I have hypothyroidism for the last 7 years and I have the treatment with Synthroid 50mcg.
Since I started the treatment for the entire 7 years I have anxiety problems and angry management problems, which I didn’t have before. I had problems in 2 jobs for anger explosion. It is terrible , my heart beats are 100 per minute even seating and resting. My TSH never got really good, so the medication is not helping and I feel better without it.
3 months ago my TSH was 2.9 and T4 was normal, at that time I was already feeling anxious and angry all the time. This month I did the test again, I didn’t change the t4 dose but I was way more anxious, almost having a heart attack, not sleeping at night, feeling tired, with diarrhea, Did my blood exam for my surprise my TSH was 4.2 and my T4 and T3 normal levels (in the middle range). I guess because my cortisol was too high, because of the stress and anxiety, my body started to save energy and the TSH got worse.
My GP asked me to increase the dose to 75, but I wont and I cant handle, I cant increase it because my heart beat is going to get worse and for sure the anxiety as well.
For the last 7 years my T4 is always normal, only my TSH is high. I would like to know if someone in the same situation got better taking T3 together with T4.
I am trying to get pregnant I need TSH below 2.5 and since I got the thyroid problem I never could get anything below 2.5. Please help me.
I will have my first consultation with endocrinologist in 2 weeks. Please help me.
Written by
Elaine2509
To view profiles and participate in discussions please or .
No, for a start, I have to say, there's no such thing as 'normal' where thyroid blood test results are concerned. There's only what suits you, and that's a very individual thing. So, instead of talking about 'normal' and making wild guesses about cortisol levels, just give us the numbers - results and ranges - and we'll interpret them for ourselves - and for you.
Anger and anxirty can be symptoms of under-replacement. And 100 mcg is not a very high dose. And if your TSH is over 2.5 then you are still hypo and what you are experiencing are the symptoms of under-replacement and nothing to do with the levo itself. You need that increase in dose.
OK, so if we look at your results as percentages through the range, you can see they are far from 'normal'! 'Normal' (euthyroid) would be both results around 50% through the range, with the FT3 just slightly lower than the FT4. And most hypos feel best when their results are quite a bit higher than that. You cannot possibly be well with an FT3 that low.
Your TSH is reflecting these low levels and telling you you need that increase in dose.
What time of day was the blood draw for this test? TSH is highest before 9 am.
I take T3 only because I have a certain degree off Resistance to Thyroid Hormona, which means that I need to take high doses of T3 all in one go to flood the receptors and force a certain amount of hormone into the cells. I take 75 mcg T3 only. The dose of T4 I would need to take to get that much T3 would be dangerous.
Well, 7 am is great! Just no after 9 am because after that it starts to drop sharply. And you want it as high as possible because that's all doctors tend to look at.
This is difficult as too much hormone can cause anxiety and a rapid heartbeat but also hypothyroidism can cause anger which can cause a rapid heartbeat. Your mildly low fT3, fT4 is consistent with your slightly elevated TSH. This suggests your levothyroxine dose is a little low but it shouldn't give these strong symptoms.Are you taking any other supplements or medication? It could be due to other hormonal problems which should be checked by an endocrinologist rather than a family doctor.
Have you ever been prescribed a beta blocker to slow your heartbeat? Is your pulse rapid all the time or just when you are angry?
Thank you. I'm taking vitamins, iron, magnesiu, omega 3, zinc, vitamin d, vitamin a, vitamin, selenium, because my vitamins are low on blood exam. I will talk to the doctor to try to take t3 to see if it helps, because when my t4 is close to the maximum normal i get anxiety. I also have high blood pressure and when my Gp asked me to increase the dose I felt it wouldn't be safe for my heart to do it. I know most of people tolerates well the t4 hormone, but i dont. Its being 7 Years struggling with the effects and my Tsh is always bad. What is a beta blocker? Maybe i should try it.
High blood pressure can actually be a symptom of hypothyroidism. Low thyroid hormones slow your heart beat and can stiffen your arteries, therefore your heart has to work a lot harder and blood pressure can rise. This can normalise again when on the correct thyroid treatment. A beta blocker, also known as beta adrenergic blocking agent, works by blocking the release of adrenaline and noradrenaline, which slows the heart rate and reduces blood pressure. But if your heart rate is already slowed due to the low thyroid hormones, a beta blocker might not be the best option (do you know your resting pulse?). Beta blockers may also decrease the conversion of T4 to T3, so not ideal.
How is your cholesterol? High cholesterol is also a sign of hypothyroidism, especially when we do not have enough T3. T3 is the active hormone that increases your metabolism and is responsible for your lipid metabolism, including cholesterol. If thyroid hormones are low, the liver cannot effectively process cholesterol, hence levels can rise. I would keep an eye on that too.
Beta blockers act on the heart, some slow down the heart rate so e make it more regular. If your heart rate is high most of the time your doctor can prescribe a beta blocker to slow it down a little. Note that they can make you tired sometimes. This might be a short term option to see if you tolerate a higher dose of levothyroxine. If your heart rate only goes up when you are stressed beta blockers may not be appropriate.What were your signs and symptoms and blood test results seven years ago when you were diagnosed?
Dose is increased slowly upwards, usually in 25mcg steps
Levothyroxine is a replacement thyroid hormone as your own thyroid is not making enough
It doesn’t “top up” your own thyroid output, it replaces it
Guidelines of dose Levo by weight
approx how much do you weigh in kilo
Even if we frequently start on only 50mcg, most people need to increase levothyroxine dose slowly upwards in 25mcg steps (retesting 6-8 weeks after each increase) until eventually on, or somewhere near full replacement dose (typically 1.6mcg levothyroxine per kilo of your weight per day)
Adults usually start with a dose between 50 micrograms and 100 micrograms taken once a day. This may be increased gradually over a few weeks to between 100 micrograms and 200 micrograms taken once a day.
Some people need a bit less than guidelines, some a bit more
If symptoms of hypothyroidism persist despite normalisation of TSH, the dose of levothyroxine can be titrated further to place the TSH in the lower part of the reference range or even slightly below (i.e., TSH: 0.1–2.0 mU/L), but avoiding TSH < 0.1 mU/L. Use of alternate day dosing of different levothyroxine strengths may be needed to achieve this (e.g., 100 mcg for 4 days; 125 mcg for 3 days weekly).
Thank you for your reply. I think i dont tolerate well the t4 because my t4 was always normal, never low. I never had low cortisol in the morning. I wonder if getting t3 would help, many people with anxiety says that t3 is better for that. I'm supplementing all vitamins, iron, magnesium, zinc, vitamin e, a and d3, omega 3, q10, everything.
Have you ever had your vitamins tested? A deficiency in B vitamins, particularly B6, B12, and folate, can be linked to increased anxiety symptoms, as these vitamins play a vital role in the nervous system and neurotransmitter production, meaning low levels may contribute to feelings of anxiety and stress.
It would be good if you can test at least B12 and folate, as especially good folate levels are essential when trying to get pregnant. Many hypothyroid patients take a good quality Vitamin B complex, some might need an additional folate supplement as well.
How are your Vitamin D levels? Low levels of Vitamin D have also been linked with anxiety, so worth checking your actual levels. Recommendations are that Vitamin D levels should be at least above 75nmol/l, better even if you can get them to above 100nmol/l.
Your thyroid hormones are also not ideal, especially your T3 is very low in range and will contribute to your anxiety - it should be at least 50% through the range. I know you have mentioned that your symptoms are getting worse when you try to increase your levothyroxine, but many people find that this can happen when your nutrients are low. Once the nutrients are in a better place, it appears that an increase in thyroid hormones can be much better tolerated.
And just another point, if you are trying to get pregnant, your baby will be relying entirely on your thyroid hormones in the first trimester, as it cannot produce any thyroid hormones on its own. Therefore you will need a much higher thyroid hormone level that can actually meet your as well as the baby's needs - hence you need to find a way to get your levels higher.
Thank you. My folate and b12 are great, I got my results last week and it was good. I'm supplementing vitamin D, last week mine was 66 mol. I will improve my vitamins to see it i can tolerate t4 better. Thanks a lot for your explanation it really helps.
Ferritin is increased in a number of conditions unrelated to iron status. This may cause a falsely normal value in an individual with truly low iron stores. Thus, an opportunity to ameliorate symptoms using iron supplementation may be missed. The ratio of serum iron to total iron binding capacity (a.k.a. transferrin saturation) may reveal decreased iron stores in such situations despite a falsely normal ferritin. Transferrin saturation < 20% is indicative of iron deficiency.
Ferritin is an acute phase reactant and as such, inflammation increases ferritin independent of any true effect on iron stores. Therefore, ferritin is most likely to be spuriously normal in the setting of inflammation.
Aim for Vitamin D at least above 75nmol/l, most people feel much better when the level is above 100nmol/l. And the higher levels will help with the conversion of T4 to T3.
You keep saying that you don’t feel good on T4 so you won’t raise it. Have you ever tried taking 75mcg Levo for 6-8 weeks? If you haven’t, then you don’t know you can’t raise it successfully. 50mcg is such a low dose, it’s not enough to live on so it’s little wonder you feel so unwell. Increasing to 75mcg could make you feel much better after the first 2 weeks (which are always rough for me). You must give it a try or your life will remain throttled back and having a baby and then looking after a child is going to be very hard.
Or even slower ….50mcg and 62.5mcg alternate days for 6-8 weeks before increasing to 62.5mcg everyday
Then retest before slowing increasing to 75mcg daily
Meanwhile ESSENTIAL to work on improving low iron
Look at increasing iron rich foods in diet
Eating iron rich foods like liver or liver pate once a week plus other red meat, pumpkin seeds and dark chocolate, plus daily orange juice or other vitamin C rich drink can help improve iron absorption
Content on HealthUnlocked does not replace the relationship between you and doctors or other healthcare professionals nor the advice you receive from them.
Never delay seeking advice or dialling emergency services because of something that you have read on HealthUnlocked.
TSH &T4 levels after total thyroidectomy
18 weeks pregnant on NDT with low T4 
Fluctuating T4 pre-treatment
Central hypothyroidism and T4-T3 conversion
TSH levels were elevated during pregnancy and I was put on Levothyroxine now my levels are very very low.. confused
