. Started feeling ill (stomach cramps, nausea, fatigue). Just not right.
2 weeks ago the fatigue became extreme (starting day of blood test). Sleeping 10 hrs an night and not being able to stay awake in the day, literally passing out for 3/4 hrs a day. Too exhausted to function. Pulse normal (70–80 bpm), temp normal for me (36.2). Falling asleep seemed to happen 2–3 hours after taking meds. Getting chills coinciding with fatigue.
Dr suggested I’m over-medicated (they panic about the TSH, of course). Willing to try, I reduced my meds a little.
Started by reducing T3 down to 12.5 mcg. This gave me heart palpitations, fluttering, feeling like my heart was skipping a beat. Not extreme, but enough to be uncomfortable. Still fatigued.
I figured that if I’m over-medicated I’ve got too much T4 in storage, and it’s easier to microdose with T3 if I go too low. So instead, I reduced my T4 to 75 and then 50mcg, (with 20 mcg T3).
Now I can’t sleep at night. No matter how tired, or when I go to bed, my heart is beating too fast (85–90 bpm). ‘Tired but wired’, I believe it’s called. I’m also getting chills at the same time as the palps, but my body temp is 36.6 under my duvets. Taking my T4 in the middle of the night seemed to calm my heart a bit last night but I still couldn’t sleep.
I feel like I’m hyper and hypo at the same time. I got chills when I was super fatigued with normal heart rate, now getting chills with high heart rate.
Back in July my heart rate correlated directly with my medication dose. Stopping meds made my heart slow way down, and when I started taking them again I increased slowly till my resting bpm was 75–80. Now, it’s all over the place. Sometimes it seems like my heart speeds up a little after taking T3, sometimes it seems to slow down.
Any advice is welcome, I haven’t slept in days.
Can someone maybe remind me how adrenals/cortisol interact with T3? I’m wondering if that’s a factor.
(Additional info: 34 yrs, female. I’m on low dose HRT. From bloods tested 2 weeks ago: FBC (normal), B12 (bit high), folate (bit high), ferritin (low end of normal), electrolytes (normal), estradiol & gonadotrophins (normal). And I have low stomach acid, think that’s a thing?).
Racing heart rate - RHR 90+ hypothyroid 
Over or Under medicated.
Am I under or over medicated
Odd Results from T4/T3 Combo - Help!
