Thyroid UK
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Starting T3 and other questions!

I could really do with some advice!

I have suffered from hypothyroidism for 11 years (I'm a 37 year old man.) Having been under the care of an NHS endo for the first three years in London, I have just been being treated by my GP with thyroxine since. I still had all the symptoms of being hypo and over the years they got worse and worse.... Extreme fatigue, low body temperature, depression etc... All the usuals.

Havig seen a hopeless private endo in London at the start of 2012, who said all my levels were fine I eventually sent to see Dr S in Birmingham in October 2012. At this point my body temperature was between 34.5/35.8 degrees and I felt horrid. Dr S said there was no doubt I was still very hypo and has raised my dosage of thyroxine from 150mg daily to 325mg currently. My GP has been great, fully supportive and done exactly what Dr S advised.

Every time my dosage increased by 25mg I felt better after a few days for about the next three weeks before the hypo symptoms would reemerge, but gradually the symptoms lessened. When I saw Dr S at the start of January he said that we should review how everything is going at the start of February and think about starting T3 medication in addition to the thyroxine.

Over the last two or three weeks I've started attending the gym again, which I hadn't been able to do for about four years, as I was just too exhausted. However, as the exercise progresses at the gym and then afterwards each time I've felt really unwell.... Pale, faint, cold, really achey, light headed, and it's taken at least two days to recover and for my body to stop hurting.

My last set of blood tests (done this time at the GPs, so no T3 result) put my T4 levels above the acceptable range (42?) and my TSH at around 0.5. When Dr S took my temperature in January it was slightly higher at 35.9, but I do feel much warmer generally - if not all the time, most of it. I do feel better for taking more thyroxine but I don't feel anything like 'normal' yet, especialy around my fatigue levels and how much sleep I need to feel ok. I'm taking a multivitamin and B12 every day currently and take my 325mg of thyroxine at night.

So what I would appreciate some of your advice about is:

1) Has anyone else experienced similar symptoms during/after exercise? If so, do you know what causes it.... Is it lack of T3?

2) Has anyone any advice about starting T3?

3) Is it better to take the T4 and T3 synthetic thyroid prescribed by my GP, rather than starting on NDT, like armour?

4) I was thinking of paying privately to have another full thyroid screening as the GPs rest are not good (another £300...). Has anyone any experience of also having thyroid urine tests and how accurate these results are? Are there any other useful tests that will help diagnose optimum thyroid replacement/treatment? I'm guessing I also need reverse T3.

5) Whilst Dr S is friendly and supportive, I slightly worry sometimes that he is just treating symptoms and not looking at the chemistry. Also he is miles away in Birmingham and I live on the Surrey/Hampshire boarder. Does anyone know of an amazing endo that's London or South East based?



6 Replies

Hi Philip,

I have actually learnt to not look at bloods anymore, however I do know some others do not feel like me, and I do know Dr S, Dr Lowe (RIP) and some other doctors do not look at bloods.

Just thought I'd say that to support Dr S's approach, just to say although it feels at times like no one is like him, he is really not alone.....

onwards now:

I think you may be better off trying synthetic T3 in addition to levo 'first' only for the reason that it might end up being easier to get off your GP on NHS than NDT.....

so it's purely 'politics' :)

PS a full set of thyroid function tests will not cost you £300, it's more like £125 or so, at least with Genova and the Thyroid UK discount (or was it 165?? can't remember) and that is for TSH/fT3/fT4/reverse T3 and thyroid antibodies.


Absolutely yes I have been dreadful with exercise. I used to work out 2 or 3 times a week with a trainer, but recovery took longer and longer. Eventually after almost 3 years training, I gave up. I did an adrenal saliva test and it showed that the adrenals were tired and exercise was causing them more stress. It took me a couple of years to get them right, I used hydrocortisone.

Have now returned to working out, doing boxercize , trampolining, Pilates and considering getting my kayak out of mothballs.

Getting fitter week by week so there is hope..... CHeck the adrenals, salia test is about

£80. From Genova...



Oh yes, forgot to add, I was on t3 and adding more didnT help the recovery after exercise.....



I've had lots of issues with exercise, in fact I think it was my taking up running and running my first 10K that made my thyroid problems much,much worse. I now know that cardio is what does it. Every time I have felt better I start running again, always pushing myself too quickly and I always make myself ill again.

I know when my body has had enough, my heart starts beating out of my chest and I can't get my breath, if I continue, I start to get facial pain and eventually flu like symptoms. It can take up to 2 weeks or more for me to recover. Adding T3 to my T4(endo thinks I have a reverse T3 issue) has definitely helped but I'm not sure when I can get back to cardio, if ever. I am however now doing a great weights workout at the gym which doesn't seem to effect me at all.

Good luck with finding answers :)


Pip, have you heard of Dr. Raymond Peat? Here is an excerpt about exercise from an interview:

Dr. Ray Peat: I'm not sure who introduced the term "aerobic" to describe the state of anaerobic metabolism that develops during stressful exercise, but it has had many harmful repercussions. In experiments, T3 production is stopped very quickly by even "sub-aerobic" exercise, probably because of the combination of a decrease of blood glucose and an increase in free fatty acids. In a healthy person, rest will tend to restore the normal level of T3, but there is evidence that even very good athletes remain in a hypothyroid state even at rest. A chronic increase of lactic acid and cortisol indicates that something is wrong. The "slender muscles" of endurance runners are signs of a catabolic state, that has been demonstrated even in the heart muscle. A slow heart beat very strongly suggests hypothyroidism. Hypothyroid people, who are likely to produce lactic acid even at rest, are especially susceptible to the harmful effects of "aerobic" exercise. The good effect some people feel from exercise is probably the result of raising the body temperature; a warm bath will do the same for people with low body temperature.


I love Dr Peat. His articles are fantastic and have helped me with my lifestyle changes. I also try to follow his ratio of t3 to t4 (I think its 1:4) for taking my pills ie I am on 100mcg T4 and 25mcg T3 daily. Danny Roddy is also a great blog to read as he kind of translates Ray Peats papers which can be quite lengthy and 'sciencey'.


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