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Low T3 Syndrome V: Should It Be Treated with Thyroid Hormone?

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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.

In other words, T3 levels are low because the body is attempting to conserve energy and resources to better cope with the challenges it is facing. Increasing thyroid hormone levels in this situation could conceivably have adverse effects.

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.

Taking T3 when you don’t need it is potentially dangerous. It can significantly upregulate the metabolic rate and lead to cardiovascular complications in some patients.

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:

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1,033 Comments

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  1. Chris,

    These articles have been very interesting. My family has a history of autoimmunity, and I have MTHFR mutation, double HLA DR dreaded haplotypes, high biotoxin/inflammation markers, high lead during provocation, high measured inflammation (up to 6 inches at the waist in one day), and a past CMV infection. With what you said about “infections, autoimmunity, and inflammation”, sounds like I’m a poster child.

    When I started on naturethroid, I experience uncontrollable weight gain (40-lbs in 1 year on a paleo diet while working out 5 times per week) and sudden vision decline – both which continue to get worse and worse with no end in sight. What were the typical bad effects from taking thyroid hormone when the underlying issue was infection, autoimmunity, and/or inflammation instead of the thyroid? I am very tempted to stop the thyroid hormone and see if things improve. Since taking the thyroid hormone, my TSH came down, but my t3 free and t4 free *never* changed, and my reverse t3 has always been 11 or 12, with that t3 to reverse t3 ratio being around 25.

    I have been taking LDN for two months now, so hopefully this will help, but my doctor said that it can take up to 6 months to see any benefits. Why does it take 6 months? I feel very skeptical of this medicine, but I hope that I’m wrong since nothing else is working.

    Thanks,
    Camille

    • Camille, I’ve been on 4.5 mg LDN for 2 years for autoimmune issues. It’s been a miracle. Elevated my energy and mood within days, then took 12 weeks to get my autoimmune disease into remission.

      • Just curios Viv, my doctor is suggesting LDN for autoimmune issues, did/do you have any side effects from taking it?

        • Deb, I had brain fog, slight headache and grogginess for the first 3-4 days, then the cloud lifted and I felt great. I lost some weight, especially water weight, and I notice I have to get up to pee about 2-3 hours after I take it. Some people do experience insomnia, but others sleep better than before. I notice if I take the pill and don;t go to bed right away, it can delay my ability to fall asleep.

          • Thanks for your reply Vi, I will have to check it out. I have had so many bad side effects from traditional drugs that it’s hard to want to take anything!

            • On LDN, I had really weird dreams and slight insomnia for about two weeks and then that went away. I feel a bit more energetic in general, but I don’t feel a huge change. My doctor said it can take up to 6 months to see any benefit.

  2. I have mild dermatomyositis and have long had signs of “clinical hypothyroidism” — low BP, low HR, low body temp, cold intolerance, etc. TSH and antibody tests were always normal but TSH started to creep to higher than “optimal” range and T3 was low. Integrative medicine doc prescribed 5, then 10 mg Cytomel, which made me feel much better, then switched to 1 grain Armour Thyroid. Thyroid tests came back slightly high, so she switched me to 3/4 grain Naturethyroid and I’m feeling great. I did have a moderate flare of the DM after I started the thyroid meds, but I had an EBV relapse and gluten exposure to blame it on, so I’m not sure the thyroid meds contributed. Doc called it Wilson’s Syndrome.

    • I was told several years ago I had Wilsons Syndrome, but try to get anyone to treat it properly. The only thing I had good results from was T-3, in the form of a Px called Cytomel. The integrative Dr. also then put me on Armour Thyroid, and it did not do well.
      I am so worn down from no one finding out what is wrong with me I just keep chasing symptoms. Sigh

  3. Good Morning . . . I’m sure my story is an old one, but it’s certainly new to me. This whole thing started a couple of years ago – subtle weight gain. Honestly, I was baffled by it. After being a woman who had dropped 115 lbs in 4 years, I had embraced my new life fully. My eating went from disastrous to healthy, and my activity went from couch potato to athlete/personal trainer/coach. I never “fell off the wagon” because my changes were life changes. Anyway, little by little I was gaining weight. No matter what I did, nothing seemed to make a difference. I visited numerous docs, and oh wow, what a depressing time. I’ve been told to eat less and exercise more. I’ve been told that obviously I’m depressed. LOL! I was also handed a script for weight loss pills and then asked “Will that make you happy?” Last August, I was hit between the eyes with a fatigue and brain fog that I had never experienced before. I had begun to lose hair, struggle with constipation, and felt easily chilled. My husband made an appointment for me to see a sports med doc that we both respected. He truly was so validating. He KNEW that I did not feel well. He began to run a myriad of blood tests to try and find out what was going on. The only test that came back grossly abnormal was the RA Factor. Among many other tests, he did run a thyroid panel which included TSH (middle normal), T4 (high normal), and T3 (low normal). At the time, the focus was on the RA Factor. Honestly, I thought it was a false positive, as I really had no joint issues to speak of. Still, he referred me to a Rheumatologist to get things checked out. In the 6 weeks that I had to wait for my appointment, I woke up one morning to my hands/fingers looking like sausages – stiff, swollen, and red. I was mortified, but the blood test result became more real to me. I since found out that my grandmother had RA also. Since the end of September, I have taken Plaquenil (did not help at all), and Methotrexate which I took for almost 5 months. In the beginning, it seemed to help, but then it didn’t. Actually, the side effects became unbearable. Now, I’ve just started taking Enbril – TNF inhibitor. Still, I continue to exhibit hypothyroid symptoms. My weight gain has been around 30 lbs since this all started. I’m so so sad and frustrated. I continue to eat clean and I exercise, even when it doesn’t feel good, yet my body weight never drops. Chris, when I was reading these articles on inflammation, I was drawn to your information on TNF and Interleukin-6 receptors. Enbril is a TNF inhibitor. My last appointment with the Endo, I told him about my continued issues with hypothyroid type symptoms. He looked at my blood work and told me that he did agree that my T3 was quite low, especially compared to the TSH & FT4. He referred me to a ENDO which only resulted in getting a prescription for weight loss pills. Truly, the guy did not care. Sigh . . . I decided to take matters into my own hands and pay out of pocket, on my own, for some thyroid blood tests. The results were TSH: 2.750 (.450-4.500), FT4: 1.30 (.82-1.77), FT3: 2.6 (2.0-4.4), Reverse T3: 21.8 (9.2-24.1) with a FT3/Reverse T3 ratio of 12%. Bingo! Autoimmunity antibodies were surprisingly negative. I think I found the answer to my hypothyroid symptoms and weight gain. Then, I read your running articles on low T3 and found it interesting that high levels of Interleukin-6 would cause an elevated Reverse T3. I started wondering if Enbril is not the appropriate RA med for me – maybe a IL-6 inhibitor instead. I’m also debating on working with taking some T3 as well. There just has to be something that will help me. Thanks so much for your insight and articles.

  4. When I was 35 years old I began to have symptoms of low thyroid. (I have no idea at that time what my problem could be.) I went to a well know internist who did TSH level and told me my thyroid is fine and asked me if I was having trouble at work, or with my husband, or anything else. I continued to have the following symptoms for YEARS: difficulty concentrating and staying awake, continuous pain in my legs 24/7 unresolved by pain meds or elevating my legs, severe constipation, and other more subtle symptoms. I moved to California, and when my father visited he said he had never seen anyone so tired as I was. A friend gave me Armour Thyroid to try. After one week all my symptoms when away! I continued on Armour until I had to change physicians, and my new physician said I only needed Synthroid. That was a disaster. My symptoms came back plus racing irregular heart rate, urinated 4-6 times a night, and severe difficulty concentrating. After several years another doctor gave me cytomel and I have been fine since them. My TSH and T4 levels are always almost non-existent, and my T3 is a little below normal, but I feel fine.

    • I have had the same results. Awful symptoms for 3 years, countless doctors, no answers or improvement. Finally my doctor tried Cytomel. Within 2 weeks I could tell improvement and after 6 weeks it was amazing! However, after 12 weeks, my levels started falling so they decreased the dosage. Withing 3 days symptoms had returned! I asked to go back to higher dose and was told to go ahead. However, he referred me to an endocrinologist who poo-pahed the use of Cytomel and didn’t seem to believe me. Felt more harm than good would come from using it. After the tears started to fall because I told him this was the ONLY thing in 3 years that had made me feel better, he agreed to continue but on a lower dose. 1-1/2 days in to lower does, symptoms returning! So frustrating. My TSH, Free thyroxine and T3 uptake are all almost non existent – yet I feel good.

  5. I am posting this again at the bottom of this board as people tent not to go back & read replies to old post:

    I have followed this diatribe and argumentation between IVY & Faith since the top of this tread & I feel like at the beginning of it, it was more of a misunderstanding than anything. The first thing that ticked me off was when Ivy said, “Faith is very educated but her condition is so unique that you should not follow her therapy.” Funny thing is that Faith said, everyone’s condition is different & should be treated on an individual basis (which, is very true but I cannot find her original post with her exact words). She was totally right. But then after seemingly being harrassed she said, “Vit D and Thyroid are NOT connected (nor do I view adrenal hormones and thyroid as being connected), OTHER THAN they share a receptor, and the hypothalamus as a control. Each endocrine hormone has its own chemical/biological pathway, and are controlled by completely separate chemical/biological markers. I have often suggested that people may have issues with hypothalamus or pituitary IF they have more than one endo hormone issue. But no, individual hormones, have no bearing, biologically, on other hormones…they are for all practical purposes, unrelated..” This statement is just plain false. What Ivy has said over * over again is that if one hormone &/or essential nutrient gets out of the normal range, many more usually started getting abnormal, as well. But Ivy when you responded to Mohamed, I think I began to see a little but of what Faith was talking about, your responses became manic & never-ending. This comment section was entitled “Have any of you tried thyroid replacement for Low T3 Syndrome? If so, what was your experience? Please let us know in the comments section.” Ivy, although, I feel you mean well, you are not a doctor. and you do not know why Mohamed was taking psychotropic medications & I hope to God that he has not committed suicide or attempted to commit suicide or some other horrible psychiatric problem has happen to him as a result of your irresponsible admonishmement for him to get off of them because he has of Low T3. It is not your place to suggest that anyone to get off psychiatric medications, for any reason WHATSOEVER, especially, in order, to raise their T3. Also, Mohamed posts is about having hypothyroidism & these comments are supposed to be about people who only have Low T3. Ivy, you obviously have a lot of personal experience with hormone imbalance & you have seemingly overcome a lot, if not all of it & you feel wonderful about it & did a lot to help yourself overcome your situation. You have a lot of helpful advice to give & you need to keep giving it. But when someone’s passion overcome’s their ability to be rational & responsible then that person begins to lose their credibility & their arguments just stop holding water. I feel at this point the author of this article, Chris Kresser needs to jump in & correct some major misstatements that have been made on here & reign this comment section in & think about posting a date when this board will be discontinued or brought down as it is getting out of control.

  6. I was diagnosed with very low TSH and T3 a year ago, after gaining 15 pounds in a very short period of time with no change in diet – I have eaten no sugar or any other refined carbs for years and eat all organic – or exercise regimen, after being a lifelong normal weight person. The worst of my symptoms was inability to maintain normal body heat and I spent the most excruciatingly cold winter of my life. I was put on ArmourThyroid and continued to be cold all the time and the weight gain never budged. I then spent considerable time educating myself on everything there is to know about the thyroid, from a lay person’s perspective, and came to the tentative conclusion that I may be converting too much of the T4 in the medication to rT3. I also suspected some level of leptin resistance as a result of the recent weight gain. I requested that my doctor order the relevant blood tests, which he did. In addition, I requested the tests for thyroid antibodies to rule out Hashimoto’s and I am also am aware of the inflammation issue and put myself through an elimination diet to determine whether I was intolerant of any foodstuffs, which I am apparently not. As it turned out I have no thyroid antibodies, my TSH was normal to slightly high again but my T3 to rT3 ration was off, as in, too much rT3. My leptin was normal. I have now been on compounded T3 for three months, starting with a very low but steadily increasing dose of time release T3, and carefully monitoring my basal temperature and other symptons, and have topped out at 44 mcg per day, taken in three doses, the largest being in the morning. As of about a month ago, I am, for the first time in a very long time, no longer cold. That in itself is just the most wonderful thing I have experienced in a while. Aside from being able to maintain normal body temperature my weight is slowly coming down, emphasis on slowly, I have lots of energy and my mood is more stable as well. So this is my story. Feel free to contact me for more detail on blood test results or any other questions.

    • What should the free t3 /rt3 ratio be? I started tirosent 4 months ago. I had tsh bouncing around 2-4, borderline low t4 and low t3. My rt3 has gone from 13 – 25 during this time. Tsh almost nonexistent, t4 a little high and ft3 a little higher. I actually feel pretty good but concerns I’m over medicated or should be taking t3 med. I am gluten free, celiac. Any advice?

    • I have been struggling with hypothyroidism and Low T3 Syndrome for many years and no endocrinologists are able to find a solution to my problems. Recently an eminent functional Doctor put me on cytomel and after a week or so I began to feel as if I was literally going to explode. He then changed me to a porcine glandular T3 and after taking it for two days I felt so terrible, I thought I would have to go to the hospital. Clearly my body rejected T3 replacement but I have extremely low free T3 and am exhausted all the time, unable to think. Does anyone have any ideas???

      • Hi Barbara
        I am really sorry that you have these symptoms, I know them from my own experience and still have them.
        However, I came across a book called “Recovering with T3” in which there is an abundance of information regarding all sorts of problems in the thyroid metabolism pathway, and you symptoms for instance could perhaps be low cortisol.
        I can only recommend reading this book, even if it is rather difficult to comprehend or grasp all at once. But at least this is very good information if you (like I) have to find out diagnosis and treatment on your own, because no doctor or endocrinologist is able (or willing) to help.
        Kind regards
        Anne

      • Hi Barbara,

        Is there any chance you could be allergic to any of the “inert” ingredients in either med?

        I had bad reactions to Mylan T3, which contains corn, but do fine with Paddock/Perrigo, which has cellulose as a filler. I can’t take NDTs as they all have allergens and must have T4 compounded.

        I’ve been utterly amazed reading drug ingredient lists to find carcinogens, allergens, sugar, and other stuff that shouldn’t go into our bodies.

        Maybe try a different generic if what you tried didn’t work.

      • Is it possible that you were given too much T3 to start? I think it is best to start very slowly and increase over time if necessary. Two months ago, I convinced my doc to add 5mcg of cytomel to my regular synthroid dose after my Free T3 test results were low. I take half a pill (2.5 mcg) in the morning, and the other half before I go to bed. I feel so much better…both increased energy and emotionally. Don’t give up!

  7. I gained a significant amount of fluid after taking Methimazole 3 yrs ago for graves disease. Now, I can’t get rid of the tremendous amount of fluid I gained (70lbs). Doctors are absolutely USELESS! .

    I’ve been told that T3 is the way to go with returning to normal size.

    Is that the case, I have tried EVERYTHING else (diet, exercise, etc). Nothing works, absolutely NOTHING.

  8. You all seem very knowledgeable and I am desperately hoping for some insight. I was on levothyroxine for eight years without issue. I was then diagnosed with Lyme disease and became very sensitive. I am on a very strict AIP diet and switched to Armour thyroid because I wanted something more “natural”. After three months on Armour I was having heart palpitations, racing, anxiety and insomnia (not something I had ever experienced before}. I stopped all thyroid 8 weeks ago and my levels are TSH 60 Free T4 0.3 Free T3 100 T3 47 Reverse T3 <5 Thyroglobulin Antibody 531. I have tried to start a compounded T4 and then Synthroid but each time my BP, Heart rate insomnia increase too much that I cannot tolerate it and stop all medication. I know I have to begin therapy and was wondering if maybe compounded T3 alone would be tolerated. Any suggestions would be sincerely appreciated. Thank you!!!

    • Ive also had lyme disease and it messes with all your hormones. See a llmd *lyme literate dr* or an *nd* naturopath to help you heal the lyme. You need to start there to get your immune system back into shape

    • You may be reacting to the armour? From what I understand, because of molecular mimicry, taking natural dessicated thyroid when you have elevated thyroglobulin antibodies may make the problem worse…

    • Disclaimers First – I am not a Dr but do have an excellent Endo (Dr. Kadambi – Ft Wayne, IN). My thoughts to help you are as follows: (1) The symptoms seem to be very consistent with a thyroid meds overdose (TELL YOUR DOC!). Thyroid meds overdose can be life threatening (think Thyroid Storm). (2) Too much thyroid med can happen for many reasons (your script was right and your stress level drops – warmer weather – lot-to-lot variation – change in your weight – change in when and with what you take the meds (milk/coffee/calcium vitamins can all interfere) – your own thyroid kicking in and creating havoc – etc). (3) The specific med that works for you is specific to your condition – and as frustrating as it is – the docs need to move slowly and carefully when trying to get you to the right place for your situation. (4) Switching from one med to another (Levothyroxine-Armour-Synthroid) is absolutely NOT like going from Walmart Aspirin to Kroger Aspirin. Many of my friends with Thyroid issues (I have several who I confer with on their experiences) have experienced this issue courtesy of the benighted yahoos at their various health care insurances flipping them. They all work for someone – but they may not work for you specifically. (5) There is a pretty good network of help in the blogoshpere – read up and don’t lose hope. (Also – depression goes with the hypothyroid territory – please remember that it is not REAL – it is your body trying to get you to pay attention – don’t do anything rash! – it may take awhile but you can get the right help.)

  9. I’ve been on Nature-Throid for several years. T4 alone didn’t work. T4 & T3 compounded didn’t work. To treat my symptoms, my NT dosage has to be high enough to raise T3 to the top of the normal range. That puts T4 above the high end of the range and TSH close to zero. I feel good, but my doctors hate my labwork. Any thoughts on how to do better?

    • I understand COMPLETELY!! The definition of insanity is doing the same thing over and over and expecting a different result. I have been through this with 3 endocrinologists and 4 primary care drs. The give me Synthroid, I feel sick, my joints hurt, I have brain fog, severe constipation, weight gain, insomnia, the list goes on. I get Cytomel and everything goes away. Literally. These 7 doctors are responsible for the 50 lbs I am overweight. One doctor didn’t believe any of this until I showed him a fresh bag of poop in which you could see that half the food was NOT digested. Then he started treating ME and not the piece of paper from the lab.

  10. anybody have a good NYC dr except Dr. Borenstein? he doesn’t take major medical insurance anymore.

    • Dr Levine in nyack. I know it’s not in the city, but he’s the only thyroid doc I’ve met that knows how to test the thyroid, including reverse t3 and proper ratio. He’s also the only one that put me on cytomel. Worth the trip. His number is 845-358-1700

  11. i create test on lab and this is my results
    T3: 2.2, T4: 1, TSH: 1.11
    Vit D: 18 ( i take 5000 per day from 3 months after this result )

    should i take cytomel? how much mcg per day and for how much time should i take it ?

    • you should take no t3 for now..only t4…t3 is not for everyone and not to be taken as sole therapy, Faith is very educated but her condition is so unique that you should not follow her therapy…she says that herself many times, you should take t4 but its normal that your ft3 is low becasue you can not convert properly without good vit D lvls and your lvls are very low

      • With all due respect, I said no such thing.

        Many people live very well on T3 only. Just because you have an opinion on need for T4 does not mean that is a shared view. I do not normally suggest T3 only (unless there is cause to) simply because it is more challenging to get a doctor to rx it, and opens you up to commentary from doctors who have no clue. Why put anyone through that? That said, if doctors were widely educated and it was widely available, why bother with T4?

        Vit D and Thyroid are NOT connected (nor do I view adrenal hormones and thyroid as being connected), OTHER THAN they share a receptor, and the hypothalamus as a control. Each endocrine hormone has its own chemical/biological pathway, and are controlled by completely separate chemical/biological markers. I have often suggested that people may have issues with hypothalamus or pituitary IF they have more than one endo hormone issue. But no, individual hormones, have no bearing, biologically, on other hormones…they are for all practical purposes, unrelated.

        I get that there are often internet fads out there, and I get that some well meaning practitioners sometimes capitalize on these fads in thinking…but I do not contend myself with any of that. I only look at how the actual biological pathway works. Because for me, I need real answers that really work, not things to try for the sake of trying something or supplements that don’t ultimately work. I don’t fault anyone who does do those things, I just personally don’t have time or health to waste on that.

        Never can man, no matter how much he tries, reproduce what nature created in us. Meaning, in that YOU could never, ever know what anyone’s ratio for anything should be, ever…because not only would it change throughout the day and seasons, it would be different in each person.

        There is no one right way. There is just the way we each choose, and in sharing the ways we have found, arm others with more information to make their own choices.

        I hope that clarifies.

        • hi Faith, ok i wanted to say you said yourself that people should not follow your therapy….

          as a person who is suffering hypo state i think i am called to say several of my observations that are written in the literature , and i have felt them on my skin too and these are:
          vitmain D and thyroid ARE connected, we just dont know yet how…

          and adrenals and Thyroid ARE VERY much connected….it goes like this:
          when you dont have enough of t4 or t3 you lack energy, adrenals pump to get energy …which is not there, your adrenals are constantly under attack due to lack of thyroid hormons, i know this very much becasue i have experimented with all possible doses, and I FEEL HEALTHY now so i can tell very well the difference between bad state and good state….and this is what i discovered by trying to lower my perfect therapy which includes 98.5% of t4 and 1.5% t3, this is by the way something that is called physiological dose….

          beeing on t3 only is not proper for majority of people, only for very sick who have no other way to fix their healt, also, beeing on a good therapy wont cure you instantly , the healing process may take 1-2 years when on a good therapy!

          • Ivy,

            I am not sure what your issue is today, but there were like 60 emails in my inbox today from you, and almost as many yesterday…or why you feel the need to say anything about what I say.

            My information is spot on accurate if you would pick up some medical texts or run it by a knowledgeable doctor you will find they agree with me.

            While I am glad you fixed your thyroid issue please be aware of the one guiding rule of this forum – EVERYONE IS DIFFERENT…and…WHAT WORKED FOR YOU WILL NOT NECESSARILY WORK FOR ANYONE ELSE.

            So please, take a rest from the forum today and let things go.

              • i came here to give some light into the matter , and we can join the forces…but i see you want to be the doc here….so be it 🙂 ….i am not interested in that……..did you hear about people in india who look at the sun and dont eat anything! for months……did you ever ask yourself why is that so?….its such a pitty we know so little…do you know that t3 plays role in ATP? mabye thats why t3 and vit d have the same receptor casue they are interchangable?

                • Ivy,

                  Attacking people is not the way you “join forces” with them…and it is not “lightness” either. It is negative, and hurtful.

                  I am very glad you feel you helped yourself. I would be very interested to hear your story. But to insist that your story is right and everyone else and their doctors are wrong, tends to rub people negatively.

                • Ivy,

                  I am very glad you feel you helped yourself. I would be very interested to hear your story. But to insist that your story is right and everyone else and their doctors are wrong, tends to rub people negatively.

        • i really think you help people by your advices but i also notice that your knowledge is just half time true, becasue you are no MD, neither am i, but as a person who was very sick, and now cured….i give myself right to say something i am SURE of and what i lived through, also i read many medical books researches too….but most important i learnt it from MY BODY! my body is not lying, and i know that vitamin D and thyroid are connected, all 80 hormones are connected in a way if you lack one the other will be exploited more, thats why….when someone has metabolic problems: either diabetes, autoimune disease…it has to be tackled from 10 different points not just one, becasue all of this is like an orchestra, and this is something i found out very clearly recently, i finally understand how adrenals are connected with thyroid! ….you get anxious and depressed for the same reasons, when you lack energy….you go in the state of fear….panick attack is sudden onset of fear for life, while depression is ongoing state where you dont have enough energy for life…all of this can be healed ONLY by adresssing metabolis problem….
          also taking t3 only will mess up with your insulin lvls! this is proven too….measuring sugar blood after every meal

          so as long as i like what you say, allow that someone maybe has more knowledge of a certain matter then you do, becasue the truth doesnt lie with you.

          i hope my experience can help somone. i spent 4 years trying to figure out my condition! and whats the best of all it worked out!

          • Again, Ivy

            You are manically posting and you really are not making much sense.

            I have other emails I need to get to and it is really hard to weight through all these repetitive posts from you.

            I am glad you fixed your thyroid. Please consider taking a walk and enjoying the weather.

            • i am sorry you see no good in my info, read all of the posts, where i explain why its better to give a try on physiological doses of hormones, then jumping into the t3 quick fix…….i hope you dont mind that some other people can say how things work just as you do this EVERY single day 🙂

            • Hi everyone! This is my first time here and my question and comment will be lengthy so I apolize ahead of time. My problems have been going on for about three years, initially diagnosed because I had many complaints of extreme fatigue to my primary care doc who of course goes right off the TSH and no other tests. My TSH came back at 3.9 and I asked if I could at least try a small dose ? She put me on the lowest dose of Levothyroxine which did not nothing. Three months passed I asked for more blood tests, and once again she only did TSH and it was now 4.9 so she increased it to 50mcg. After six months of no change I wouldn’t leave the office until she promised me more tests. I wore her down I guess and she ran the TSH which now was 6.230, the free T4 which was 1.0 and the free T3 was 1.0. She thought maybe she could increase it to 75mcg which I knew wasn’t going to change anything, so I had to say goodbye to her!!!! A week later I found another doctor and brought all my labs which he refused to look at. Had me do some sit up/sit down exercises, checked my neck, asked me how I felt and then prescribed two grains of Naturethroid without taking any blood work and for to come back in 3 months. When I came back to see him after my labs came in I waited 3 hours and 45 minutes to see him. He looks at me, says your really strange, and then accuses me of taking meds incorrectly. His labs were TSH of 0.03, free T4 0.7 and free T 3 of 2.0. So he upped my dosage to 3 grains of Naturethyroid. His attitude put a bad taste in my mouth so I threw the prescription in the trash on the way out. It took me a week to find a doc that spent a long time going over and explaining everything to me and he said that the last doc was right to up my dosage. I just got his labs back yesterday and after 7 days without any meds my TSH went back up to 7.0 and my free T4 went further down to 0.6 and my free T3 down to 1.8. My reverse T3 and estrogen and testosterone levels won’t be back until later this week. He changed from Naturethyroid to Armour thyroid at 3 grains. I go back in two months. Since my brain fog is just so overpowering, I can’t seem to remember how he explained how all these things are connected and work together. You all sound so very knowledgable, could you look at my numbers and how and why they changed and rell me what you see? Sorry again for the length of the post.
              Thanks so much
              Laurie

              • Hi Laurie,

                How frustrating. I am so sorry that you are going through all that. If the current doc doesn’t work, might I suggest an integrative doctor? They are good about wanting to get to the bottom of things.

                There are two things I think about with lab patterns like yours, either classic low thyroid or Hashis, which would cause your TSH to go up and down.

                When you are truly low thyroid, like you were (high TSH, low T4, low T3 (which is what I think your numbers were since you didn’t include the lab normal)…you want to look into why you are not making enough. Assuming that you still have a thyroid.

                Sometimes people truly don’t have enough iodine. It is rare in our modern world, but not unheard of. Be cautious about taking it…but you might want to look into that and consider trying it.

                It may have gotten too much thyroid because you were taking thyroid (low TSH high T4). But it may also have been a Hashi’s swing, I believe in hashi’s it goes up and down. If Hashi’s you would want to be cautious in taking natural thyroids because that would have the same thyroid matter that causes the immune attack. It is not unheard of that people can take it with that condition, but it is something I wouldn’t do.

                None of the so called natural thyroid rx’s are as natural as they seem. Armour comes from Armour pigs, aka Amour Hot Dogs. Slaughter animals are fed excess endocrine hormone causing premature death. Some people do really great on it, just that I think it helps to have all the information. Also, they often use fillers, like soy, that inhibits the thyroid.

                You may also want to look into your diet and match that with what is known as “goitergens” these are foods that inhibit thyroid function. Soy and walnuts top the list, but there are many others as well. This might be playing a role.

                As well, antidepressants (not that you are on any) can inhibit thyroid as well. Something to think about if that is an issue.

                Hang in there. Keep walking towards your answers and you will eventually find them. I know it can be a frustrating long slow process. I really hope you find someone that can help you with this soon. And I hope you will come back and let us know how it goes.

              • Laurie, The ups and downs in your thyroid levels all make sense based on your increases, throwing it in the garbage and being without for days and so on. I liked the way your levels of T4&3 came up with the increase to 2-grains and the tsh went all the way down to .03. The increase to 3 grains is needed based on the inadequate t3&4 levels. The tsh should be low or nonexistent-.03. My tsh is always very low at .03 or .04. This last DR sounds like a keeper as long as he doesn’t believe the tsh is the gold standard. In the event you take other meds daily, a t4/t3 combo like armor is the best choice due to the effect other meds can have on t4 only. The first dr that dosed you based on tsh only…sorry you had to go through that.

          • I 100% agree with you! Thyroid, but D & adrenals are all connected, what I’ve read Ivy post is not accurate. This coming from someone (myself) who is suffering from all of the above. Regular doctors are clueless to how everything works!

    • also you dont take any thyroid therapy before you do ultrasound of your thyroid gland……no self medication!

    • i was diagnosed by Hyperparathyroidism from 6 month after 12 years of Suffering from symptoms
      PTH: 207 ( 10-75 )
      after taking 5000 UI Vitamin D for 3 months and 1200 MG Calcium per day now it decreased fro 207 to 52

      i still have osteoporosis and my doctor tell me it will take more than 2 years to get my bone density back to normal

      i think i have vitamin D in range now after taking it for 3 months and still take it.
      is my FT3 Low ?
      And what should i do now because we haven’t T3 in Egypt
      we have T4 only but i can get T3 online
      i get (Now Foods Thyroid Energy ) online and will start on it after it arrived to me
      i increased 18 lbs in last 2 months by eating less that 2000 calories per day and exercise 5 days per week (Length: 180 CM)
      i have cold hands and legs, taking depression medical from 6 months with Hypnotic (follow Psychiatrist)

      • hello Mohamed,

        1st of all i am no MD, so no doctor, i have fixed my thyroid problem, that was going on for a decade before beeing aware of it…and all i know comes from experience + researching……+ doctor.
        1. you have to have good doctor, that is very knowledgable of the matter
        2. i know that vitmain D FROM THE SUN is not the same thing as the one you take orally, its of MUCH better quality, the synthesis of it follows completely different path, through skin and not throuigh liver….we have limited capacity, with aging we can not use that much of the sun as when young…..so you have to get vit D from the SUN! not orally! it may not have all the benefits…..
        3. parat hormone regulates calcium which must be held in a very tight range this much i know, and thyroid hormones also affects metabolism of electrolites and minerals….its in the esssence of metabolic process….you ft3 looks low, you have to provied lab ranges,,,in my country all below 3 is VERY low, i had once 2.9 and i felt really bad!…..

        i cant help more, then warn that WHATEVER you put in your mouth you must know why and what you are doing……taking calcium only and not magnesium as well, doesnt sond balanced, the best would be you drink milk eat fresh cheese and let body recover in natural way but you have to fix PARAT hormon levels, i dont know how is that done! you HAVE to talk to a doctor

        low t3 is beneficial in your condition becasue higher t3 would melt your bones even faster so …you have to adress your FIRST problem with help of doctor…and BY NO MEANS TAKE T3 before you know why you need it!

      • oh yes your low ft3 is giving you all the symptoms:weight gain, depression, but you should not take t3 now! only t4 ……becasue this way you can not make much of mistake, so try with small dose like 12.5 or 25 t4 if needed

        so your condition is improving and your doctor is right! if you suffered 12 years undiagnosed it must take time to heal, the body NEVER heals overnight! its a healing process…i would only suggest you go in the sun 30 mins every day at least you have plenty of the sun there….but must be the strongest sun…your vit d would go up ……thats what i would do….
        and i would try with t4 to help your metabolism…try very small dose like 25 mcg t4 and see if you feel any improvement after 4-5 days….
        and you must wait for 6-12 months for this to start working out…..also pls dont restrict yourself from the food!!
        you have to eat….but try to eat only healthy food, and no sugars becasue when your enegry is low, i.e. thyroid not working ok then you have sugar cravings and eating sugar aggravates the situation even more…..
        i hope t4 will help you! t3 can be taken only as a part of therapy never alone!

      • taking psychiatric drugs can lower ft3!! its VERY bad to take them for a long time…after better readign your problem i am sure you must take therapy for thyroid too, and that t4 start with 25 mcg for 5 days if you feel improvement keep taking it ……and then see if the dose must be upped, on higher t4 doses you have to take a tiny bit of t3…..but you must be sure you dont take too much of t4 as well……it can surpress ft3 as well
        yes all of your symptoms come from very low ft3 and you should seek doctor for thyroid hormone replacement!

      • you are young and you should fight for yourself…..you have to avoid any pshyciatric drugs! and seek ways to fix metabolic problems , becasue those problems are at the CORE of psychiatric issues……search until you find…i always knew my panick attacks are coming from the bad heath and i would never take psychiatric drugs….and i had probably like 1000 panick attacks….had 2 of them every single day! and i would never give up…..fixing my health fixed all the problems that somone would describe as head problems, i could not drive a car!…..when your health is very bad and CALCIUM is the most essential mineral that builds muscless and electrical impulses in your head!……when you have calcium problem you cant fix it by taking some drugs that will throw you even more out of balance!

        remember everything you take will afect something else in the body! the question is only if body will find the balance with it….naturally or it will create imbalances in some other arrea…….give yourself a chance…and try to kick out psychiatric drugs…t4 may help you…..and if needed a tiny bit of t3! by no means more then 1-2 or 3 mcg!!COMBINED with t4 never alone. most of people here take like 5 times over this….let me know after 5 days how you felt on t4 and yes ask for a doctor for thyroid, you will feel much better you cant cure yourself alone

        • i was taking aside from my hormon therapy a little bit of zinc, selenium, magnesium oil over skin…..and good b complex…. this helped somwhat, also vit C! yes it must be taken so 1-2 lemons after going in the sun, without sugar vit C is very importan….everything is important but i can not elaborate here forever :)…..be happy with tiny improvements becasue big improvements come only after 1 month-2-3-6-12 month time…..

          • what is that now foods? no you should not take t3 first! NO NO , read my posts 🙂

            you should go in the sun and consider taking t4 only so levothyroxin t4…….i dont know what company you have there, and ask for a doctor!…..dont do it yourself…believe me! you can tweak from what docs say a bit but not take all on your own….i tested things on my skin and its hard way! and you can get lost.
            if your doctor doesnt see your ft3 is low search for a GOOD doctor that knows what is low ft3!

            • what all sick people want is to fix themselves over night, with one pill only, unfortunately it never goes that way….it so much better to give body to heal itself properly on a physiological doses and uses of hormone….so replicating what thyroid is doing a lot of t4 and just a tiny bit of t3! then jumping on the “FEEL GOOD overnight” that you can get from t3 , this is like taking the shortcut, thats why i wanted to warn people they can go 2 ways! but if you are observable you will see that t3 shortcut is not that nice one!…i was there taking 25 mcgt3 for 15 days! and it is brain drug…and i sensed what effects it produces, it messes a lot with insulin! hear, puls rate etc….you have to go out of the problem the same way you fell into it! you should do a lot of thinking about your life, your habits…and healing process is collaboration with your doctor, noone can cure himself alone, going t3 only by reading it on some forum, internet whatever….. and another wrong step in your life….unless YOU KNOW what you are doing…..

          • what all sick people want is to fix themselves over night, with one pill only, unfortunately it never goes that way….it so much better to give body to heal itself properly on a physiological doses and uses of hormone….so replicating what thyroid is doing a lot of t4 and just a tiny bit of t3! then jumping on the “FEEL GOOD overnight” that you can get from t3 , this is like taking the shortcut, thats why i wanted to warn people they can go 2 ways! but if you are observable you will see that t3 shortcut is not that nice one!…i was there taking 25 mcgt3 for 15 days! and it is brain drug…and i sensed what effects it produces, it messes a lot with insulin! hear, puls rate etc….you have to go out of the problem the same way you fell into it! you should do a lot of thinking about your life, your habits…and healing process is colaboration with your doctor, noone can cure himself alone, going t3 only by reading it on some forum, interent whatever…..is suicidal! and another wrong step in your life….

        • hey ivy,
          its an astonishingly bad idea to tell people who are taking psychiatric medication that they shouldn’t be taking them (long term or otherwise). you are not qualified, in any sense of the word to recommend something like that. 1. you have no personal knowledge of the person, what they are taking, or why. 2. you are not an MD, psychiatrist, etc. and i highly doubt even remotely close, 3. if someone was taking such meds, and decided to follow your haphazard advise, there could be DIRE repercussions.
          you need to exercise responsibility and common sense when doling out advise, or just dont.

      • Sounds very like Wilson’s Temp Syndrome but you need to take your waking temps at least for a few days to see if low [below 36C] and also later on in the day ti check rise [may not happen]
        I’m on T3 and worked up to 45mcgs a day split two doses. It’s not a bad drug at all but needs to a) be needed correctly and b) increases ultra slow with monitoring of BP Pulse and temps daily.
        Mine was Rx by a clinical pathologist in the end and he is open minded enough to let me get on with it.
        To answer the main post article, T3 is very useful in cases of Wilson’s. Read Paul Robinsons book on it- ‘Recovering with T3’ – and get wised up.
        T3’s not for everyone- but then neither is the awful, unconvertible by many, Levo T4.
        Vit D is best via sun -or Cod Liver Oil of the best quality.
        Hormones DO affect each other.
        T4 conversion involves Testosterone for a start and vice versa.
        We are complex organisms, indeed!

    • oh your vit D lvls are still low! should be 25 at least..if i remember numbers correctly….those numbers come in units 🙂 noone talks of units here hehe

    • oh your vit D lvls are still low! should be 25 at least..if i remember numbers correctly….those numbers come in units 🙂 noone talks of units here hehe…maybe thats why your ft3 went low casue you were taking vit D orally……so Faith is right about receptors….etc….

      i tell you sun sun sun sun……

    • Mohammed, you need a doctors to answer here. not the general public. While I believe many if not all of us on this site have T3 Syndrome, it is not for us to tell you what you should take.

      That said, the only thing I take it T3. becuase it is low. I don’t need T4. My T4 is fine, so I don’t take anything for it. The T3 works great for me. It helps me so much.

    • after trying (Now Foods Thyroid Energy) for 4 months i create another lab test and here is my results
      TSH 1.85 ulU/ml (0.3-5.5)
      Free T3 3.1 pg/ml (2-4.4)
      Free T4 1.1 ng/dl (0.7-1.8)

      i went to Endocrinology and he told my my both tests inside normal range and he have nothing to do with my
      then i went to my Psychologist from 5 days and after some argument with him he write Eltroxin 50 to me and i start to take it
      i will create a new thyroid test after 6 weeks and write here the results

  12. i very much like what faith says here, vit d is a hormone! its not vitamin….and it is very important as t3 there is some huge connection between vit d and hypothiroid status…..i know that beeing in the sun helped me tremendously with hypo symptoms that no homrones could cure only the sun, oral vit d is completely different thing then the one taken in the sun….it may help to improve depression somewhat but its limited compared to the sun…..

  13. your vit d is too low….only this is a sign of serious imbalances….you have to go in the sun for 2 months , but summer sun, not winter….

  14. Hello, I just received my lab results from my PCP. She has put me on 5mcg of cytomel. She said I am hypo and my T3 is low. My labs are as follows…. TSH 1.4 ,(normal) T4 free .99 (normal) and T3 free 2.93 (low) . I also have a low vit d25 hydroxyl of 19.4…….. Everything else was normal except my bili total and bili direct which were high by .1 I am 30years old and have no other issues that I know of. I was wondering if anyone had any advice for me. I don’t want to take meds unless absolutely necessary. Should I be looking for underlying diseases ? I do have stymptoms of fatigue, hair loss and intermittent heart palps. Any feed back is appreciated. Thanks in advance

    • Hi, and I am sorry that you are going through this.

      It is true, Vit D is another endocrine hormone, like thyroid. Unfortunately, they tested the wrong Vit D levels…they tested your storage Vit D. You need the 1,25 D test to test the active Vit D.

      The reason you cannot trust the other Vit D test, is about half the population has a genetic defect (that doesn’t bother them) where they over make the enzyme that converts storage D to active D…so will ALWAYS test low on the wrong test. Only by testing the active 1,25 D will you be able to know what your real levels are.

      Now, that does not account for why you have low T3, which does look like a classic sign of some other underlying condition. Heart palps are generally considered to be a sign of too much thyroid so I am kinda wondering if maybe you fluctuate from high to low? But I think your TSH would be wonky (over time) if that were the case.

      The body normally lowers T3 when it is trying to recover from things. I think the logic is to make you tired so you will rest so the body can better recover. This, however, does not help much in chronic illness.

      Sometimes a bit of T3 can really help…sometimes it doesn’t work well. T3 is something your body makes, so it is unlike a drug that is foreign to your body…if that helps.

      The trouble with the Vit D…is all endocrine hormones share the same receptor…and the receptors have a preference for Vit D over T3…so as to create a situation (when people take Vit D) of being low thyroid because the thyroid cannot get into the receptors, but having plenty thyroid in their blood on tests…making it hard to get an rx for it.

      This is why I suggest getting the 1,25 D test before taking Vit D. If the 1,25 D test is also low…they you will likely feel better with some Vit D.

      The other cause of low the wrong test and high or normal the 1,25 D test…besides genetic, is bacterial infection.

      On the side of screening for what else may be wrong, I suggest these tests:
      ANA or FANA (autoimmune screen)
      RA Factor (autoimmune screen)
      SED Rate (inflammation)
      C-Reactive Protein or CRP (inflammation)
      CBC with Differential (tells you what white blood cells are active)
      Along with, of course, the
      1,25 D test….(I like to get both the 25,D and the 1,25 D at the same time)

      Hope that helps.

      • hi Faith, is that your pic on? 🙂 looks beautiful

        heart palps mild one come from shift in hormones up down, what basically happens people who have sick or slow thyroid….dont get t4 or t3 in time, either there is lack of hormones or the conversion is not smooth…so one can feel heart palps, either from lack or too much, it has to be looked within the context.

        ft3 must be constant, this is why body created this perfect mechanism that t4 is storage and t3 active and must be kept in very small variation, so when there are fluctuations that you notice in heart, thats a sign you have imbalances…becasue body is trying its best to keep ft3 in constant flow!….and heart muscle is especially sensitive to that, thats why people who have low thyroid hormones over many years develope shortness of breath, and dyastolic heart problems….

      • and on vit D, vit D is not in competition with T3…..becasue t3 will be much better with your vit D lvls as they should be, i know it since i had severe hypo status for probably 6-7 years before i discovered it…..and beeing in the sun over 2 summers helped me tremendously, the vit D researches show that comes from sun is of much better quality, so taking vit D oraly will compete with t3 becasue it must be processed through liver the same as t3 but the one that comes from sun is VERY BENEFICIAL, and everyone with low vit D must be worried…..we all generaly lack sun exposre, and we can not live without the sun, it has huge role for our health!…….

        • Hi Ivy,

          Not meaning to argue, but they do compete in the receptor…as the receptor is one for all endo hormones, and prefers Vit D to T3. One study even stated that Vit D will “displace” T3 from the receptor.

          The normal lab test done is 25,D…that is the storage form and to understand it, compare that to the T4 test. Half the population will LOOK low on that test, but are not truly low.

          People need to do the 1,25 D test, which is comparable to the FT3 test, to see if they are truly low.

          Sun and supplement alike will help us make the storage form of Vit D or 25,D…which we will later convert, or some will over-convert, into 1,25 D the ACTIVE form.

          The problem for thyroid patients in 1) trusting the wrong D test, which for some will ALWAYS look low when true Vit D levels are not low; and then 2) supplementing…is that they may unknowingly be creating excess ACTIVE Vit D (1,25 D)…and the excess will bump T3 out of the receptors leaving one’s body LOW thyroid even though there is plenty of T3 in serum levels.

          This is not a problem for most people…but with the advent of the Vit D fad, and the misinformation from study after study that used the WRONG Vit D test…is that more people were taking Vit D than ever should have been.

          So again, the walk away should be to always insist on both tests, the 25,D that they always run and the 1,25 D that will really tell you what you need to know.

          Hope that helps clarify.

          • hi Faith, you are repeating this thing over and over again for a year that i know of, but probably for several years, you take this place as your private MD office 🙂 i dont intend to spend any more of my time here, if you got several mails it must be becasue of bad servers becasue i posted only about 10 replys to Mohamed mainly…..dont make out problems over that 🙂 i dont have time to spend living here on this page

            this is why i say to people to go in the sun only and not take oral vit D there are studies that show its not the same thing, i also dont have time to go into details how it all works, cause docs dont know as well…but i do know that if you are low on vit D compared to your best posssible vit D status you will not have energy! you cant convert t4 into t3….and this is why it takes time for hypo patinets to recover….vit D is crucial for life, its also very very logical…..all these problems people have come from lyfestyle chnages, most of these people work in the office…..there is no study done about thyroid status of people like farmers……this would put some light into the matter….also saying that body is compartment of organs, or compartment of individual hormons tells that you dont undrstand the core of life, i.e. metabolism and this all looks like blind leading the blind

            enjoy in your online MD office 🙂

      • and on vit D, vit D is not in competition with T3…..becasue t3 will be much better with your vit D lvls as they should be, i know it since i had severe hypo status for probably 6-7 years before i discovered it…..and beeing in the sun over 2 summers helped me tremendously, the vit D researches show that comes from sun is of much better quality, so taking vit D oraly will compete with t3 becasue it must be processed through liver the same as t3 but the one that comes from sun is VERY BENEFICIAL, and everyone with low vit D must be worried…..we all generally lack sun exposure, and we can not live without the sun, it has huge role for our health!…….

    • can you speak arabic?
      i create test on lab and this is my results
      T3: 2.2, T4: 1, TSH: 1.11
      Vit D: 18 ( i take 5000 per day from 3 months after this result )

      should i take cytomel? how much mcg per day and for how much time should i take it ?

      • mohamed? you come from the area where people cover too much of the body and is known for the lowest vit d lvls (middle east), your vit D lvls are too low to function normal, you must get 30 mins of sun exposure in the strongest sun light every day for 2 months to recover your vit d status!

    • Hi Nadia. I had heart flutters/palps with HYPOthyroidism. I had them during an undiagnosed 3.5 yr period of time. I did not fluctuate between hyper an hypo- my heart rate was a consistent low 55-60bpm. Cytomel 5mcg is what I am currently taking along with 112mcg Levoxyl. I have to divide my Cytomel into 3 doses per day. If I take 5 one time a day it makes my heart rate increase to an uncomfortable rate for a couple of hours. T3 is fast acting and has very short half life so it is better to divide and take throughout the day. The other alternative is to have it prescribed compounded and time released for a once a day dose-avg $40/mo no insurance coverage. Since you are not taking t4, you may find that you need more T3.

      • hello Becky no you should decrease your t3 to 3 mg max! you are taking too much of t3 , on a good therapy you should have 0 heart palpls!

        i fixed my condition over the 4 years time, it took me 6 months of extensive reseaching, and now after 1 year from educating myself i can say i am healthy person, with proper therapy , ofcourse, i can not live without my 106mgt4+ 1.5 mgt3……i chopp my 25 mg tablet, dont ask me how 🙂 but i nopticed that body doesnt mind if you take 2 or 1.2 mg even 3 mg is ok, all above those doses is too much and you get various issues……..read the book from dr blanchard its the BEST book on thyroid i have read….and i can prove you its all true whats written there

        • Ivy, I don’t have heart palpitations while taking my T3 and never did – even when I was taking seven twice a day. I had heart pabitations when I was low hypo thyroid undiagnosed. At that time-2002 to 2006 -my heart rate was consistently below 60 bpm and my blood pressure was somewhere at 90/60. Doctor never thought to run a thyroid lab eve with all the visits I made bc my body and mind were breaking down. Of course, I had to fire him. I was myxedema coma pre-coma and started losing weight after back to back bladder infections. He then put me on narcotics for add. Bad stuff for hypo undiagnosed.

          • i am so sorry Becky to hear that!! you were in a serious situation, your situation maybe does need quick fix by the help of t3…becasue you had no time to wait for a healing process, but in general i would always thrive to try to replicate the nature , becasue then you will be more healthy if thats possible ofcourse! its not possible for every single person! i also think Faith maybe can be on normal therapy..i dont know such things, i just want to say….that i was severely hypo..and my therapy could not work instantly it took me several years before the body started to work properly……but one should give a try with that physiological doses therapy for few years before jumping on a t3 quick fix…i read several books that helped me there….i know how t4 and t3 affect heart, its mainly t3 that casues heart palps, yes either when you lack it then you have low blood pressure and low HB or when you are overdosed, thats why i say heart palps can be from either too uch or too little hormons! one can get lost easily in those symptoms

            • Ivy writes: ” i also think Faith maybe can be on normal therapy”

              Ivy, again, with all due respect – I am under the care of a competent doctor who knows better what is the best treatment for me, than some person on the internet.

              I am starting to realize that you do not realize how you are coming off. To sit back and judge me and my doctors based on what worked for you is insulting and rude.

              Please, just let it go. Find what works for you, share your story…but don’t cross the line and start judging others, not if you hope to keep friendships with them. Please take in my words…and understand then in the spirit in which they are given.

              It is also overwhelming to check one’s email and have umpteen emails all essentially saying how right you are and wrong everyone else is, it is sort of insufferable. I am not sure what is going on for you, and I am a bit concerned…and thinking you maybe are not doing near as well as you see yourself to be doing.

              No one is trying to fight with you, I am hoping to just help you see yourself a bit…to understand how you may be impacting people here…which may not be the way you wanted to impact people here.

              Please take a step back and think about what I am saying.

            • Ivy writes: ” i also think Faith maybe can be on normal therapy”

              Ivy, again, with all due respect – I am under the care of a competent doctor who knows better what is the best treatment for me, than some person on the internet.

              I am starting to realize that you do not realize how you are coming off. To sit back and judge me and my beloved doctors based on what worked for you is insulting and rude.

              No one is trying to fight with you, I am hoping to just help you see yourself a bit…to understand how you may be impacting people here…which may not be the way you wanted to impact people here.

              Please take a step back and think about what I am saying.

              • it was typo, i replied later but the answer did not went through…..i wanted to say you CAN not…but you will see later when my answer wil be released…i said too many good things…..

              • yes i also think you should take a step back from this site, becasue it turned out into your private practise, and your knowledge is way below that…..

                • you missinform people presenting yourself, on vit d, on thyroid hormons you know very little….and especially on other hormones which you dont even consider in equasion, and yes they are very important…..adrenals will never be normal without good thyroid, insulin will also spike on too much t3, and on lack of thyroid hormones, this is why thyroid problem can lead to diabetes in some cases….its an onset of metabolic problems, and head is just one organ that suffers under metabolic issues….so people get depressed and all sorts of issues….and most of young woman have too low progesterone if their thyroid was not doign well, etc etc…..its always 3 homrones that are in imbalance when thyroid is not working well…etc etc…you dont know anything about this….so please take step back and alow that somone else has more insight into these topics …..this is me helping to see yourself a bit.

                • *Sighs* I am not even sure how to respond to you at this point.

                  The last couple of days you have been posting manically, and you are clearly not aware of the number of posts you are making or that each time it generates an email for people following Chris’s blog.

                  You seem to have some need to bait me, which is weird. When you put words in my mouth, I corrected you and clarified my words, and then you went on attack mode.

                  I am not sure what kind of response you are looking for or expect to get from all this, but the response you are evoking in me is one where I am thinking you have some kind of mental health issue.

                  You may not realize this, but I have some serious health issues going on with my mom right now and need to be attending to emails back and forth between her doctors. Amid everything going on right now with my mom, it is beyond hurtful and yuk to have to wade through umpteen emails of your posts to get to the ones from her doctors.

                  I have tried being nice, but that is clearly not working…so I am regulating posts from this site to my spam folder.. I do not think you are as healthy as you are saying, but the sounds of your posts…and I am concerned for you. Whatever you feel helps you, please get help.

                  Take care Ivy.

              • wanted to say that F. maybe can not be on normal therapy…becasue she will jump on my neck casue i made typo…also you notice english is not my native language and i want to say as much as possible in shortest time….casue i go out now 🙂 in the sun hehehe…..try to read some books, dr b. is genious if you ask me, he figured out soo well thyroid therapy that i wonder why docs still cant understand how it is all simple for majority of patients and still insist on wrong things like all t4 all t3 and such nonsense…..sooooo little knowledge is in the medicine compared to quantum physics and other areas….that i wonder why is that still so, and i know how much of suffer it is when your thyroid doesnt work only 10% from the optimal

            • Vit D….I was within range until I stopped taking t3 for 2years. At the end of the first year without t3 is when a D test was done that was low. My t3 lab went back down as well to within range but barely.
              At the end of the 2nd yr I had been on vitD for a full year and my t3 was still low barely within range.
              Also during those 2 yrs my legs have been scaley dry and my ankles more filled with what I thought was spider veins. My legs will not tan like my arms. So, I put my legs in the sun for a full hour this summer and they didn’t even burn.
              I have read that sun exposure of a large area of the body is needed to soak up vitD so I guess since my legs won’t tan I only soak up sun and D via my arms.
              Showed my ankles to the doc and he said they were varicose! I don’t have obvious varicose veins in my legs. He sent me to the vein center for a leg ultrasound and they found that I have sever reflux of the sephonous veins in both legs-bad circulation. Now I understand the dryness, pooling of blood at the ankles, no tan and possibly low D. I’m having the sephons ablated in January after the required 3-months of compression socks. The ankle veins started after 2002 when I started my 3 1/2 yr undiagnosed hypo period of time. They have gotten worse with time. But the dryness and no tan since the lack of t3. Will be interesting to see if D changes next summer. Back on t3 for 7 months but definitely not reversing the dryness or tanning ability. Also read that long standing hypo and pregnancy can cause sephon vein reflux.

              • hi Becky….yes i can confirm this with my own experience too!, this summer my ability to tan was the best in the last 15 years, my TSH before summer was 2.77 but i was on a good therapy and i felt good so i did not chnage anything, after the summer it fell to 0.7, and i never felt better in my life, also everyone noticed my tanned skin and i was really not doing much different then before, becasue if you would be too long in the sun you would get burnt…..so yes its true when you are hypo , you can not tan!…..also i completely chnaged into much happier person, now i tried to lower my t4 by only 10% and it did not work out, i was thinking that TSH at 0.7 is a bit hyperish but it looks like….TSH is not the definitive guide when you are on a therapy……yes this is what i understood even 2 summers ago, that every summer raises my health, so to sruvive winter time its best to be loaded and not defficient in anything let alone vit D, after 5-10 years of vit D defficiency i think people can develop all sorts of health issues…..thats why people get sick in the spring when their vit D lvls are lowest, hence this spring tiredness…etc…..this is why vit d is so important but as you noticed the ability to produce it falls with age! so its like any other hormone, as we age we loose it….unfortunately…..

              • i think taking too much t3 is not good as well, i tried it…..it must be balanced therpay i understood that you are on a combined therapy t4+t3, but you take too much of t3 i di dnot feel that good on the same therapy as i take now, but it improves gradually over time, also you must get the feeling of rested body…and never push it too much into exhaustion, we who have these problems should never exhaust ourselves….this is as important as taking good therapy…..if you take too much t3 the body knows it and reduces t4 in the body also makes tsh going lower! so that the process of conversion from t4 into t3 is lowered….unf there is no other way to heal that mechanism unless filling up the gaps in minerals, in other homrones..the body needs support from various sides……i took progesterone , but very small doses not the one like 20 mg, 2 mg per skin was enough….i did mistakes there taking 30 mg for 35 days….etc i did every single mistake….but how the body works with t4 and t3? body must be soaked with t4…..then in converst into t3…if there is enough ingredients..if there is not…you have to wait , rest, eat well, do all the good things for yourself…and go in the SUN! during the summer…..and miracle may happen! it happened to me, and i was not even aware how good i am doing….the same as i was not aware for 8 years that i have problem :)…..i wish you find your way…it takes a lot of thinking about your life ….i dont eat glutens , but eat all the rest, one can get easily lost in all the various info that you get to….but try to think how you lvied last time when you were healthy…..and how you felt….this is where you should aim…and go in the sun it helps in t4 to t3 conversion! so much that i start breathing properly in only 3-4 minutes in the sun, but the zenit sun not late afternoon

                • yes exposing all the body is the best, i take break from the office sit on a bench and sun my legs and arms….even belly :)….its that good, and take vit C if its summer! becasue it must go together, vit C is also great energy booster! sun can make you feel exhausted then take vit C and you will see the miracle happening!…i tried all possible suplements, spent so much money….nothing worked except few logical things like, a little bit of zinc, magensium, selenium, b complex….everything else you should take from fruits, vegetables, meat cheese fish….whatever you like to eat….no restrictions except sugars…and gluten stuff….if you eat live food you will thrive :)…grains are not live they can be stored for 2 years! all seasonal and you will see miracles, also i reduced exercising increased salt a bit this was tremendous help……little by little, it doesnt happen over night! but do all the good and thats all you can do….and be patient….dont obsess over therapy…beeing on too much t3 gives you a feeling of beeing healthy quickly, but …….try not to go above 5 t3 at least if you can not live without it….i never went above 3t3 this was enough …although my doc siad i can take 6 mg t3 🙂 i had tinitus when i was taking 6 t3…on 3 t3 it was perfect…now i am on a 2 t3 and its even better :)….i dont even feel if i take 2 or 3 i just get tinitus if i take too much…..i learnt my body, we all have to learn about our body!

            • Fluctuating T3 while consistently hypo undiagnosed makes sense for my hypo palps! I get that if the lab minimum is 78, I could have been at 55 low and food, sugar caffeine intake could cause a jump to 65 (if a lab could track that…). Then I would get a flutter from the increase-although still low -not “hyper”. I only remember having the palps whil hypo. Even when I went through thyroid storm when I was given prednisone for 3 to 4 weeks for tennis elbow – this is what brought me out of my severe stages of hypothyroidism. – I didn’t get palps. But, I felt like my body was going into shock and had to lay down for fear that my body was going to shut down . And then the doctor put me on thyroid medicine without listening to me. I asked him if there was a chance I could be hyper he said no there is no way. The reason I ask is because the uptake test technician came out before I left and asked me why I was there. I said hypo. He said I will get that rechecked. I looked at the test long after the doctor gave me my thyroid medicine and I was producing very healthy amounts of thyroid hormone. Nevertheless, I did with my doctor told me to do and I started with 25 µg and ramped up to 100. About a week to two weeks after taking 100 I start feeling symptoms of hyper- faster heart rate and hot. So what the doctor should’ve done is tested me again or at least taking my pulse before he gave me thyroid medicine. So of course I stop taking thyroid medicine altogether for about three months thinking that I did not need it. While I was coming down off the thyroid medicine I had pounding heart palpitations that started with a jabbing feeling in the back. My thought is that it was due to excessive release of adrenal cortisol. I say this because they ran cortisol test at about three months off thyroid med and I was in the Cushing’s range. At that point it was time to start squeezing thyroid into my body again. Armor with active T3 was killing me at the lowest amount I could take. So I eventually switched back to levoxyl and found out I need to add time released to t3 at 14 µg per day. Stop drinking tap water and I had to reduce my T4 to 112 from 125. Also on my own reduced myself to 1 T3 7 µg pill per day. Then on a trip in Jamaica my T3 which had to be refrigerated found a itself in a dead refrigerator. That ruined the T3. So I just stop taking t3 altogether -thought maybe I can do it now since not drinking tap water increased my t4 and the doc reduces to 112. It didn’t work and I was at the very lowest within range on T3 labs again, so I’m back on T3 for 7 months now. 5mcg split for 3 doses. No heart palp/ flutters.

              • oh yes yes yes i know it all!! i was on a wrong therapy for 3 years , was upped to 150mcgt4!!…it is disaster to push hypo people and push their TSH in 6 months let alone in several weeks, its total disater and not understanding of metabolism!…..if i could go back i would stayed on 65 mcg for a year before upping it and adding like 1 mcg of t3……becasue just like you my adrenals were under great stress when i was on 150 and my body was not able to produce that energy thyroid is gass peddal! if you dont have fuel you cant produce energy!….fuel is progesterone..and all the things you misss in the body….you should have taken progesterone for elbow!! progesterone works tremendously antiinflamatory! a little bit 2mg not 20 daily….and it is not a lifelong hormone it can be stopped ….its miraculous, i put it on my knee….i was taking larger doses at the begining because i was experimenting 🙂 and it felt soo good….until i got issues becasue taking too much……

              • you have to find a therapy that you can take for a year….without changing, if your t3 goes low it means that there is too much of t4…….the best for you would be to be on t4+t3 in this 98%t4 and 2%t3….try like this…112+3 sounds like possible maybe it will be 120…or 107….you will know it in a month time……..unf i dont know your thyroid ultrasound…and everything about you to be able to say…but i trust doctor who did that for 50 years and he said he is sure of this that the above t4+t3 ratio is the only way to go……t4 is just for few …..t3 alone i wont even mention…..if you thyroid is sick, then do what that gland is doing not something else….if you are sick elswhere try to fix that…and not take t3 shortcut, t3 creates ATP, so it gives energy..but why body created t4 and every organ has its own way of converting t4 to t3….this is why taking t3 in doses larger then your thyroid makes to me makes no sense

                • maybe you need 65 t4+1 t3….dont know your numbers…, you should aim for t3 to be above 4! thats enough! mine is 4.1 and i have enough of energy!……if your ft3 is 5 this is defo sign you take too much of t3….when i was on 6 mcgt3 i had my ft3 5.1! and this felt good, but i had tinitus, and i did not want to go above physiological doses…now after a year i feel soo well 🙂 so its not all about thyroid only! there is much more to it all, and to the numbers!…..

              • you have to know what kind of an energy person you were before, i knew when i was on 5-6 mcg t3 that its not me! that it was false!….i di dnot want to take shortcuts…and today i am so grateful for beeing logical! it payed off.—–yes your blood numbers can guide you when you dont feel well…..but try to find some therapy that you can stick to for a whole year before changing!…..if your thyroid is very damaged then you need 100% of hormones …so 100t4.3t3 sort of lvl…..if its 20% damaged then you probably dont need that much but maybe half….my thyroid is like 40% damaged and 100% replacement i need! i cant go lower …..for now…and probably for another 10 years 🙂

  15. Perhaps someone can suggest a protocol to help me. For over15 years, I have been having 3 month cycles of hair loss and sleepless notes, only to be followed , 3 months later, with normalcy. I have had every endocrine and blood test and all fall within normal ranges, but, consistently, my total T3 is low, 100; and my TSH is low, -837; my free T4 is 1.2; and my free T3 is 2.72. My Pituitary tests are mid range. No one can seem to suggest what my problem is. One day, I took a half a tablet of porcine thyroid extract and I never felt better, but I don’t wish to self medicate without advice of a medical professional, but every one I go to refuses to accept that I have a problem. One even suggested I see a psychiatrist! Any suggestions?

    • So free T3 is supposed to be in the range of 3.5 to 6.5? Yours is 2.72. T4 max is 1.8 and yours is 1.2. Ask your doctor if he thinks it would kill you to take the next level of t4 above what you’re taking. And add 5mcg time released t3 to start. If he is not agreeable then you could try calling a compounding pharmacy near you to ask them what physicians prescribe compounded T3.- preferably the Doctor Who prescribes the most. That doctor may be more open to helping you by adding T3 at least or prescribing armor if you think that will make you feel better. They are his best taken in at least two doses per day. So whatever is prescribed break the pill in half and take it morning and night. I couldn’t handle armor. I use time released t3 and have my t4 near the top of the range. Tsh stays around .05(nonexistent- 8 years ). Psychiatrist? Not until the thyroid is right.

    • I was just reading yesterday about Non-24, a sleep disorder. Read the second paragraph in particular below:

      From the website http://www.sleepreviewmag.com/2015/05/need-know-non-24/

      Instead of sleeping at roughly the same time every day, persons with free-running non-24 will typically find their sleep time gradually delaying by minutes to hours every day. They will sleep at later and later clock times until their sleep periods go all the way around the clock. Patients’ cycles of body temperature and hormone rhythms also follow a non-24-hour rhythm. This is the characteristic symptom in sighted non-24 patients, but also occurs in many blind patients.

      Other patients maintain a sleep cycle linked to the 24-hour clock, but their underlying circadian rhythms, as reflected in body temperature and hormone levels, continue to cycle with a non-24-hour period. As a result, these patients experience a periodic form of insomnia. When their body clock is aligned with their sleep cycle, they sleep normally. When the body clock is out of sync with the sleep cycle, they experience severe insomnia and daytime sleepiness. The periods of normal sleep and insomnia alternate in a periodic fashion over weeks or months. This pattern occurs mainly in blind persons with non-24 but is sometimes seen in sighted patients.

      Since the abnormal circadian function in non-24 affects not only the sleep cycle but also multiple cellular and hormonal rhythms (melatonin, cortisol, testosterone, TSH, etc), other symptoms such as severe fatigue and digestive and metabolic disturbances are common.

    • I was just reading about a sleep disorder called Non-24. I may have it because, like you, I have periods of relatively normal sleep followed by long periods of insomnia. I would recommend seeing a sleep specialist who understands circadian rhythm disorders.

      Below is an excerpt from the website
      http://www.sleepreviewmag.com/2015/05/need-know-non-24/

      Take note of SECOND PARAGRAPH in particular.

      “Instead of sleeping at roughly the same time every day, persons with free-running non-24 will typically find their sleep time gradually delaying by minutes to hours every day. They will sleep at later and later clock times until their sleep periods go all the way around the clock. Patients’ cycles of body temperature and hormone rhythms also follow a non-24-hour rhythm. This is the characteristic symptom in sighted non-24 patients, but also occurs in many blind patients.

      Other patients maintain a sleep cycle linked to the 24-hour clock, but their underlying circadian rhythms, as reflected in body temperature and hormone levels, continue to cycle with a non-24-hour period. As a result, these patients experience a periodic form of insomnia. When their body clock is aligned with their sleep cycle, they sleep normally. When the body clock is out of sync with the sleep cycle, they experience severe insomnia and daytime sleepiness. The periods of normal sleep and insomnia alternate in a periodic fashion over weeks or months. This pattern occurs mainly in blind persons with non-24 but is sometimes seen in sighted patients.

      Since the abnormal circadian function in non-24 affects not only the sleep cycle but also multiple cellular and hormonal rhythms (melatonin, cortisol, testosterone, TSH, etc), other symptoms such as severe fatigue and digestive and metabolic disturbances are common.”

    • Basal body temperature is the only way I am able to regulate my thyroid. I started with 30mg of dessicated thyroid (Armour, West throid, ERFA, etc). I monitor my temperature first thing in morning. If its 97.8-98.6, then I’m in a good range. If temp drops to 97.6 or lower, I increase by 30mg. Very few doctors are up on thyroid, so prepare to do battle to get the amounts you will need. I now take 390mg of West throid in a.m. and again in p.m. Most Dr’s are quite ignorant on correct dosage. Therefore, carry a thermometer with you. That’s the only help you’ll get.

    • Have you had your thyroid antibodies checked for Hashimoto’s disease? It can cause thinning hair and can cause your thyroid labs to look normal at times. It can also cause those fluctuating sleep cycles as the thyroid fluctuates between hypo and hyper. Good luck.

    • you have endocrine problem thats for sure, your symptoms tell this, dont ignore it and who ever sends you to psychiatrist for hair loss, needs to loose job,cause thats a sign that person has 0 knowledge.

      do you take any meds? you should check also progesterone lvl, vit d lvl ,ferritin, b12….to see where you stand …..and then take proper hormonal therapy

  16. I’m at my wits end! I just got my newest labs back … I am currently on NDT but the day of the labs I didn’t take my pill and my numbers came back still lower than they should. TSH 0.57, free t4 0.9 and free t3 2.3.

    Sigh. I have microscopic colitis and celiac and spent all of last year getting MRIs done because every single hormone in my body was low. I am 34 year old female. My estrogen at one point sat at 23 yet fsh, lh, progesterone- all of them were significantly low. No pituitary tumor was found and at this point no one can offer an explanation or how to fix it. Last year I was pretty sick w colitis and by August I started putting on weight very quickly- 5 lbs a month until I hit about 25 lbs. I can’t lose a pound to save my life regardless of what j do. I am on nature throid (which has been doubled and tripled over the course of the year) and I still feel depleted and exhausted. I follow a strict Paleo diet and I also take LDN. Any ideas? If it isn’t the thyroid that’s the problem/ how do I fix this? HPS axis issue… Obviously with the pituitary gland this may make sense but I just don’t know how to solve it. Do I up my thyroid medication? Thank you!!

    • Hi Tori,

      Assuming that your only medications are thyroid replacement and low dose naltrexone, your low FSH and LH makes one wonder about pituitary malfunction caused by something other than a pituitary tumour. Pituitary underfunctioning is called hypopituitarism – here’s a link to the Mayo Clinic handout on it – http://www.mayoclinic.org/diseases-conditions/hypopituitarism/basics/definition/con-20019292 . Pituitary inflammation is one of the causes of hypopituitarism and is called hypophysitis.

      Given that you have celiac disease, the papers below on the association between celiac disease and hypopituitarism/hypophysitis may be worth discussing with your doctor?

      I hope you find the answers you need soon . . . .

      Best wishes,
      Gillian

      http://www.ncbi.nlm.nih.gov/pubmed/18463048 (abstract only)
      Endocr Pract. 2008 Apr;14(3):381-8. Celiac disease and the endocrinologist: a diagnostic opportunity. Fisher AH1, Lomasky SJ, Fisher MJ, Oppenheim YL.
      1 Endocrinology and Diabetes Associates of Long Island, Rockville Centre, New York 11570, USA.
      (excerpt from abstract) Celiac disease has been associated with numerous disorders, including several conditions treated by endocrinologists-type 1 diabetes mellitus, autoimmune thyroid disease, Addison disease, osteomalacia, secondary hyperparathyroidism, vitamin D or iron deficiency, fertility problems, hypogonadism in men, and autoimmune hypopituitarism.

      http://www.researchgate.net/profile/Barbara_Predieri/publication/6889850_Growth_hormone_impaired_secretion_and_antipituitary_antibodies_in_patients_with_coeliac_disease_and_poor_catch-up_growth_after_a_long_gluten-free_diet_period_a_causal_association/links/0912f511fa0de4915c000000.pdf (full text)
      Eur J Pediatr. 2006 Dec;165(12):897-903. Epub 2006 Aug 3. Growth hormone impaired secretion and antipituitary antibodies in patients with coeliac disease and poor catch-up growth after a long gluten-free diet period: a causal association? Iughetti L1, De Bellis A, Predieri B, Bizzarro A, De Simone M, Balli F, Bellastella A, Bernasconi S.

      http://press.endocrine.org/doi/full/10.1210/er.2001-0035 (full text)
      Endocr Rev. 2002 Aug;23(4):464-83. Endocrinological disorders and celiac disease. Collin P1, Kaukinen K, Välimäki M, Salmi J.
      (excerpt from abstract) The endocrinologist, especially, should maintain high suspicion and alertness to celiac disease, which is to be found in 2-5% of patients with insulin-dependent diabetes mellitus or autoimmune thyroid disease. Patients with multiple endocrine disorders, Addison’s disease, alopecia, or hypophysitis may also have concomitant celiac disease. Similar heredity and proneness to autoimmune conditions are considered to be explanations for these associations

      http://pathology2.jhu.edu/hypophysitis/pdf/483_2000_Collin.pdf (full text)
      Scand J Gastroenterol. 2001 May;36(5):558-60. Autoimmune hypopituitarism in patients with coeliac disease: symptoms confusingly similar. Collin P1, Hakanen M, Salmi J, Mäki M, Kaukinen K.

      • Gillian!

        Thank you for the reply. Yes I have had an MRI checking for pituitary tumor which wasn’t found… I believe some of my other hormones have come up a bit? But definitely not optimal by any means. Every doctor and endocrinologist seems to be baffled and no one can give me a way to fix it! I will look into the article that you have linked! Thank you kindly for that. It’s very frustating to have an issue that no one seems to have a grasp on! I’m not sure which direction to move next. Between the thyroid and celiac and colitis I also have a genetic mutation called MTHFR -(677 homogenous) and I’m not sure how it all relates together. Sigh. Thank you again for taking the time!

    • Hi Tori. If my levels were at the low end within range I personally would feel bad too. I was on my 5th day of augmentin for a tooth abscess when I had a 6 month check up scheduled for thyroid. My T4 went down to the mid point within range and it took 3 weeks to feel better. My cholesterol also went up 30 points and the results also showed I went through menopause(haven’t had the symptoms though so I am very suspicious). I take levoxyl 112mcg and it keeps my free t4 at the top of the range. My Tsh is always about .05 (non-existent basically). I do better with the T3close to the middle within range. By topping out t4 I get best t3 conversion I can get. If I add 5mcg of t3 it is enough. I prefer time released t3 once a day. I tried not taking t3 for 2.5 years and there is a tremendous difference in my skin, joints,etc. I feel better. My doctor told me last visit that there is a definite correlation between thyroid and other hormones. Tried armor years ago and it was too inconsistent. Might want to focus on improving thyroid labs. Don’t give up.

    • Take your temp! Odds are your temp is below 97.6. Your body cannot heal anything if it’s fighting just to keep your vital organs warm. T4 won’t help you. Most people cannot convert synthetic T4 to the necessary T3. Can’t get your doctor to get past his paperwork to look at his patient? You can get dessicated thyroid without a scrip at pharmaoffshore.com. But read my previous post concerning how to regulate your body temperature. I am a multi generational hypothyroid. Family members have hypo, hyper, Graves, goiter, etc. We all prefer natural to synthetic.

    • NDT has bad ratio of t4 to t3 ….the ideal one 98% t4-2% t3…so if you take 100 t4 you should not take more then 2 mcg t3…….for majority people…..your NDT has way too much t3 in it….also you will never feel better if you dont balance out all hormones: progesterone, vit d, ……only then your problems will fade away slowly….

  17. I have been getting full hormone replacement therapy for 16 years. I had two pituitary surgeries and lost the gland in the second one, I still have the stalk. I am still sluggish and have to force myself forward. I take 150 mcg of synthroid, 15 mg of
    Hydrocortisone, .04 mg of genatrophin (5x week), 100 mg test (per week). Is the T3, T4, TSH covered by the synthroid? Yes, it is very low.

    • Hi Anthony,

      The pituitary regulates more than growth hormone and testosterone, I am a bit surprised that you are not on some kind of replacement for the other things the pituitary does. You have probably already looked into the other hormones it regulates, but just in case:
      https://en.wikipedia.org/wiki/Pituitary_gland

      If the TSH and T4 are low, then you probably need to increase the synthroid. If just the T3 is low, that suggests that your body has some other illness pattern going on (and is normal).

      I cannot imagine, without a pituitary that you would feel good at all. Losing my thyroid, made me intimately aware, that we do not have adequate replacements. And it can be a fine art to get the replacements right. For me, my thyroid needs shift…sometimes I need more, sometimes less…and any deviation from what I need makes me feel yukky.

      I wish I had more to offer in the way of ideas. Keep looking, because eventually you really will find your answers.

      • she needs to replicate thyroid secretion in physiological doses so something aroudn 100 t4 and 2-3 t3 for a start….i was taking 106 t4 and 3 t3 for a year it helped me a lot…..i feel healthy again!

  18. So, I am new to this.. i have been feeling like i have all of the symptoms of something wrong with my thyroid so i went and got a panel done on my own. My mom and older sister both have hypothyroidism. My results came back as the following. ..
    T4 : 8.9 which is normal
    Free thyroxine index: 1.8 which is normal
    Tsh: 1.84 which is normal
    Then T3 uptake: 20 which is low.
    I haven’t shown it to my doctor yet but, im going to. Now I’m trying to figure out whats wrong with me???

    • I just thought of something else. I am also vitamin b12 deficient and was diagnosed with irritable bowel syndrome over 12 yrs ago. I can’t drink beer without it getting me sick. People have said that i may have celiacs but ive never looked into it. Now that i have low t3 and b12 those both can be signs of celiacs? Now, i think that i may finally ask about it with my doctor.

    • Hi Katie,

      T3 uptake and T3 levels are different things. You will want to test FT3 (Free T3) to check T3 levels.

      That said, in cases of normal TSH, normal T4, and low T3 is usually a sign that another disease process is going on. This is a normal thyroid response to other illness…so, not a thyroid issue per se.

      B12 will mess with all kinds of things. My doctors recommends Adeno-B12, which works very well…or hydroxyl-B12 which is a liquid. Again, not that adding B12 doesn’t go a long way in helping you feel better…to me is suggestive of another disease process taking hold in you.

      The question is what? And unfortunately, western medicine is not set up to help people figure out what is wrong, and they really fail us when it comes to things like this.

      If you have access to testing, I would recommend these:
      CBC w/ Differential
      ANA/FANA
      RA Factor
      C-Reactive Protein
      SED Rate

      These will give you a good idea what is going on. The CBC with differential will tell you what white blood cells are doing…you have different ones for allergies, for bacteria, for viruses, etc. The ANA and RA Factor are standard auto-immune tests. The CRP and SED Rate are inflammation tests.

      They also might be fine, and that does not mean you are fine…it just helps you know where you are in the disease process.

      If these tests are fine, the next factor to consider is diet. Diet can really affect how we feel, low energy and brain fog, and overall yukkiness. When diet does this, it creates the hot bed for disease processes to take root and grow.

      Ignoring what the “experts” say, because everyone and their brothers think they know…I personally have had the greatest success in trialing an elimination of all dairy and all grains. This is not easy to do for long without making major adjustments…but within a week if you can keep at it, you should see some improvement…and then after a week when eating it again, a reaction…and then you will know for yourself how you might be contributing to a bad out come for yourself.

      That is what steps I’d take next.

      Best of luck, and I hope you feel better soon.

      • Faith,

        I hope you don’t mind me butting in hear but that response is so informative. I have low-normal T3 and have severe CFS and Fibromyalgia. I’d love to get a better understanding of my illness. My GP said, “Just let me know what tests you want” and I didn’t have a clue. The Open Medicine Institute gave me tons of blood tests, but most of the tests you mentioned weren’t among them. Are you accepting new patients by chance….?

        Also, I have never had GI issues. Dr. Kaufman at the OMI gave me what I think was a rather dubious test for SIBO (the lactulose hydrogen breath test). It suggested that I had SIBO, so I went through two weeks of hell on Rifaxan and Neomycin. They didn’t do anything except make me feel even more horrible than I already do.

        So, my question to you is: If a person with CFS and Fibro has no GI symptoms, would she benefit from the diet you suggested above?

        Thanks again!

  19. This is a very interesting article. I was put on synthroid for just being borderline hypothyroid. It really helped for a short time as they said it was post partum. Unfortunately I was kept on it too long and now I’m suffering from heart palpitations and OCD and a menstral cycle that lasts up to 14 days . All of this is hormonal related and I have had no help from Drs except saying I need to see a psychiatrist and also put on birth control to regulate periods . I eat a paleo diet I’m active for the most part . now these heart palpitations happen right before a menstral cycle. No dr believes me that this is from being treated with a thyroid medication. They all say it’s a coincidence. I can’t afford to go to a naturopathic dr and all the Drs want to do are more meds and I refuse . I tried taking serotonin drugs for the OCD /anxiety and everything made it worse so I stopped. I would rather deal with the anxiety then have it worse. I went to a cardiologist and I do have mild mitral valve prolapse but I have never had any of these issues till after taking synthroid . Now I’m on birth control pills because a dr says I’m peri menopause at 35 years old. This is getting ridiculous. I know the synthroid have done something to my hormones but blood test come back normal and everything normal . Is this truly a coincidence or has the synthroid really messed up something?

    • Hi Tasca,

      I am sorry that you are going thru all this. Too much thyroid does cause heart palps as a symptom. However, it shouldn’t cause an actual problem with your heart.

      Most doctors do not run all the tests, and depending on your personality and the doctor you are dealing with you might be able to argue for the full body of labs.

      TSH is the pituitary’s request for thyroid
      T4 is the storage form of thyroid and is what Synthroid is
      T3 is the active form, your body has to convert T4 to T3
      RT3 is the inactive form

      If you had the T3 test and is normal, then I would suspect your heart palps are due to the heart issue. But chances are, even if the T3 is in the normal range, yours is too high for you. Some swear to only feel good when T3 is at the top of the range, others only feel good when it is at the lower end of the range.

      Good news, you do not need a nutrapath…look instead for an “integrative” doctor, most large clinic systems have them. They combine western medicine with alternative things and supplements….and they are covered by insurance.

      In a normal body, even taking too much thyroid should cause your thyroid to make less. Stopping the thyroid should cause everything to return to normal. Your did not.

      The bad news is, that despite all our wonderful research in the world…doctors really do not know much about the body. They don’t know why it goes wrong…95% haven’t a clue what was in their books from med school. The last two years of medical school is ONLY matching symptoms to medicines (hence, the practice of medicine). That is pretty much all they can do for you. They even say diagnoses that they don’t really think you have because they have to put a diagnostic code in for billing to justify the medication they gave you.

      Now we, the patients…we need them to know. We need them to tell us what our body is doing and why…and we need them to fix it. They cannot do this.

      I know that doesn’t help you get your answer much, but I hope it helps you get some perspective. It is sad for me to think of all the millions of people out there suffering, needing answers, and all the doctors that just shrug their shoulders…and I am sorry that you have become one of them.

      I sincerely hope that you find your answers…please don’t give up. Sorry I didn’t have a better answer for you.

    • Hi Tasca. Low thyroid can cause a lot of the symptoms you have-anxiety, long menstraltrial cycles, heart palps. I had all of these when I was undiagnosed. I ended up getting a noninvasive ablasion to end my cycle because it was so painful and lasted so long. I did not do well on synthroid once diagnosed so since 2007 I still take Levoxyl. Synthroid caused some unusual symptoms for me. Check your heart rate and body temp. If you of are taking too much your body temp will be a title elevated and heart rate too fast. I found the best way to take my temp is under the arm and add 2degrees. I had heart palps until I was adjusted on thyroid replacement. I was hyperthyroid at one point and did not have palps-just a fast heart rate. Do you feel cold when most others are comfortable? Just because you are within range on thyroid tests doesn’t mean you are taking enough. Look at your labs and see if you are within range low or in the middle on T4. You may need more to get the anxiety and heart palps to settle down.

      • Hi Becky,
        I’m thought that anxiety and heart palms were due to too much thyroid hormone and not too little? I’ve always thought that was the “norm”??

        • I was undiagnosed for three and half years. My symptoms where much worse towards the end. In the beginning when I was going down I was extremely anxious. When I got really really bad I didn’t have the energy to be anxious. I had never had palps before and I thought I just had cough and clear my lungs. When I talk to my endocrinologist after I was diagnosed he asked me if I had palpitations during that time. I told him maybe that was what the feeling was when I thought I needed to cough. My heart rate was about 58, body temperature was low and my blood pressure was about 90/55 at that time. When I was hyper thyroid I would just get tired really easy from walking up the driveway to get the mail or trimming a couple of branches off of the fig tree. It didn’t take much but I didn’t have palpitations I just had a fast heart rate. Not to say that hyper could not cause palpitations and anxiety too, but body temp and heart rate is a pretty good indicator of if you are too low or too high.

        • When I was undiagnosed hypothyroid, my heart palpitations felt like flutters. After I was diagnosed I decided I was going to stop taking thyroid medicine and I had pounding palpitations bad enough that I had my 18 year old take me to the emergency room.

          Abnormal thyroid function
          An underactive (hypothyroid) or overactive thyroid (hyperthyroid) intensify heart palpitations at rest. Palpitations combined with rapid heart rate (>100 bpm) are typical signs of hyperthyroidism. Get a thyroid (TSP) test and if your thyroid is not functioning correctly, that could be the cause. A beta blocker like atenolol or propanolol usually helps relieve the palpitations. Heart flutters when lying down from uncontrollable anxiety or abnormal thyroid level usually can be controlled with a very benign dose of prescription toprol XL which will slow your heart rate and thereby decrease the number of palpitations you feel. Related reading: Complete Symptoms of Hypothyroid / Low Thyroid Functioning.
          http://www.heart-palpitations.net/causes/heart-palpitations-when-lying-down

  20. I suffered fatigue. My immune system was scanned and determined to be hyperactive. I was diagnosed with chronic fatigue immune dysfunction syndrome based on a 42-page immune scan.

    I have suffered low red cells for decades. In the mid-90s, my red cells fell to 3.9. I started Epogen alfa to stimulate my red cells. It brought my count back to 4.5. But I ran out money could not buy the drug. I went to an older doctor and he told me T-3 would boost my red cells. I started taking 10 mcg day and worked up to 25 mcg day and with in 3 months my red cells were up to 5.2. I stayed on low dose t-3 for the next 10 years. I would skip a couple of days every week and go off every 2-3 months for 2-3 weeks and then start back again at 10 mcg. But in 2005 I could no longer get a prescription because I am in the Philippines where t-3 is not sold.

    My red cells and hemoglobin started falling. By 2010, I was down to 3.4 and hemoglobin was under 10.

    I was finally diagnosed with myelodysplastic syndrome (5q syndrome). The latest research indicates that 5q syndrome is as likely as not caused by inflammation. My red cells are not down to 2.7 and my hemoglobin under 10. I tried Epogen again, but started getting small numbers of nucleated red cells in my blood

    http://www.ncbi.nlm.nih.gov/pubmed/25761935

    I find Dr. CHRIS KRESSER’s connection with inflammation and low T-3 to apply perfectly to my situation. My inflammation has been proven. My MDS has been officially diagnosed by bone marrow examine. I felt so much better on low dose T-3. The problem is that main stream medicine has been scared away from this hormone by over abuse by diet doctors.

    I think inflammation-induced low t-3 might be associated with anemia far more than doctors even know or care to talk about.

    I need to find a new supply.

    Thanks, Dr. Chris.

    David
    [email protected]

    • Hi David,

      Wow, I am impressed by all the work you have done to figure out your illness. My daughter also has low red blood cell count and some abnormal blood cell shapes…so it touches close to home.

      I cannot explain, medically, why your numbers improved on the T-3, but I can say that often when people are sick with something (as you are), our convert less T-4 into T-3 (labs look like normal TSH, normal T4, low T3)…and when sick our bodies may even over-convert T-4 into unusable RT-3 (labs look like normal TSH, normal T4, low or normal T3 and high RT3). By taking T-3 you bypass your body’s need to convert it and it makes up the difference of what was probably already low T3 numbers, helping your body work better and helping you feel better.

      What I do know about the low hemoglobin and blood cell numbers is that the body needs all three things: iron, folate, and B12.

      Hope that helps, hope you feel better soon…

    • I agree on your inflammation point! I’ve had Hashimoto’s for 14 years, and for several years, I took VERY large amounts of curcumin daily (2,000 – 3,000 mg, sometimes more) to reduce inflammation from an inner ear condition (Meniere’s Disease). I think the high doses of curcumin MUST have reduced inflammation and been helping me to avoid Hashimoto’s depression. Because, in May 2014 I was in the hospital for 3 weeks, and then stopped taking the curcumin. When I got out, there was a lot to deal with, and I did not take the curcumin any more, because my ear condition disappeared (because I stopped taking porcine thyroid meds.) BUT, depression started like I HAD NEVER EXPERIENCED IN MY LIFE and I am STILL grappling with the depression. I am going to start taking 3000 mg daily of curcumin and see if it helps the depression. Before May 2014, I was careless with my diet, ate gluten, sugar, drank fluoridated water, alcohol, didn’t supplement vitamins and minerals, didn’t use progesterone cream, but STILL DID NOT have depression! I think it MUST HAVE BEEN BECAUSE I WAS TAKING SO MUCH CURCUMIN!! (Now, I very carefully address all areas to help the Hashimoto’s – clean diet, vitamins, minerals, no chemicals, progesterone cream, but I still have the depression).

    • I have researched T-3 and red blood cells for years. A lot of weight lifters take T-3 to build muscle mass. The big side effect for them is excessive red blood cells. It is recommended that they donate blood every two months. Wow… I would like to have this side-effect. If you are not aware of T-3 and increased red cells I suggest you take a quick look at PubMed. And look at some of the body-builder website. Anyway, Thanks for a great website.

      • 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!