This article is part of a special report on Thyroid Disorders. To see the other articles in this series, click here.
In this final article in the series on Low T3 Syndrome, we’ll discuss whether thyroid hormone replacement therapy is an appropriate treatment in these cases.
Why T3 Levels Are Low
Unfortunately, there are few studies that have examined this question specifically, and even fewer that have explored the question of whether T4 or T3 (and which type of each) would be the best choice.
As a clinician, my primary concern is always primum non nocere, or “first, do no harm.” From this perspective it’s important to recognize that the changes seen in Low T3 Syndrome may represent a restorative physiological adaptation by the body to chronic illness.
For example, the changes observed in the thyroid axis in acute illness are similar to those observed in fasting, which can be interpreted as an attempt to reduce energy expenditure and protein wasting. (1) Giving fasting subjects thyroid hormone results in increased catabolism (breakdown). (2)
In cases of chronic illness, however, it is less clear what effect thyroid hormone replacement has. The few studies that have been done produced mixed results. (3)
Some studies show that treatment causes harm, others show no change, and still others show an improvement. After reviewing the literature on this, I’ve come to the following tentative conclusions:
- T4 is rarely, if ever, effective in Low T3 Syndrome and may even cause harm. This is probably due to the decreased conversion of T4 to T3 that is seen in chronic illness.
- T3 replacement has been shown to be consistently beneficial only in cardiac patients who’ve recently had surgery, heart failure or a transplant.
That said, I’ve heard anecdotal reports of improvement from people who have taken replacement T3 hormone for a condition called “Wilson’s Syndrome” (which does not exist in the scientific literature or according to any mainstream medical organizations). Wilson’s Syndrome refers to low basal body temperature and other nonspecific symptoms occurring in the presence of normal thyroid hormones.
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I’ll be the first to admit that “lack of evidence is not evidence against,” and as I mentioned earlier, there’s not a lot of research on the effectiveness of T4 and T3 replacement therapy in Low T3 Syndrome. It may be that as we look into this further, we’ll discover a role for thyroid hormone replacement in these conditions.
That said, I think caution is warranted.
And, if the changes seen in Low T3 Syndrome are a compensatory adaptation of the body in response to chronic illness, increasing T3 levels artificially may have undesirable effects.
In the majority of cases of Low T3 Syndrome, I think it’s preferable to identify the underlying cause and treat that. As I discussed in articles #3 and #4 in this series, those causes most often include infections, autoimmunity and inflammation.
Articles in this series:
- Low T3 Syndrome I: It’s Not About The Thyroid!
- Low T3 Syndrome II: Myths and Misconceptions
- Low T3 syndrome III: Inflammation Strikes Again
- Low T3 Syndrome IV: An Autoimmune Disease You’ve Never Heard Of?
- Low T3 syndrome V: Should It Be Treated With Thyroid Hormone?
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You asked for feedback from anyone with experience with supplementing thyroid meds with T3. Well, I suffered with hypothyroidism for years because doctors kept telling me that my TSH was fine, so it could not be a thyroid problem. Finally I read Dr. Barnes” info on basal temperature as an indicator of thyroid issues. I finally convinced by doctor to prescribe thyroid med, Synthroid. Over the next 15 years I was increased up to over 200 mcg of T4 and still never got rid of my lingering hypo symptoms.
Only after finding out about the importance of Free T3, and that it correlated best with hypo symptoms, I was able to convince my current doctor to test for it. I was very low in the range, even though my Free T4 was at the top of its range. I convinced my doctor to switch me to NDT med in order to raise my Free T3 level, and after some tweaking I felt better than I could even remember.
Then several years ago when Armour was not available and the doctor put me back on T4 med, without changing anything else, I gained 18 pounds over about 9 months. I also came up with bad acid reflux, and also carpal tunnel syndrome. Needless to say I also had little energy and had to sleep a lot.
As soon as Armour was available again I switched back and in just 3 days the acid reflux was gone. Within a week the carpal tunnel issue was gone. I started to have more energy, and over the next 8-9 months the 18 pounds went away, with no other change to my diet and exercise.
I cannot fathom why doctors continue to be taught in med school that TSH is basically all that is needed to diagnose and treat a hypo patient (with T4 meds of course). Even the professional thyroid organizations preach the same. Yet there is much scientific evidence that TSH doesn’t correlate well with either of the biologically active thyroid hormones, Free T4 or Free T3, much less correlate with symptoms, which is why we go to see doctors in the first place. A good thyroid doctor will treat a hypo patient clinically by testing and adjusting Free T4 and Free T3 as necessary to relieve symptoms, without being constrained by resultant TSH levels.
I went through 40 years of frustration with being told that all my symptoms were not thyroid related because my TSH and Free T4 were within the “normal” range. Finally I learned differently from an internet Forum and got my doctor to reconsider my treatment, and add a source of T3 to my med, with great success. Now that I know this, I hear from people every day with similar stories of inadequate testing and treatment. I have written to the AACE and the ATA about this and basically been ignored. There seems to be little hope of any significant change in the foreseeable future.
Good to hear that someone else is doing well on a combination. I’m on a very small dose of WP Thyroid and find it very effective. Too bad the medical community seems to be lagging behind on this.
Ok, I could really use some help right now. I have battled a chronic bacterial infection for the past 6 years. I have finally got my immune system up but now its attacking me. My labs never show anything and my levels are usually good. Last time i checked them my TSH was about .5 or so. I’ve done the conversion from FT3 and RT3 and it was ok too. (except they were from diff labs). Anyway, my doc thinks i have hashi’s along with another autoimmune disease and he put me on the Wilson’s protocol to see if it would help. I did 2 cycles on it and my temp would be stable at 75mcg and then drop. So finally he just put me on compounded instant release T3 (cytomel made me sick). My dose was 25mcg twice a day. That didn’t work very well so I had some compounded sustained release left over from the Wilson’s protocol so I have been adding that as well. This is what i take daily:
Morning-30mcg SR T3 and 25mcg T3
Noon-25mcg T3
3:30pm-25mcg T3
Night-30mcg SR T3
This to me seems like a WHOLE LOT. A few times throughout the day I do feel better and the fog has lifted and my temp goes up to about 98.3. But then it drops and i have to take a nap. I have a 3 year old i have to take care of. Can someone help me?? I thought that much T3 would have side effects like heart palps, energy, insomnia, etc. I have NONE of those. It does give me a little bit of help with my hypo symptoms but I’m not sure what it going on. Should I add T4?
Anyone?? Could I possibly be thyroid resistant? I’m getting desperate. Lol
HI, Jess. My doc (nutritional) just told me to take Lauricidin –little tiny pills you swallow with cold drink 3 x daily (start with 1/4 cap and work up to one cap daily) to fight all kinds of virus, fungus, bacteria in your system. (Long story–the point is this may help with my autoimmune problems.) Luaricidin is an “oldie” that is somehow related to the anti-virals in mother’s milk and has no (wow–really?) side effects, but it takes the tummy a while to get used to it. I’m just starting–but hopeful.
Sorry no one answered you right away…I just saw it…and I don’t have much to say as I am not a big believer of the Wilson’s thing (for many reasons). What I can do is to restore some logic to the things you are dealing with.
Core body temp is 100% controlled by the hypothalamus…and no where else. It is what raises our temps to give us fevers and lowers core body temp in certain disorders. I am not sure which chronic bacterial infection you are talking about, but if it is Lyme…I suspect that Lyme purposefully causes inflammation in the hypothalamus in order to reduce core body temp in order to not allow that many white blood cells to be made to attack it. If that is so, then no amount of T3 or adrenal whatnots will raise the body temp no matter what. The thing to address is inflammation. Regarding feeling hot and having low body temp…that is generally a sign of adrenal issues IF coupled with needing to eat all the time or losing it (which is the sure sign of adrenal involvement).
That said…pretty much ALL illnesses, esp chronic, will throw off the body’s levels of things…that does not mean that the individual things are wrong, or that they need correcting…just that is what the picture of the illness looks like…if that makes sense? I know it can be hard when one doesn’t know exactly what is wrong and all they have is thyroid numbers (that is how my journey started out too, so I am very sympathetic), I often encourage people to keep looking for what is wrong.
You ask about thyroid resistant…it is a hard call and more voodoo philosophies out there on the subject, however…one thing you should become aware of is what is called Vitamin D Reversal Pattern…many people have either a genetic defect (that they would never know) or a bacterial infection (like you)…this causes the over-making of the enzyme that converts active D (not D3, but the true active D) so as to over-convert it to the active form. Doctors (for whatever illogical reason) only ever test the storage form of vit D and for these two types of people, they will ALWAYS look low…but in fact and either not low or too high in the truly active D.
This only becomes a problem when someone has normal thyroid numbers, but still feels low…because Vit D is an endo hormone and not a vitamin (despite its name)…and as an endo hormone uses the same receptor as the thyroid…and is more dominant than T3…so it boots the T3 out of the receptor.
The test they run is the 25 D (it tests D3 and D2)…D3 needs to be converted twice to become truly active…you can think of D2 and D3 like T4. The truly active D is tested with the 1,25 D test…you might have to argue for the test, and is best to test both together. This 1,25 D test tests the truly active form. My personal opinion is that having a bacterial infection could cause a problem of too much 1,25 D and thus a thyroid type issue…but that is just my opinion and if the cost is not an issue, it might be worthwhile to get the test.
Have you had an ANA or FANA test run?? That is a better way to determine if you have an immune issue. Immunology can get complicated, but a super good book on the subject is Dr. Datis K’s, Why Do I Still Have Thyroid Symptoms When My Lab Results Are Normal? which you might find worthwhile. My ANA, Anti SM, RA Factor, and something else I forget is positive. It is also well known that Lyme can cause autoimmune conditions…generally, Rheumatologists are the ones to see. Don’t stop looking into this if you have anything positive…it can be a real challenge to find an answer and a treatment…and don’t go by the internet stuff. For me, it took 6 years…1.5 of which I was made so much worse on antibiotics…to come up with Myastenia Gravis and an actual treatment that is helping! I wish someone could have told me back then that it would take a while and not to stop looking…which is why I say that.
So called natural doctors and naturpaths can seem like a nice thing at first…but just as often as not they scan these sites and take their ideas from patients trying to figure things out and give us whatever we will buy into…even if it makes us sicker. Too much T3 can cause heart issues, even heart attacks and death…as well as bone loss…I have never heard of Wilson’s practitioners testing or monitoring those things which to me is dangerous and illogical and makes me doubt their practice…your health is worth more than the latest fad out there. The only people it might possibly make sense for is people with excessive RT3…however, people with chronic health conditions will have high RT3 anyways. I did, but for me I just switched to T3 only and have done well.
Hope something I said helps in someway, sorry that I did not have more helpful info.
Faith
Hi Faith
thanks for that insight -one of the things I have been chasing down for a while is the significance of the D enzyme mutation you talk about(which I have) and have not heard of its effect on T3 receptor site-most interesting.Can you recommend any other reading on this-I am specifically wondering how to supplement D with this mutation(I live in scotland so sunbathing is a rare treat!)
Congratulations on your perseverance – I too am struggling to find answers for symptoms and it is hard but endlessly worthwhile.
Hi Judith,
If you have the Vit D enzyme mutation (not sure there was an identified mutation or that it is picked up on the 23andMe.com test)…then you have likely discovered this by having run both Vit D tests (the standard 25,D and the 1,25 D test). The way you determine that there is an issue is that while your standard 25,D test was low…the 1,25 D test was either normal, ideal, or high. In such a case…if your active Vit D is high…why would you want to supplement????
The standard 25,D test that doctors routinely run is for the storage form of Vit D…comparable to T4 for thyroid. 25,D…also known as D3 and D2 must undergo 2 conversions to become usable. Any medical book dealing with the subject should suffice to convey this information. The 1,25 D test is for the only active form of Vit D…comparable to T3. Just like you would not supplement additional thyroid hormone if T3 is over range…nor would you on the Vit D issue, so I am a bit confused.
The other investigative resource is again, the medical books and studies that deal specifically with how exactly the body does things…in this case, how the endocrine receptors work. As well, what endocrine hormonal function Vit D has in the body…again, should be standard medical knowledge.
Not everyone wants to take their research to the nth degree like I have…or cares to get that technical so I try to make it easier to understand. The area where this is an issue…the only area where this is an issue is with people who have normal thyroid serum levels, but who have solely hypo symptoms…in which case there are only two known causes: excess RT3 (likely because they have some underlying illness and the symptoms are most likely explained by the illness and not thyroid) or they are taking Vit D when they do not “truly” need it as evidenced by the dual Vit D testing. It is illogical to continue supping Vit D when one’s active levels are ideal or high.
The problem is, because all the subsequent studies on Vit D never test the active form of the hormone (and because public perception is, oddly, that D3 is active when it is not) the studies are invalid on their faces. From there, each individual will have to make up their own minds about what they care to do.
Hope that helps.
Go to Stop the Thyroid Madness website. they explain about how to take T3-only meds. I have the book and have joined the “For Thyroid Patients Only” Facebook group. Lots of good discussions there. The administrators will help guide you at the group. Elaine is one of them, and she is on T3-only and NDT together.
Hi,
I am a Hashi’s patient. I take 130 mcg of WP Thyroid and 13 mcg of Tirosint daily. I just had my blood work done and my TSH was .61, Free T4 .85, Free T32.6, Reverse T3 13. Although all the labs are considered to in the normal range, they’re all on the low side of normal. I have been feeling fatigued lately, have had headaches and insomnia. My basal temps range between 96.6 – 97.6. Any suggestions?
Thanks,
Kim
Hi Kim, I appreciated reading your comment. I am struggling with finding the right dose of thyroid hormone and do not feel well either. I don’t know your age or how long you have been diagnosed, but I started adding 5mcg T3 (generic cytomel) to my 88mcg T4 (synthroid) and my symptoms are no better even though my blood work “numbers” are now in range but on the low side of normal. I have been reading another post where it is suggested to take the T3 at night, so I am going to try that. Then maybe adjust the amounts of the T4 and the T3. If I could get my doc to Rx Armour or Naturethroid I would try that as well. Good luck to you!
hi i always had bit larger amount of red blood cells…..for a female on the top of the range, after i started taking thyroid supplements it fell not significantly…but i suffered anemia! if you have iron problem there is no way…that you will feel better on any hormones…..anemic people must avoid all exercising! do a lot of rest and take thyroid supplements….only then your iron may slowly improve…..with improved iron you will be able to use t4 better and convert to t3……this is my example! my ferritin was always below 35! its 36 now for the first time ever and i am not supplementing iron…..for a year now! it improved only becasue i am on a good thyroid therapy, i imporved my other hormons progesterone, vit d, and most important! i stopped swetaing and exercising! and taking a bit more salt then before…….and results are miraculous for me becasue i was not able to improve my ferritin for 7 years!
Hi Kim & Kathy,
It can be a struggle to get to the right doses for you. T4 is a storage hormone and so anywhere in the normal range is fine. TSH is just the request for thyroid hormone, so anywhere in normal…or even lower than normal is good (if you have no thyroid). T3 is the active hormone and the number that you need to concern yourselves with mostly.
RT3 comes into play if your TSH, T4, and T3 is normal and you still feel hypo…it is possible to over-convert T4 into RT3 which is not usable and thereby fill up the thyroid receptors.
T3 being low is common when one’s body is struggling in some way, such as chronic inflammation or illness.
Core body temps (despite what odd people on the internet believe) is 100% controlled by the hypothalamus (which incidentally also controls the thyroid). Inflammation in the hypothalamus is what causes the body to set its core operating temps lower. On the flip side, it is the hypothalamus that also causes the core body temp to rise and gives us a fever when we are sick. Unfortunately, doctors are not real keen on testing whether one’s hypothalamus is working correctly…instead just sup hormones to cover the problem.
Insomnia is a symptom of too much thyroid hormone, rather than too little. Ironically, you can get the same fatigue and weight gain with high thyroid as you can with low.
Doctors are probably not keen on increasing your thyroid dose slightly, so one thing you can do is to pay attention to avoiding foods that reduce its effectiveness. Walnuts and Soy is listed on the Synthroid sheet, but I found pretty much all “goitergen” foods caused me a problem on T4. Some people with thyroid issues insist that one can eat broccoli and the like, but I couldn’t and would become miserably symptomatic…bottom line is everyone is different and it is one thing you can have control over.
Vitamin D is a nothing thing I have found interfers with thyroid. Your blood levels can be fine, but at the receptor level, Vit D dominates and doesn’t let T3 in.
Lastly, it is possible to have genetic defects with your thyroid receptor. There is a test readily available on 23andMe.com for 99$ and you can search your code. I found I had a lot of defects with my thyroid B receptor which may account for why I need higher levels of thyroid in my system to be able to use it.
As well, I did a stool test and found I was very low in something that helps you process endocrine hormones…also might explain my need for higher levels.
Although all these tests can give an amount of insight, doctors do not know what to do with them or how to help so they are of limited personal value.
Part of autoimmune conditions is inflammation, so the best recommend for body temp and overall function is reducing inflammation where you can.
Hope some of that helps.
Faith
Thanks Faith, your post was very informative. I am trying to soak up as much information as possible before my Dr appointment on Saturday. I am also thinking that maybe I need to get rid of the Tirosint and just take the WP Thyroid. I also take magnesium, selenium and Vitamin E supplements, and a progesterone cream at night. I am 51 and in full blown menopause. It’s odd because I am hot all the time, yet my basal temps are low. I have read recently about Wilson’s Syndrome and that is why I am starting to track my temps. I know for sure I need to work harder at getting gluten out of my diet as well.
Thanks again for your insight Faith.
FWIW, my sister and I (we both have Hashi’s) have found WP Thyroid so effective, that we’ve had to reduce our dosages due to hyperthyroid symptoms. If you try it, I hope you have similar success.
Hi Kim. My t3 was low within rang( 82& 78-181 is normal) I added 5mcg T3 to bring my body temp up and alleviate other hypo symptoms. TSH is .04-if this was brought within range I would be in bad shape- normal low is .5. With undiagnosed Hypo, I had horrible insomnia. Tirosent is a great choice. I am wondering why you are taking only 13 mcg when you could take more and possibly do away with the WP. I thought Tirosent was too expensive so I take 112 mcg levoxyl now with 5 mcg T3. When I took 112 mcg Tirosent I didn’t need T3. If you are willing to pay the price, I think Tirosent would benefit you greatly!
Thanks for the informative articles!
I had a total thyroidectomy just over three years ago, because I was diagnosed with cancer, but it ended up being nothing which I’m very grateful for, but also annoyed as you might imagine. But anyway, it is what it is. So, since then I have been on a roller coaster of trying to manage my hypothyroid symptoms even when my TSH is normal. To cut a long story short, over a year ago, I changed to T3 only medication because I believed that I had high level reverse T3. It really did help a lot, but after about 9 months, other issues arose like very high BP. I did some tests: my T3 was at the top of the range, and T4 at the bottom, and TSH in the bottom of the range, so, I slowly changed back to a combination of sythyroid 150mg and 12.5 of T3. And then, when I ran out of T3, I went back to 200mg of sythyroid. (Oh, I forgot to mention that I’m living in Jordan where the only thyroid treatment is synthyroid, and many of the tests are unavailable eg: RT3, cotisol saliva etc, and also Dr. Google is a safer bet than the doctors here who say things like…’there’s no such thing as T3′!). At the same time, my AM cortisol was very low at 4.2 (range 6-20). I got the ACTH test done and my adrenals were making the right amount of cortisol, so the cause of the low cortisol still remains a mystery. I started on a very low dose of cortisol 5mg twice a day. That helped a lot too, and I kept taking that until my BP started going up again (I also had my heart checked and everything was fine and my high BP was symptomatic, even though they couldn’t tell me what from). So, I stopped the cortisol. I have made sure to take a range of vitamins and minerals daily (Multi B, D 5000, zinc, magnesium 400, selenium, krill oil). In the last few weeks I have been feeling unwell again: shortness of breathe, dizzy, more aches than usual, hair falling, very tired. My BP is fine, sugar is normal, and so I did the usual blood tests: TSH 0.442 (0.27-4.20), FT3 2.92 (2.2-4.4), FT4 21.52 (12-22), AM cortisol 9.65 (6.2-19.4), PM cortisol 8.56 (1.8-6.5). My T3 is in the low range which is much lower than last time, and T4 is in the top range much higher than last time. So, I have reduced synthyroid to 150mg and added T3 at 12.5 again. But that was only yesterday, so I’m not sure if this will help. Oh, one last thing to add. I have always had a very low temperature, between 35.5 and 36. When I take T3, or cortisol it goes up a bit, but never to the normal range. Any ideas or suggestions would be greatly appreciated 🙂
Hi Lucy,
You have done remarkably well treating yourself given your resources in Jordan, I don’t have much to add but a few things.
One is to understand that Vitamin D is not a true vitamin, but rather another endocrine hormone (like thyroid and cortisol)…and being another endocrine hormone, shares the same receptors as the thyroid hormone does. In addition, it appears that the body has a preference for vitamin D over the thyroid’s T3…and so will prevent and even at time boot the T3 out of the receptor.
As you know, blood tests only show what is circulating…and not what you are using. T4 is the storage form, so it is good being near the top of the range. I would not worry about the T3 being near the low end of the range, unless you feel crappy (which I suspect). That said, that might be explained by your taking Vit D. There are other reasons for symptoms of low thyroid and that might be possibilities too.
Despite what it says all over the internet, the thyroid and adrenals have NOTHING to do with body temp. The body’s temp is controlled exclusively by the hypothalamus and inflammation in the hypothalamus can result in a lowered core body temp. low body temp is also found in many illness conditions like Lyme disease for one example. The hypothalamus ALSO determines and controls how much endocrine hormones one produces. But, again despite all the beliefs on the internet, adrenal hormones and thyroid hormones are signaled by very separate chemicals in the body…again, the signaler being the hypothalamus. I suspect that the body lowers its temp as a protective devise. it is also the hypothalamus that increases body temp (fever) when we are sick…and it does this because a higher temp is needed for white blood cells to attack whatever we are sick with.
To me, your thyroid levels look great…even ideal. However, many doctors say it is more important how you feel. I am sorry that I don’t have many answers for you. My only suggestion would be to maybe try stopping the Vit D and see if you don’t feel better…or to slightly increase the T3 level??? Again, you have done an awesome job figuring this all out, hope something I said might help further your search.
Faith
Hi Faith
Thanks for much for your input! I didn’t understand that about Vit D. So, if I stop it, I know my Vit D level will dramatically drop again which also makes me feel crappy, so is there another way to maintain a healthy Vit D level?
I have been feeling slightly better since I started taking the T3 a few days ago, but I still feel like someone is sitting on my chest, and light headed – the kind when you hold your breathe.
One other thing….whenever I test CRP in my body, it’s always above the range, but where to look after that, I do not know. I have moderate arthritis in my knee, and I’m suspecting in my feet now, but I haven’t checked that yet.
I’m actually leaving work in two weeks time to concentrate on my health and go to the gym daily, mostly to swim and do weight training. Hopefully that will pick me up a lot, and I’ll lose some of this weight, that doesn’t shift with good diet, even low carb.
Thanks again for your comments!
Hi Lucy,
As you probably know, elevated CRP is inflammation…which could explain the low body temp. The suffocating feeling and knee issues sounds like Lyme disease…although there is no really good test for it. The standard test only has a 35% of picking it up. And there are no real good answers for Lyme disease either.
Here is the funny thing about Vit D tests…the 25,D test which they run is similar to a T4 test…it is the storage form of Vit D and not the actual usable form. The 1,25 D test is the one people want, but are not given unless you argue for it. The 1,25 D is the active form, like T3. When they only test the 25,D…it is like dosing thyroid only testing T4 levels. It makes sense on one hand, but when one is having problems then it probably should be looked into more deeply.
Oddly, people with bacterial infections and people with a genetic defect (that would not be noticed normally), over-make the enzyme called CYP27B1 that over-converts 25,D into 1,25 D…so that they will ALWAYS look low on the standard Vit D test, but are in fact normal or high active 1,25 D. I am one of those people. My standard test was 6, but the 1,25 D test was 50, right in the middle of the range.
When I tried taking D, I felt great for a while…then not so great. Another little known fact about Vit D is that it is also a steroid and immune suppressor.
I would never hope to imagine what anyone should do regarding this issue with Vit D, but I do think it helps to understand it before deciding whether to take it, especially considering that it competes with thyroid hormone in the receptor.
Again, not a problem for most people…however, it is something to consider when thyroid levels are normal and one still feels hypo-thyroid as a possible explanation.
I don’t have much to say on the diet front largely because no one seems to know much. I have had really great success with going grain free. I thought to try it for a month, but felt so much better within a few days. That said, not only do I not digest grains (and most other things), but just found out from a stool test that I don’t have the bacteria to break down complex carbs. either way, I lost a pound or two a day just not eating grains.
I hope your time off helps you feel better. 🙂
Hi Faith
Thanks for all this great info. I will see if the 1.25 test is available here. I’ve stopped taking it for now to see if I notice any difference. In regards to diet, since the thyroidectomy, I have become gluten intolerant which I think is a blessing in disguise because over here, all the flour is GM so its probably not good anyway. After I leave work, I am also going to try and get off all grains, and try low carb again. I went really well on it a few years back. Hopefully all these changes will make a difference. Many thanks, and all the best 🙂
Hi Lucy
Good to know that there other other patients in Jordan suffering from what I suffer.
I’m a Hashimoto’s patient and have been searching for a long time for a progressive doctor in Jordan who might consider T3 or Armour. Do you know any? It is not easy to get meds into the country. Can you advise me on what to do and is there a Dr. who you recommend?
So much information here to absorb and I know that Drs don’t know either. Or at least the ones I have seen for 20 years. I have been on synthroid that long. Am overweight/obese, tired, achy most days & pain in various body parts. Jumps around from shoulders to hip to lower back. Bruised feeling when I touch the locations.
Last week I went to a new dr who I hoped could make me feel better. I talked about Armour and that I would like to try it given that I have been on synthroid forever. He did not agree & said the American Association (or college of) Endocrynologists have not found any studies to prove it works better than synthroid. He said he has had 3 patients that insisted they wanted to try Armour. He said none of them showed improvement. As for what I told him I have read about his response was “you’re not going to get accurate info in chat rooms “. UGH!!! I didn’t push it. These are my test results;
TSH: 1.65
T3: 2.8
T4: 1.15
What is really interesting is the last time my TSH was high at 4.5. I take 75 mcg of synthroid.
There is an ongoing issue with my Vit D. The last 2 times it has been checked it was low (22 then 25) The first time I ever had it done it was a 9. I’ve been taking 50,000 units one per week for about 2 years.
I got my results online and have t heard what dr will advise. All other blood tests in normal range except cholesterol. But triglycerides were good. Checked for any muscular problems, that test also normal. All the chemistries normal.
Any ideas from anyone? Will ck back in once I hear from dr. Sure wish I could find the right doctor. To think there is something to make a big difference & they are standing in the way!!
Brends, You gave values for your thyroid lab results but didn’t tell the minimum and maximum for the lab. If you are on the low-end of the labs with your thyroid results and you probably need to be taken a higher level T4 for max conversion to T3. Taking t4 with purified or distilled water will also help,to maximize. Levoxyl is more effective than Synthroid.you will likely feel healthy when TSH is non-existent or very low…not within range. Doctors believe the TSH is the gold standard for determining thyroid health. If you call some compounding pharmacies in your area and ask the which doctors are prescribing compounded T3 for their patients, you will have a better idea of what doctors to employ. My TsH is very low out of range and has been since taking thyroid meds. My t3 labs without t3splement is 82 with a lab range of 78-181. T4 Is at the max-18…so can’t take any more t4. When taking t3, my tennis elbow, etc heals. I just started taking t3 again after a 2.5 year break realizing that I couldn’t make t4 alone work. Armor has to be divided and taken a few times a day-same with Cytomel t3. Compounded t3 is the best since it is time released.
Hey everyone, reaching out to see if anyone can provide me with any advice or experience. I’m a 25 year old male with a long history of bulimia (10 years) and anorexic tendencies that led to that. I’m still struggling, but somehow am managing a bit better in terms of frequency than I have in the past. Over the past year, I’ve begun trying to sort out my health issues, specifically related to my thyroid. I am essentially broke so seeing a quality practitioner regularly is not possible for me. I have had some blood work done recently, which confirmed that I have low T3, borderline low t4, and normal TSH. Even after a long stint in treatment (refraining from bingeing and purging), I had these same results several years ago. I’ve been taking 1 capsule of Thyrogold daily for the past few weeks but have felt no difference. I’m going to try increasing to 2 capsules tomorrow. I’m normal weight (120 lbs. at 5’7″) although I have gained a solid (taking fluctuations into account) 3-4 pounds over the last month. Any feedback anyone might be able to provide would be so unbelievably appreciated. Thanks in advance and let me know if you have anything that I should clarify.
Josh, have you looked into the book and website, Stop the Thyroid Madness? or Why do I Still Have Thyroid Symptoms? The former has many self-help suggestions. Read up and gain the knowledge you need, while you are saving up for testing and treatment. You could also consider joining Life Extension, they have a blood test sale annually in May, if you live in MD or NY it’s a bit tricky but elsewhere you can order your own tests. Best of luck.
I have a strong family history of thyroid problems. I felt mine was not right by the end of my twenties and struggled with weight loss after each of my kids even though I only gained 22-30 pounds with each. At 35 I went on phentermine, ate well and jogged 3 times a week. Lost weight and felt good. I was diagnosed with Hashimotos at 42 when they accidentally found nodules in my thyroid. Two years later they put me on levothyroxin 50 then 75 then 88. In one year I gained 30 pounds and felt worse than ever. Constipated, fatigue, hair falling out, extreme cold all the time, do not sleep well and can’t lose weight no matter what. Tsh is .371, t4 1.62, T3 3.57, cortisol 24/urine 47.9. Endo placed me on phentermine last September to help me stop gaining. It did but NO weight loss this time. I keep my calories around 1,200 because I gain very quickly if I don’t. Now he’s put me on Belviq which I feel like both are a band aide and do not address why I’m struggling to lose weight. I have a BS in dietetics and fully understand the nutrition side but I am struggling with what to do. Help!
You could be describing my life, exactly. To a “T.” I think our pregnancies kicked off an “autoimmune” response. (Common.) We developed autoimmune disorders. I have hashimotos (that is an autoimmune disorder. Now I think I have autoimmune pituitary. (One cause of Low T3.) This article was informative, but it didn’t REALLY say how to treat it, did it? Confused.
I had a total thyroidectomy 15 years ago, my parathyroid glands were traumatized. I have Graves’ disease, diagnosed when I was 14, and now hypoparathyroidism and I’m hypocalcemic. I’ve been on Levothroid, Cytomel and Calcitriol since my surgery and have experienced long periods of great health with euthyroid tests (especially during pregnancy). I have had chronic sinus infections over the past year, a myomectomy 2 years ago, and a lot of stress.
My last test had my free T3 at 268 and my TSH at 0.46 and free T4 at 1.1, needless to say it’s been a rough few months. My Endo has reduced my Cytomel to 12.5 mcg daily (from 25), and increased my Levothroid to 112mg 7.5 pills per week (from 112mg 7 pills per week).
In the last year I’ve gained 15 pounds, even though I eat well and exercise regularly.
What now? I know I need something to change. I’ve had fluctuations for the first time in 8 years and I just feel off. Always tired, palpitations, slow metabolism, insomnia, immunosuppressed, headaches, shakes in my hands, body pain…. What do I test? Do I modify my diet? Are there herbs or natural protocs I should look in to?
I’m a single mom of two little girls and I need my health back. I’m 35 and starting to feel old again, the way I did when I was finally diagnosed.
Any direction is appreciated!
Hi Roaya,
I can so sympathize with your need to get your life back. Unfortunately, I don’t have much to offer.
Palpitations are generally a sign of too much thyroid hormone…adding as an FYI.
There is a member of the thyroid groups that only feels well when her T3 is near the top of the range…I wanted to add that so you can know that not everyone’s situation fits into some “typical” anything.
I do believe graves sends you up and down thyroid-wise, although without a thyroid that is a challenge to explain. That said, I do know from experience (I also do not have a thyroid and take T3 only), that too much thyroid can also cause you to gain weight. Most people do not know that, but as I have experienced that I try to share it.
Sometimes the fillers in thyroid meds cause issues too. There is a kind of T4 called Tirosint that has no fillers and may help you. Unfortunately, it is a brand name drug so you may have to work with your doc to give them some kind of justification for ordering it to get insurance to cover it. For me, it was because I wasn’t processing any other T4’s right and was a last resort. I have to say, it was the only thyroid med that I didn’t feel ishy after taking.
For many years, I just felt like I wasn’t able to use the thyroid hormone well…despite my numbers. Two things I did, but weren’t really helpful for any reason other than explaining things to me, is to take the 23andMe.com genetic test. This allowed me to realize that I have many defects in my thyroid b receptor. There is no treatment, but it allowed things to make some sense.
The other thing was, I studied the Vit D pathway…oddly enough, Vit D is also an endo hormone…and it shares the receptor with thyroid. Indeed, an excess of Vit D will boot T3 out of the receptor. This wasn’t the end of story for me, but should have been…but my labs consistently showed low D. So I studied further and realized that 2 kinds of people will ALWAYS look low on the Vit D test they run which is, incidentally, the storage form of Vit D (sort of like only testing T4). Those with bacterial infections and those with a certain genetic defect (that wouldn’t cause them any problem) over-make the enzyme that turns storage D into active D (the one they do not test). So I got both my 25,D and 1,25 D tests done and found that indeed I had plenty of 1,25 D (the active form). So I stopped taking Vit D and did much better on thyroid hormone.
Also, I take T3 only 10x a day…which is a little much for most people…for me it is great because I seem to benefit from it only for a short time and by taking so often allows me to feel great (thyroid wise) throughout the day.
Lastly, my suggest is to find an “integrative” doctor…they combine western medicine and supplements and generally (unlike normal drs who just want to rx something) actually try to get to the bottom of things and fix it. It is just a much more logical approach when ones symptoms are hard to pin down.
Hope that helps.
Oh, and another possibility…shaking and palps can also be too much adrenaline (different endo gland) as well as the weight gain from the body trying to metabolize the adrenaline. The very best test I know for reading that is Pharmasan’s Neurotransmitter Test…insurance covered mine, not sure if it will everyone’s…but is good to find an Integrative doc that uses these send out tests, better chance of getting it covered.
Hi Faith! I have a question regarding autoimmune and thyroid medication I have heard the same as you that taking desecrated pig hormone or armor is contraindicated in autoimmune disorders. I have Graves’ disease and I am currently taking Synthroid and have currently added T3 as well because for some reason I have stopped converting. not really sure why? May I ask why you are taking T3 only and if you loved Cairo sent why aren’t you taking that currently? I do have friends of mine who take nature thyroid who have autoimmune Hashimoto’s and do very well on it I am trying to decide whether or not to switch over I have been on this protocol for 20 years now and feel that I have had enough of synthetic hormone and would like to try something more natural
I’ve been taking WP Thyroid for a few months now, and I feel good with stable Reverse T3 numbers, and I have Hashimoto’s, so maybe Dr. Christianson is right about NDT and Hashimoto’s? I’m going to stick with it for a while longer. I like the idea of supplementing T4, T3 and even T2, which NDT allows you to do.
Hi Sam,
I am on T3 only because I massively over-convert to RT3 (I have other health issues that are behind the RT3 abundance). My labs get up to over 150 points over range and I start collapsing when they are 100 over range. So until I can get the other worked out, I am doing well on the T3 only.
Everyone has to weigh whether slaughter pig thyroid is “natural” enough, I guess. The same people who tend to think of it as natural, tend to also think hotdogs are not good for our health…and it is likely that the hotdog is cleaner than the thyroid, imho. I do think some people need some of the other stuff in the pig thyroid and do well on it. And I do think that everyone should find what works for them.
That said, there are issues with each thyroid hormone out there. Desiccated thyroid tends to go thru times when it is not available, they tend to change fillers…sometimes using soy which inhibits it. But those who swear by it, swear by it.
To me it is the fillers, rather than the synthetic part, that seems the most difficult. I have to get a special brand of the T3 because the one pharmacies carry give me hives. I liked the tirosint because it was the only one that I didn’t feel yukky after taking.
Hope that helps.
Thank you for this series Chris. We see some very complicated Hashimotos and thyroid cases at my clinic, and at times it is quite confusing.
I think I understand the relationship you are talking about when Reverse T3 remains low despite Total T4 increasing due to supplementation, but I have a patient currently that has Hashimotos with low free T3, low T4 and low reverse T3.
My strategy with her so far has been decreasing AI inflammation, building Qi and blood and a very low dose of WP Thyroid (T4/T3) just to help her feel better while we work on the underlying issues. After 6 weeks of having her on 1/4 grain per day, her numbers remained practically static – even the T4 – and her TSH dropped functionally low. Symptomatically she felt better than ever though.
Is this a pattern you’ve seen?
Thank you.
Hi Julia,
The general problem with giving hashi’s patients desiccated thyroid gland is that it also contains the very things the person’s immune system is attacking.
Low T4, if clinically low and low T3, if clinically low is fairly classic hypothyroidism and would warrant supplementation.
Have you heard of a product called, Tirosint? It is a T4 with no fillers, people often do well on it. And there shouldn’t be anything for hashi’s immune system to attack.
Faith, I’m a Hashi’s patient who is taking a small (1/2 grain equivalent) dose of WP Thyroid. My TSH has improved a bit in the 6 weeks or so since I changed the dose from 1/4 grain to 1/2 grain (from 1.5 to 1.4); my T4 is normal, about in the middle of the range, my Reverse T3 is also normal, about in the middle of the range, but my T3 is still low, just slightly under the low end of the normal range (67, when the low end of my lab’s range is 71). Should I switch to Tyrosint? If so, how would you do the transition, and to what dose? I definitely don’t want to make my Hashimoto’s worse! If you have a link to any references about what ingredients in WP Thyroid could make my Hashi’s worse, I’d love to take a look. Thanks for chiming in here. I was just diagnosed in December, and I feel like I’m trying to get a PhD just to decide what to ask my Dr. for!
I just wanted to add that I did have both of the blood samples (6-7 weeks ago, and then 1 week ago) drawn fasting, before taking meds, in the morning. So I had already decided to not increase the WP Thyroid further at this point, on the idea that I would work on putting the Hashi’s into remission. But I would hate if I was taking the wrong med, and impeding my progress!
By the way, I found this video by Dr. Alan Christainson, in which he addresses the use of NDT in Hashimoto’s patients, and argues that there is little evidence against it, and a good reason to do it: https://www.youtube.com/watch?v=V-g0yQrj-MI#t=271
Hi Amy. I saw your mention of Tirosent. It is an excellent thyroid med with a high price. Discounts are offered for the first few months and the price continues to go up. Over $100 for 28 pills. It is definitely more effective than the Levoxyl I take. I tried it when Levoxyl was discontinued for about a year. I keep my t4 labs at the maximum within range and my t3 is within range on the low end. TSH is always nearly nonexistent since starting thyroid replacement in 2007. I tried armor and cytomel too but they were too fast acting for my system. For a consistent feeling of well being, compounded t3 is great added to t4 if needed. Some Walgreens compound for a reasonable price and it doesn’t have to be refrigerated.
Hi Amy,
When they dx you with Hashi’s, it is usually because your TPO Antibodies, or TG Antibodies came back high. TPO is short for Thyroid Peroxidase, the enzyme that breaks down iodine from food or supplements and renders it bioavailable (T4 and T3 are 1 thyroid and 4 or 3 iodine). TG is short for Thyroglobulin, the thing that adds or binds the 3 or 4 iodine onto the back of a thyroid molecule.
In hashi’s your immune system attacks one or both TPO or TG.
Desiccated (or dehydrated) animal thyroid (usually pig) has TPO and TG in it (just like your thyroid has them in it). Because hashi’s immune systems attack those things…it is generally not wise to take it.
That said, some people may be low in some other of the things in desiccated thyroid and thus may benefit despite the immune issues. Me personally, I wouldn’t want to continually antagonize my immune system if I could avoid it…but that is just me.
The same issue arises with taking iodine for the same reasons.
Also, not to mention that slaughter pigs (Armor Thyroid = Armor Hotdogs) are generally fed so much endocrine hormones that they die prematurely at 1.5 years old (slaughter age is 2 years). That in itself is a reason to remain leery of desiccated thyroid products. Again, just me personally, some think it is more natural…even though the same people would probably think hotdogs were not-natural or not good for them. So again, this is just a matter of personal preference and you will have to decide for yourself how you feel about it.
There is a really fantastic book regarding hashi’s and trying to balance the autoimmune immune system called, Why Do I Still Have Thyroid Symptoms When My Lab Results Are Normal, by Dr. Datis K…
I have autoimmune issues, not thyroid related, however when I tried desiccated thyroid my RT3 skyrocketed and my inflammation went up. That was enough for me. I loved the Tirosint, it is dosed the same as any T4…and there are conversion tables for desiccated to T4. My insurance covered it, so I can’t speak to cost…but it is a brand name drug. It helped that I had a series of labs from all the trials my doctor was doing trying the different thyroid meds, so she could have made the argument for why the brand name was necessary.
Hope that helps. 🙂
My RT3 is good/stable. What other tests would you do to determine if I’m having an inflammatory reaction to the WP Thyroid? Thanks!
Actually, my reverse T3 has *decreased* since I increased my WP Thyroid dose from 1/4 grain to 1/2 grain. It was 19.9 and is now, most recently, 13.6. Same lab, same testing conditions.
Hi Amy,
The general inflammation labs are C-Reactive Protein (or CRP), and SED Rate.
But, for me, I would keep up on the antibody testing.
As always, if it is working for you, use it.
Faith,
Very helpful info you shared that includes details of your personal journey. Sharing experiences on our thyroid journeys is the one thing that makes the suffering more tolerable.
Whoops! Voice type error… Meant to say Tirosint not Cairo sent!
I have low T3 & T4 and low body temp. (under 98 degrees most days). I suffer from Renyards symptoms and can say I “never” feel warm. I just finished the “Wilson’s Protocol” which is starting at a low dose of T3 and working up to a high dose and then back down to the low dose over 4 weeks. On the way back down, I felt great. My temp was up over 98 (still not normal) and my Renyards symptoms were reduced. Two days after the protocol everything seems to be back the way it was.
The only adverse effects that I had were increased heart rate (from 80 to 100) – this made me have to be very careful with coffee and I would have to take breaks during my workouts to get my heart rate down.
A little history: I am 44, eat very clean, exercise some every day, do extreme workouts 3 days a week. Other than broken bones I have no health history to speak of. There is no autoimmune disease in my family history
I would try T4 first and a little bit of T3 compounded and Time released if you think you need it. So I am 114 pounds, I take 112 µg of T4-Levoxyl, and I would like to have my T3 back. Based on my previous experience with T4 and T3 together I felt like about 5 µg of T3 would have been perfect. (Was taking 7mcg twice a day and cut myself back to 7once a day because it felt like too much. Felt like 7 was a bit much over time-I cut out tap water and anything but purified water without minerals added for the first hour after taking T4. Took t3 at night-can be with food) Temp is 98, t4 is near the top at 1.7 on labs (1.8 is the highest lab within range) and t3 is 87 (78-181). I keep the t4 at the top for maximum t3 conversion and need to add t3 at some point-I think skin, joint health and other things would be better if the t3 were better than at the bottom of lab results.
Hi Shannon,
Low T4 and Low T3 is classic low or hypo-thyroid. I agree with Ms. Moore, in that the first step is to increase T4 and get those numbers up.
If, when your T4 is normal, you still have low T3, then you need to figure out why.
(I am on T3 only, so please take this in the spirit it is offered), excess T3 is not good for your body. It will demineralize your bones and as you mentioned the heart palps, it is not good for your heart. So my best recommend is to figure out WHY the low T3 before taking it…because, like Chris says in the article, if you fix the underlying cause of the low T3, the body will correct itself on its own. That said, we do not know if low T3 is your problem yet…gotta get the T4 up there first.
Hope that helps. 🙂
I tried T3 for 6 mos, gave up and then tried again after a yr for another yr. Neither time did ANYthing.
5mcg 2x a day. i would give myself 15mcg sometimes tho and never tolerated it.
Then I got my RT3 tested FINALLY. Well after I had been off the T3. Waddya know–its high; my ratio’s not good either. Well that’s where all the T3 went. I’m not just resistant, I also convert it to RT3 and shoot it out the bod. I could take tons; I’d just get rid of it, not use it so I could MAKE ENERGY.
I hate my body.
T3 is the only thing that would probably work, but sometimes it don’t work neither. Well *I* think, ALOTTA times it doesn’t.
Be thankful, those of you that IF you can get on it, it will make a difference.
Hi Hélène,
Sorry to hear that you have a lot of RT3.
T3 = 1 Thyroid Hormone + 3 Iodine (and T4, 4 Iodine). T4 is converted to T3 (or RT3) when it cleaves 1 iodine off. T3 is one corner, and RT3 is the other corner. The only way to get RT3 is from T4.
RT3 can happen in excess when you have too much T4 (which may have been the case when you started taking T3 that you didn’t need as much T4), or when you have other health conditions. The hallmark of whether it is a health condition or too much T4 is if you have low T3. Low T3 (with normal T4) is generally a sign of some other health condition.
It can be really hard to pinpoint what is going on within our bodies and just how to help them…and you are right, T3 is not for everyone. T4 to T3 (and RT3) conversion primarily take place within the liver…so sometimes attending to liver health is enough to help. By that I mean, resting it from time to time…the liver both processes the foods we eat and balances our hormones…giving it time to balance our hormones can be very beneficial. And yet sometimes, we just make lots of RT3…I know I do.
Also, everyone’s “ideal” numbers are different…some need T3 on the low side and others on the high side in order to feel well.
Best of luck.
Hi Faith, let me first say thank you. I have been reading all the Q&A’s and i found them very informative. Now my questions concerns my wife’s health. She has been overweight for many years even though she doesn’t over eat. Her T3 is been low (2 labs in 1 year period), T4 & TSH were normal. She has been doing a no carb diet with MIC injections for about 7 weeks and lost about a lb. a week since she started. Now last week all her labs results normal again except for the T3 and she is feeling helthier than ever before. My questions are: Can she have an undetected underlying condition (because her T3 was low before the no carb diet) or is it her body not producing/conserving T3 for energy and we should do more tests. Also her Thyroid ultra sound came back normal. Please help.
Hi José Luis,
First of all, I am sorry about your wife’s health.
Low T3 with normal TSH and normal T4 has two possibilities. One, she is not converting enough T4 into T3…or, two, she has other underlying health issues.
The best test to see which it might be is to try supplementing a small amount of T3 and see what happens. If her levels go up and she feels great, then is probably a conversion issue. If her levels stay low or if she continues to feel poorly, then is likely something else.
No one knows why the body reduces T3 conversion when sick…they only know that the body does. In critically ill people in the hospital, T3 is often very low. However, this corrects itself so that is why mainstream doctors do not treat it. And, that sort of makes sense since despite all our scientific knowledge, we still don’t really understand how the body works.
Also, and I might be the only one around saying this, NO ONE understands weight gain or why it happens. Yes, I know the beliefs…however, 100% of hospital diet and exercise clinics fail…so it is not diet and exercise. I personally believe that weight gain is a symptom…like a sore throat is…especially given that fat cells only contain three molecules…none of which is food, water, sugar, or pollutants.
If weight gain is linked to low thyroid, then supplementing with thyroid will correct it…and that does work for some. Too much thyroid can also cause paradoxical weight gain as well. However, for most there is no explanation as of yet.
Kudos to your and your wife for trying those injections…however, I might add that she might want to do the 23andMe.com genetic test…and then run that thru the online software of Genetic Genie or Livewello to get a methylation report. What I have learned from my own experiences with that is that NO supplement is as safe as anyone once thought, especially those.
The reports give you info on defects that one may have in the various ways we make and unmake nutrients. For example, I don’t process folate well…so I do well avoiding eating many greens (something most would consider good for one).
My suggestion would be to consider trying a small amount of T3 and see how she feels.
Hope that helps,
Faith
I have Hashimoto’s, have an autoimmune reaction to American porcine NDT (tried 5 different compounding pharmacies). I have CFS and depression. I am currently taking 6 OTC bovine thyroid capsules at 9 a.m., 6 caps at noon, and 6 caps at 3 p.m., with one L-Tyrosine cap at 9 a.m. and 3 p.m. Also take 10 mcg Cytomel at 9 a.m. and 5 mcg. at 3 p.m. PLUS 125 mcg of Levothyroxine at 9 a.m. (This regimen is about 70 percent effective). Haven’t been tested for RT3, but FT3 “falls within lab range.” I take ALL recommended Hashi’s vitamins and minerals; gluten free, sugar-free diet; low stress, spring water only. I’ve gotten some comments that I need right balance of T3 and T4; OR maybe I’m taking too much T4 (doctor prescribed the 125 mcg. levothyroxine is appropriate. I think I need T3 only based on Paul Robinson book “Healing with T3.” After $10,000 worth of testing they haven’t found any other illnesses or conditions.
Ms Klagh, with all that you are currently taking, what are your T3 & T4 on your labs? Concerning water, I recommend aquafina or the equivalent (distilled or something purified without minerals added-nothing but water or nothing for the first hour after taking T4-allows for better absorption and effectiveness-My levels improved with purified reverse osmosis and distilled.)
After trying only T4 for a couple years and realizing little improvement, I noticed a pattern of consistently low T3 levels in my lab tests. After reviewing the literature (including an important article addressing low T3 levels in the brain, Bianco, MD and Casula, MD), I made my case with my MD. Just 5 mcg T3 per day literally made me feel as though I’d emerged from a fog. 10mcg/day allowed for even more relief of symptoms but caused cardiac/chest discomfort. I have spoken with several physicians and patients who hear/say the same thing: feel so much better with a little T3. Hope this helps someone.
That person could very well be me.
What form of T3 do you take? I’d be very interested in knowing that.
And may I ask who prescribed the T3 to you? Man, I can’t find anyone in the San Francisco Bay Area who will even consider prescribing it.
There’s one doctor, but he charges $1000 for the initial visit. The bully.
Thanks so much, Claire.
Hi Kim,
Endos generally will not give you T3 because it is outside of the “standard of care,” however, you can often get integrative doctors to…providing you can make a good argument for it.
Kim, if you are considering compounded t3, call the compounding pharmacies in your area and ask which doctors prescribe T3 for their Customers. Some Walgreens also make compounded t3.
Claire,
I live in the SF Bay Area and I’ve heard Dr. Richard Shames in San Rafael is a good resource. He’s written several books on thyroid function, which discuss the importance of individuality in treatment (aka not everyone responds favorably to the same brand of thyroid hormone). I would definitely check him out!
Tanya
Oops- my message was actually for Kim.
Hi,
I would really appreciate comments on my situation. I am a hashimoto patient with with consistent low FT3 if on previous dose of (T4 Levo) 112 mcg and 5 mcg(T3 cytomel). I also have a suppressed TSH. In November 2014, testing confirmed too much RT3 (4 to 1 ratio) and my physician switched me to time release T3 (15 mcg x2) and T4 dosis of 112 mcg. A month later she dropped my t4 to 100 mcg. I still developed a slight fever and weakness on the third month. I am assuming due too much hormone and she dropped T4 meds to 75 mcg. I have not been able to take the t4 prescribed due to temp rising to 99.2 still. My physician suggested I switch to t3 only meds. I am otherwise healthy, have no cholesterol, normal BP, good weight, etc. I have been on this treatment for 4 months and before the temp increased to over 99, I was doing great and had lots of energy. Now I am back to feeling tired all the time. My temps used to be very low on previous meds (96.3-97.8), I had fatigue, cold all the time, constipation, dry skin, etc. Now temps fluctuates between 97.8-99.2, I feel fatigued when I have 99.2 temps. I am assuming I still have too much T4. I haven’t taken (t4) levo for two weeks. Should I have my doctor switch me to T3 only meds as she suggested or wait until my t4 levels drop enough to begin my new dosage of 75 mcg? Could I still be on a hyperthyroid state? Thank you
Hi Marcy. Sounds like your doctor should have started you out on less compounded T3. Are you taking two doses per day? If so try taking just one of those pills each day and see if you feel better. I have nonexistent TSH. I think that for most that are adjusted properly on thyroid medicine-TSH should have nothing to do with your thyroid gland. If you’re ingesting thyroid hormone there is no need for a TSH signal from your pituitary gland. My T3 and T4 are within range and the TsH has been .04 since 2007. Less t3 may have worked fine with 112t4. I used to take compounded t3. I am very familiar with the higher temp and not being able to do anything without the heart rate elevating-exhaustion….
HI Ms. Moore:
Thank you for your reply. I think she should have dropped my T4 when she increased switched me to SRT3. She did start me with 7.5 mcg twice a day and she left me with 112mcg of T4. My second appoint was 4 wks later, and she dropped the dosage to 100 mcg T4 and upped my SRT3 to 15 mcg x2 a day. I think I have too much t4 on my system and the moment I try to take my two dosages or SRT3 my temps go up to over 99. I tried not taking anything and my temps began to come down a bit. I am still not taking the 75 mcg of T4 for over a week now. I am going to start up with one dose a day of SRT3 and see how it goes. Thank you,
Marcy
Hi Marcy,
Let me start out by saying that I am by no means an expert in hashis…but I do know a bit about autoimmune.
My thoughts are that it is unlikely that the raise in temp is due to taking thyroid, however, I don’t know about taking thyroid hormone in hashis.
Raising temps is an immune function, so I am more likely to attribute the temp issue as a sign of immune attack…and feeling yuk also due to immune attack. Just my thoughts. Hopefully you are not taking iodine since that can cause immune attack in hashis.
There is a very good book by Dr. Datis K. called Why Do I still Have Thyroid Symptoms…he has a compelling idea for how to balance the immune system that is worth a look at if you haven’t already.
Any chance you have other autoimmune issues? That might explain the chronically low T3.
Years ago, people used to believe that TSH was only responsive to T4, but I am inclined to think it is more responsive to T3. I take T3 only and general have a less than 0 TSH so I only follow my T3 levels. Again, I don’t know anything of the mechanics of hashis treatment…or whether taking T4 is done to suppress the thyroid.
Anyways, I am not much help, sorry.
HI Faith:
Thank you for your reply. It is possible that it is a hashi immune reaction. I have had very high antibodies and positive ANA tests in the past. However, when my doctor runs a battery of tests, it always comes down to TPOAb. No lupus, RA or Sjogrens. Perhaps I had an autoimmune attack on my thyroid due to excess hormones. I do think my T4’s were probably too high and it caused the temp increase. I’ve dropped all meds until my temp drops a bit. I will start with one SRT3 pill a day and see how I feel. I tried taking half my 100 mcg pills of t4, but that also raised the temps. It took about two months for my temps to normalize on SRT3, and then another month for the higher than 99 numbers to show up. My temps were ok today, but I took no meds yesterday or today. Thank you for your reply
Marcy
Hi Marcy,
TPO is Thyroid Peroxidase, an enzyme, that oxidizes iodine so that we can use iodine. TPOAb is the antibody against this enzyme. http://en.wikipedia.org/wiki/Thyroid_peroxidase
There is iodine in your T3 and T4, however, it is already bound onto the thyroid hormone (T4 = 1 Thyroid and 4 oxidized iodine) so it wouldn’t/couldn’t be sparking a TPO attack.
Using iodized salt, taking iodine supplements, or eating foods high in iodine could trigger an attack…however, anything that runs your body down could also cause your immune system to amp up.
There is no known biological pathway for excess thyroid hormone to increase body temp. Body temp is controlled by the hypothalamus…and is generally raised in an effort to increase white blood cells which need a higher temp. This is why the body’s temp increases (fever) when we are sick. Inflammation IN the hypothalamus can also increase body temp.
The hypothalamus (TRH, thyroid releasing hormone) tells the pituitary (TSH, thyroid stimulating hormone) which tells the thyroid…not the other way around. High TSH might increase TPO production and thus cause an attack, but that is not at issue here.
There is a false belief rampant on the internet regarding the adrenals and thyroid, and between adrenals and body temp, but these are not connected other than the hypothalamus (CRH, corticotropin releasing hormone) and pituitary (ACTH, adrenocorticotropic hormone) also control the adrenals, but does so with completely different chemicals through different chains of communication.
Anyways, I am not much help…best of luck finding your answers, and I hope the other med helps.
Faith
Hi Marcy,
I can’t help but reply, as I moticed 2 key things. 1 is that SR is not recommended… Straight T3 is much better regulated by the body. My ND started me on SR and after not feeling well still and doing a lot of reading I found that per patient experience straight T3 is a much better experience. I noticed an immediate difference when I switched!!!! 2nd thing is I think you are raising your T3 too fast, which is causing the elevated temp and fatigue. Patient experience shows that it’s best to raise 5mcg every few days as vitals dictate … For some that could be every 3 days, for others, every week. You dose based on vitals that you take upon rising, and multiple other times throughput the day. I joined the Facebook thyroid groups and have learned an incredible amount & received endless support!!! I hope some of that was helpful!
Marcy, you are right. Elevated temp is definitely a symptom of too much hormone. I went from 3.5 yrs undiagnosed and freezing…to hyper without replacement therapy. I remember taking my winter coat off when the temps were in the 20’s because I was warm. My doc also warned me to check heart rate and temp if needed.
I want to thank all the comments made to my posts. I couldn’t find my post and I have been busy with grad school. I am currently doing much better. After all the SRT3, I ended up not tolerating any T3 replacement at all for about 3 months. My doctor rechecked and noticed my thyroid was making enough hormones, but I still had elevated RT3. Since I couldn’t tolerate time release t3, I started on regular cytomel 5 mcg. I was doing great until the winter came and I felt hypo again. By then, my doctor no longer was taking insurance. I went to my GP and she prescribed Levo 25 mcg. I have been stable since. My RT3 is 19 (20 and above is normal) which is the closest to normal it has ever been. My doctor now tests Reverse T3 on a regular basis. I made a mistake in previous posts, I had elevated anti thyroglobulin in the past not AbTPO, very high, but I haven’t had it tested since. I avoid iodine as much as I can b/c I don’t want to have autoimmune reactions. Mymom’s endo and my doctor suspect we have a problem with the deiodinase enzyme from the pituitary. We also have hashimoto and she has been placed on T3 supplementation as well.
Thanks for the informative series of articles.
I have low T3 (2.1) and normal T4 and TSH. I also have moderate to severe Chronic Fatigue Syndrome and Fibromyalgia. I’m wondering if there is a correlation, and if my low T3 is simply a byproduct of having CFS/Fibro . Or, could low T3 be worsening my already intolerable exhaustion and weakness?
Alas, there is no way to treat the underlying condition. Might I benefit from some treatment for the low T3? If so, what is it?
Kim, where is your T4 on the labs? Low, middle or at the high within range? Ask your doc to increase T4 if you are low or mid range normal. Only have purified or distilled water with your pill for the first hour.(no minerals added for flavor-aquafina is good. I stopped tap water and my T4 labs went out of range high but I was already close to the max. Your TSH should be suppressed out of range low to get the T3 within range and feel better. Don’t express to your doc that you want your tsh to be nonexistent. There will more than likely be resistance. If that doesn’t help, and your doc won’t prescribe T3, call your local compounding pharmacy to find out what Drs are prescribing t3. I was on T3 &T4 at first but now only take T4. It is much easier. I don’t have to take any other meds…just vitamin D. If you take your thyroid in the AM, take any other med or vitamins about 4hours later. I went back to my doc 30-min from my home because he doesn’t get excited about tsh being nonexistent. I tried 2docs near where I live and they wanted to reduce my thyroid med to 100mcg because of the tsh. Not gonna happen!!! I would have my Veterinarian significant other prescribe what I know I need before I would reduce the mcg and make myself sick again.
PS….your low t3 is causing CFS & Fibro. I had this in addition to cholesterol of 300+, digestive problems, eczema, etc when I was undiagnosed.
And, cytomel can be a pain since you have to divide the pill-compounded t3 is so much easier on your quality of life. Levoxyl is more effective than Synthroid.
Thank you Ms. Moore. You provided so much information that I can take to a good, out-of-the-box-thinking Endochronologist.
My T4 is 1.3 – right smack in the middle range. I’m scared to treat the T3 because it could backfire on me. But, I am terribly ill, and am willing to take a few risks.
You say you got rid of CFS by treating your low T3. Did you have “post exertion fatigue”, which is a hallmark symptom of the illness? I know some people who experience debilitating fatigue think they have CFS, but they actually don’t.
In any case, it is great to know you got better. I’m going to buy some purified water.
I didn’t really do anything or push myself. Kept a heating pad on the couch and in bed. Tried to walk around the block and made it to the corner and went back inside. I was divorced and my children were in high school. Feel guilty because of lost time with them. Wish I was up making breakfast before school and taking them to events. Anyway, Sounds like you are in a perfect position to request the next higher T4 level. Request Levoxyl if your doc doesn’t disagree. My neighbor switched from Synthroid to Levoxyl and said she felt much better. My pharmacist told me she understood Levoxyl is more effective. Studies show it is more effective. The water helped. The nurses called me and was alarmed because my T4 was over the max. I told them not to worry because I had an appt with the doc the next day and that I felt fine. (My T3 was within range…it is the most important thyroid hormone) I hope you do well! I look forward to hearing back after you make some changes. Even though the docs say it takes 2-weeks…you should feel the changes immediately. I have accidentally taken 2-doses in the past and could definitely feel it. Couldn’t remember if I took it. That was before I nixed everything but water for the first hour. I put my water pill and phone beside the bed so I’ll know what time I took it….coffee with creamer within an hour!!! Always better if I wake at 5 or so and go back to sleep.
Hello Chris. I want to thank you, great site, so much information. I have Peripheral Resistance to Thyroid Hormone and take T3 only, and my thyroid gland was removed. When thyroid gland was still there, my tests looked just like that: very low TSH, very low FT4 and FT3. I have to take very high amounts of T3 just to be able to think and not swell more than usual (not 50lbs, but 20 is a blessing). However, I am extremely ill, fully disabled, and get dangerously lethargic, always freezing to the point of emergency situations, have super low body temperature, dry painful skin, lost most of my hair so bad that we (my hubby and I ) are saving for a wig again, have myxedema of the face and overall body swelling, very high blood pressure, lost all my teeth, and in a catabolic state as well by the blood tests despite the symptoms. We are kind of caught between a rock and a hard place-I can’t be without large doses of T3, can’t be with them. I was actually diagnosed with a strange form of unmanageable Hypothyroidism first, did not respond to T4 or Armour Thyroid and developed very high levels of reverse T3 on them, responded only partially to T3, then was inaccurately treated for Adrenal Insufficiency with too much Hydrocortizone over almost a year, and I suspect that’s why my then high TSH became permanently supressed. T3 helps a little with some symptoms, and makes others worse. I also have an extreme Potassium Deficiency (Hypokalaemia) that we treat with Slow K, and chronic inflammation, both of which we think started in my childhood; and that doesn’t help. We are at our wit’s end, I’m homebound and doctor who diagnosed me long ago is not a doctor anymore so hospital staff and doctors don’t believe us, think I’m nuts fot taking large amounts of T3 but without it I get worse. What fun…I had inflammation for as long as I know it, nearly died of Mono as a child (strange as it is commonly a mild disease; I was given HUGE amounts of antibiotics before they found out it was Mono, too), and was exposed to radiation and malnutrition in my early teens, plus hiked all over the Sierras in my youth and was bitten by many ticks (add possible Lyme disease to that), so figuring out what caused the illness is like looking for a needle in a haystack-considering we are so poor that we could never afford to explore all the causes.. I don’t even have a doctor. We periodically call long distance to my most recent, nice and sweet but not knowing what to do practitioner to refill my Cytomel. I just detiriorate at home. After reading a bunch of your articles I firmly believe any of these things could have contributed to the current situation; however, I truly wish there was a way to find out which one did. Even if there was no way to treat it. 🙁
Hi Maria,
My heart goes out to you. Like you, I take very high doses of T3 only due to too much RT3 on the other options.
You sound very much like you have a health condition driving the RT3…the question is what.
I am not sure where you live, but if you are in the United States, you likely qualify for medical assistance…and could get some testing for free or very low cost.
You probably already got tested for autoimmune, but if not, you might try getting an ANA or FANA and RA Factor. The other test, probably through Quest Labs, is the C3a and C4a…that will let you know whether it could be Lyme or something else.
You might try an Integrative doctor…they do whole body regular medicine and alternative supplements etc. They are also more used to having patients that other doctors can’t seem to help. Whatever you do, please don’t give up trying to find someone to help. I say that knowing that trying doctor after doctor really sucks, I am right along with you on that one.
In the effort to say time, money, and energy…I have learned to be leery of doctors who are so sure they know what is wrong and you just have to take X,Y, Z supplement…all the hottest rage and all. Those ones tend to just follow whatever is the hot trend on the internet and seem to know nothing (nothing personal to those doctors). Best to find the one that is open to really listening and working with you over time. They are out there, took me nearly six years to find one.
The Lyme test, if you wanted it, is Igenex…it is $260 dollars upfront. If you have any insurance other than state aid, they will reimburse you…if not, there is a program (so forgetting the name, but I think is called) Lyme Aid…anyways, they will reimburse you if you can show you are low income. The upfront part is hard…I would go for the insurance covered C4a test first, if that is low or normal you can pretty much rule out Lyme and not bother with the Igenex.
Hope that helps. Hang in there.
Faith
I’ve struggled with weight my whole life, starting at around 10 years old. Despite dieting pretty much the whole time, I have slowly gained weight over the years. Of course, the natural response of all doctors is basically to accuse you of lying about how much you eat instead of looking at the thyroid or actually measuring your metabolism.
I started measuring my morning temperature a few weeks ago, and it was consistently low (high 95Fs to low 96Fs). I went in and paid for a thyroid panel including TSH, Free T4, Free T3 and TPO. TPO was negative for Hashimoto’s, TSH was high-normal, and Free T3 was low. Free T4 was about mid range.
Since I also had problems with energy and feeling cold all the time, I convinced my doctor to let my try Cytomel for a few weeks to see how I feel. The difference after even 2 days was relatively astounding – I felt like I had more energy and didn’t need 5 cups of coffee to make it through the day. I have also been measuring my average daily temperature, and it’s slowly been climbing, over a few weeks, from around 97F to about 98.2F currently. I’ve also lost 7 lbs, even though I’m not really doing much different.
So at least for me, treatment with T3 is making a big difference. I went to lab and had my metabolism (via indirect calorimetry) measured after taking it for two weeks, and it showed my RMR around 2500. I didn’t measure it before, but I was eating about 1400 calories a day and not losing weight, so it must have been lower than that.
Duane, Congratulations on finding a solution!! How much T3 do you take per dosage and how many times daily do you take it?
Hi Duane,
I take T3 only (my thyroid has been removed). My dose is .5 mcg, I take x2 pills 10x a day.
The problem with T3 is that it is the active form, which means that as soon as your body processes it, it is gone. Unlike T4 which is the storage form is available for a long time until you convert it to T3 and use it.
The other downside to T3, beyond multiple doses a day, is that you can never forget and skip a day.
The info with the rx does not say anything about food affecting it, and I often take it when I have food in my stomach and do not notice any difference.
However, T4 has on the insert to avoid soy and walnuts. I found issues converting worse when eating ANY goitergen in my diet. Others do not notice this, but for me it was a big problem. I do not know if it affects T3 users…I haven’t had any issues.
T3 is outside of the established medical care that doctors are allowed to do. Despite their poor treatment of you, they risk their jobs and license to give you T3…even with a clear chain of labwork that establishes the need. So, unfortunately, you will likely have a difficult time finding one. People often say to keep rolling the dice until you do find one, but that is easier said than done. You might try looking for an “integrative” doctor…they blend western medicine with natural. You also may have better luck with doctors in private practice than in big clinics.
The other thing to note, the general reason docs add T3 is for mental health issues…so when you mention it, the doctor’s mind will likely attribute it to your being a mental health patient. Just know that walking in.
How I got to T3 only treatment was through a year long intensive trialing of all the T4’s…my labwork clearly shows that I over convert to RT3…to the point that I collapse. Mine gets around 200 points over range. Thankfully, my doctor is in agreement with the T3 only…I think I’d be dead without it. That said, I have other health issues that drives the massive RT3 conversion.
I hope that helps you in your quest. Sometimes it helps to ask your dr to consider trying it, to see how it goes, with new testing in 30-60 days…sometimes they will do that.
Another thing you might consider is Tirosint. It is a T4 only with no fillers.
Faith, question….why do you say that you can’t forget or skip a day? I am on 15mcg of time release T3 and the pharmacist told me I could try taking it every other day and see if that helped my side effects….?
Hi CJ,
What might explain the differences…if you on T3 as a supplement to T4 or if you still have your thyroid gland.
I have no thyroid gland, nor do I take any T4. T3 does not hang around the body in the same way T4 does.
Hope that helps.
Faith,
yes, that makes sense. I do still have my thyroid. Would you mind taking a look at my numbers I posted down a few days ago on this thread and give me your thoughts? I am still trying to determine if I want to keep on this T3, and/or try the Lugols iodide/iodine, or just skip it all and try and figure out my autoimmune stuff.
Backstory- I took antibiotics for about 2-3 years for acne as a teen…later developed an allergy to that abx and also chronic urticaria which I have to this day (managed by daily zyrtec).
Hi CJ,
I looked at the labs, however, you did not offer the lab’s normal ranges. That said…two thoughts.
Most people coming to this article have normalT4 and low T3 (if you haven’t read the article above, you may find it helpful). The general reason for this is another health issue unrelated to the thyroid. You mention autoimmune, so that would likely be the cause of low T3. The operating theory is that when you resolve the other health issue the T3 will return to normal on its own.
As to iodine, I would be against it…at least until you do more research. MANY practitioners do not understand iodine and just spit out internet crap about it and thyroid. We cannot use any thyroid we take in UNTIL the thyroid digests it and makes it bio-available. The thyroid does so with 2 things, Thyroid-Peroxidase (TPO) which breaks it down, and TG which binds it to a thyroid molecule. BOTH of these things are the prime subjects of attack in thyroid autoimmune (that said, yours was negative). Taking iodine whenever there is a possibility of thyroid autoimmune will just subject one’s body to attack, which can become medical quite serious and even life threatening.
The other important part of thyroid function to understand is that T4 (yours is presumably normal) is one thyroid hormone with four iodine molecules attached. We convert to T3 by liberating one iodine molecule. If you have normal T4 you have ALL the iodine you need.
The only true cases of iodine def are when people cannot make enough T4.
Hope that helps.
No one has a solid answer on whether to sup T3 when it is low due to health issues. I think the answer should depend on the individual person – if it helps, do it…if not, don’t.
Thank you. That does help.
I decided against the iodine, I stopped taking my T3 for now and am trying to heal my autoimmune issues and see if that changes my low T3. If my TPO was negative, can that be a false negative or is there another explanation there? I KNOW I have autoimmune issues. Does this test simply show if the issues are affecting the thyroid?
Hi CJ,
Yea, the TPO is one aspect of the thyroid…Thyroid Peroxidase, an enzyme that breaks down iodine so that we can use it.
In general autoimmune is tested by the ANA or FANA, then there are more specific antibody tests as well. Also, the inflammation tests are C-Reactive Protein, and SED Rate tests.
Hope that helps. 🙂
-Thyroid Stimulating Hormone (TSH)
1.210 uIU/mL
0.270-4.200 uIU/mL
Hi Faith. I copied down my latest labs, from a few weeks ago (plus the ref. range). I did end up asking for testing for the other antibody, which was also negative. So I am pretty confident this is not Hashi’s. I went off the T3 almost 2 months ago. Felt ok for awhile and have developed terrible fatigue. I am seeing a functional med practitioner now (I didn’t like how the other doc pushed T3 and high iodine). She has me on a supp. called thyrosil which does have iodine but only 150 mcg daily. I see her again next week to go over my labs and get the results of IGG testing for food sensitivity. Anything else you can think of that I should request or ask? It is a conversion problem, apparently, and I can’t seem to get the right balance. Reverse T3 is all too high as you can see.
As always. I appreciate your knowledge and input.
-Free Thyroxine
1.42 ng/dL
0.65-2.00 ng/dL
-Free Triiodothyronine
3.2 pg/mL
1.8-4.6 pg/mL
-Reverse Triiodothyronine (T3)
25.8 ng/dL
9.0-27.0 ng/dL
I’m on 50mcg per day, taken in 4 doses (11.25mcg per dose).
Sorry, 12.5mcg per dose.
Duane, do you take it on an empty stomach? I think my stomach is never empty. I.e., it’s slow, slow to empty. So taking 4 doses a day seems hard.
Formerly an overdosed Armour patient, and briefly a Levothyroxine patient, which exacerbated my insomnia, I’m now on an OTC, Swanson’s Thyroxine-free Bovine Thyroid Glandular. I’m alternating 1 a day, 2 the next day, then 1 again, etc. Swanson’s isn’t allowed to make claims, so they won’t answer my question does food interfere with this supplement; but I assume it is T3, so I assume yes.
I read stories like yours and want to try a more quantified approach to how much and what timing works for me. But as it is, two doses requires that I pay way too much attention to what I eat and when.
Here in Tennessee, we alternative patients have to do most of our own thinking; holistic practitioners are rare and out-of-network.
Well, I’m in Canada, and the situation isn’t much better. I’ve been told at least some of your holistic doctors can write prescriptions – ours can’t. So either way you have to convince a family doctor of your issues, and that’s not always easy since most of them assume you are a hypochondriac with access to Google!
I usually take the first dose on an empty stomach when I wake up and then take a shower. I’ll eat about 30 minutes after that.
Then usually another dose around 11am, which is usually an hour or so before eating.
Next one is usually around 3pm or so, usually between meals.
Last one is usually around 7pm, or so, so typically after dinner.
I don’t find food much interferes with it for me. I read something about calcium blocking the effects, and that seems plausible, since if I have milk in my stomach I don’t normally feel that subtle warmth that happens about 15 minutes after taking a pill. But I’ve been tracking my temperatures and they have consistently trended upwards since starting, so it appears to be working at least.
I took a T3 replacement for about 3 weeks. I become so swollen I could barely walk. Could hardly bend my fingers. My hips ached and knees were extremely sore and could barely bend them. I was out of town and returned to my doctor telling me to stop immediately. I had a severe reaction to the medication. He advised me to start again at 1/2 dose, however, I simply cannot bring myself to begin on it again.
My uneducated opinion is that the problem with L-T3 is that the smallest possible dose is way too high. My doctor gave me a free rein to take up to 2 pills per day as I felt I needed it.
I started on it, but after the first dose of 1/2 pill, I could tell it was too much, so I decreased it to 1/4 pill every other day. Eventually I figured out how to split it into eighths and took one a day for a week then advanced to 1/4, then another week took 3/8 etc. until I was stabilized.
I am off of it now but I am convinced it was good for me at the time.
Fern, the lowest dose of T3 was too much for me too whether armor or cytomel. Time released compounded T3 was the only solution. I am not on T3 now either but have made the T4 work for me. I am sure the addition of about 3mcg T3 would be just right for over all physical well being and bring my level to something more acceptable than lower 10% of the labs. At this time I am having a hard time finding a healthcare provider that will even allow me to stay on my current 112T4 since they see my nonexistent TSH as a threat. That’s what get for trying to find a dr near home I guess. At this point I will either end up traveling to my old dr or get what I have been using-112 from my sig other who is a veterinarian (not sure that is going to work…)
Hello,
I could really use some advice. I am 37…healthy and of normal weight. I am so confused with all this conflicting thyroid information and am thisclose to just chucking all the meds in the trash!!
Here was my initial blood work results:
TPO- NEG
TSH- .99
Rev T3- 22
Free T3- 2.8
T4 1.2
Vitamin D was a bit low, and ferritin was very low, 18!
I have been taking a T3 compound called Triiodo-l-Thyronine Sodium S.R. I started at 10 mcg, went to 20, it wa a bit high so I am not taking 15.
My integrative Dr. wants me to be taking Lugols Iodide/Iodine. I have not been tested but she maintains she is 99% sure I am deficient. I am just really unsure about it. Reading about the issues with taking only T3 make me more unsure about taking that compound as well.
I will say I feel great. I have more energy and feel happier and more like myself than I have in years. BUT I do not want to take any chances with causing a more severe health issue. I can GET BY without the meds if need be.
I know I have some autoimmune issues after taking antibiotics for a few years as a teen (acne). I have chronic itching and rash that I take zyrtec for. But my TPO was neg, so no Hashi’s?
Please please help me understand this better!
sorry, that should read “I am NOW taking 15″… as in mcg
Do any of you have any expertise reading the test results, and would be able to look at mine above and let me know what you think? I can’t find anyone in town to give me a second opinion.
Diagnosed with Hashimoto’s mid 2013. Fatigue, depression, consistent weight gain, loss of hair. Primary doctor told me to exercise more and eat less. On the way out the door my comment about my swollen throat caught his attention. He ordered a THS which can back 98.8. I went on levothyroxine but 2 days later had swollen tongue and difficult breathing. Dr said that it must be an allergy even though you can’t really be allergic to thyroid medicine because of its integrity to the natural compound. Sent me to an endocrinologist who did several tests for autoimmune and said no Graves, etc. Switched me to Synthroid. We messed with dosage for 8-9 months and then stayed at 150 daily and 2 xtra 125’s on weekend. Some symptoms have gotten a little better but still loss of hair , weight gain, lack of energy…but the stuff that really bothers me is the lack of desire for about anything…and the fog. I am definitely not my dual-tasking self. Everything takes so much energy both physically (which could be the weight) and psychologically. I miss the old me…and everyone else around me does too. Today my results were TSH 2.22, T4 FREE 1.3, T3 FREE 2.2. Any suggestions with what I could talk to my doctor about?