T3 only and feeling a bit desperate

[Icicles]

I have been taking T3 only for a handful of years now and for a couple of them on a LCHF diet I was happy enough. I lost weight, and felt good. In October 2020 I restarted HRT (I still had/have) hot flushes, but within 2 months I had started to gain weight and on balance I thought that I would rather stay low weight and after 10 years of sweating I thought I could cope. So I stopped the HRT after about 4 months of it. I knuckled down even further on the LCHF, but the weight didn’t come down and now 3 and a half years later I am almost back to where I was when I started my weight loss. I abandoned the LCHF late last year, tried it again this year, with no success. I’m now on Zoe, and my weight has rocketed.

I spoke to a friend who said ‘think about all the other things that might be going wrong if you’re not on the right dose’. I felt as if I was on quite a high dose, but I increased it a bit and after 6 weeks I did a blood test. I did it all properly. The results have come back and, while I expected everything to indicate that I am over medicated, I don’t think that they do.

I had wondered whether some of the ridiculous joint pains, tennis elbow (which never subsides), neck pain, sweats, tiredness, stiffness etc were related to over medication and everyday hesitated to take the increase. I have cold agglutinin disease, I’m nearly 62, my average resting heart rate for the last 3 months is 56bpm.

I read a lot of posts last night and I thought, maybe I need some advice/ an increase.

I felt a bit presumptuous to contact anyone directly but I hope that someone could have a look at my results and say what they think.

many thanks 💚

[Sunflower64]

I saw that you used to be on levo and T3; why did you switch to T3 only?

Some American functional doctors claim T3 only is a panacea for weight loss (they tend to blame rT3 dominance for all symptoms), but not everyone needs to be on T3 only.

You said three years ago that transdermal HRT reduces the effectiveness of thyroid hormone. I think it is oral estrogen that reduces T4 levels through increased TGB levels, and it also decreases free cortisol and growth hormone levels through increased CBG and IGF-1 levels. It has to do with it being metabolised by the liver. For that reason, functional doctors prefer transdermal estrogen which bypasses the liver and does not affect other hormones.

Were you also taking progesterone with estrogen? Daily or cyclically?

I personally found that going off transdermal estrogen led to weight gain. I went off if because I fell for the ’estrogen dominance’ myth. In my own experience, progesterone (even Utrogestan) causes more weight problems than estrogen, especially if taken daily (but that is unfortunately the only way to be bleed-free).

[Icicles in reply to Sunflower64]

Thank you, Sunflower64, I am afraid that I do not have the capacity to think about things in that sort of detail anymore. I took NDT at first. When I couldn’t get my numbers up others here suggested levo. During Covid supplies of everything seemed to dry up. I may well have gone back to NDT when levo didn’t seem to ‘work’ but I didn’t know where to get any. In private helpful conversations with others more knowledgable and experienced than I, here, it was suggested to try T3 so I did. It coincided with weight loss and feeling better so I stuck to it.

The HRT experience was a shock, there was no other way to explain what started to immediately happen. My weight has just kept going up ever since, my CAD diagnosis seemed to explain some of the other symptoms too. I took my eye off the thyroid stuff.

I have never suffered nor struggled if I’ve missed a dose even though it does feel quite high to me. I think I’m going to increase slightly and see how I get on

[DippyDame]

How much T3-only are you taking?

As expected T3 has lowered TSH and FT4

Your weight gain suggests low T3

Your RHR is on the low side

How much levo were you taking before you added T3, or changed, to T3-only

Why did you change to T3-only? Had you reached a high dose of T4 with no improvement?⁹

I'm afraid I know very little about cold agglutinin disease, others may comment though I would ask if you have had a diagnosis of thyroid autoimmune disease/ Hashimoto's disease. I'm not aware of an HRT/CGD interaction .....but you have now stopped HRT so likely not relevant

Dieting often affects the hormone balance

If weight gain is due to low T3 then dieting doesn't really help, to find this out try the pinch test

If you pinch skin the area that is pinched can appear...

a).....as a hard piece of flesh between the thumb and fore finger

This is most likely water logged mucin which lies under the skin and is very often the result of hypothyroidism.

Correcting inadequate thyroid treatment very often slowly gets rid of this but I don't think this is always the case

b).....as a wobbly piece of flesh that can be manipulated so that thumb and forefinger come close together this is usually an accumulation of fat cells.

This will very depending on the level of adipose tissue

But...it sounds as if your problem is thyroid hormone related

If T3 is low then metabolism slows down, that reduces the calories burned which causes weight gain.

For good health every cell in the body must be flooded with T3 by way of an adequate and constant dose.....this possibly isn't happening.

Your labs don't indicate overmedication.....your FT3 is 70.27% through the reference range....to be overmedicated you would be close to or over the top of the range.

Did you test at 9am, at least an hour away from food and drinks and 24 hrs after your last dose

Are you self medicating? Back to the size of your dose which is a vital clue..

Depending on your dose, if high, you may have developed a form of thyroid hormone resistance....or it may be that your system just needs time to settle after HRT and dieting

I'm on high dose T3 only...recently reduced to 100mcg...all in my bio.

T3-only is the last resort after other options have been exhausted

Just a few thoughts

We're all here to help.....just ask!

[Icicles in reply to DippyDame]

Thank you DippyDame. It’s so worthwhile asking for help because now that you mention inflammation and mucin, I remember reading something about that before. I can remember gripping the bits around my knees and thinking that it didn’t feel like the wobbly bits elsewhere,

When you ask why I changed from Levo to T3 I know that at the time, I felt I had good reason. I can’t remember exactly why anymore, but I always took advice and read a lot on this site at the time. Levo never made a lot of difference to the way I felt and I think that the combination of starting to take T3 and starting to lose weight and feel better made me think I’d got it right at last.

[greygoose]

I agree, you are under-medicated. But, some of your symptoms could be due to nutritional deficiencies. When did you last have your vit D, vit B12, folate and ferritin tested?

[Icicles in reply to greygoose]

Thank you for your comments Greygoose, I confess I have not had a test for sometime but I have been taking a good vitamin B complex, D3, folic acid for my auto immune condition (CAD) and extra biotin because I have had poor levels in the past. I stopped the biotin a couple of weeks ago before my blood test and should restart that.

I’m going to add a quarter tablet in - 6.25mcg - and see how that goes. Maybe not be so worried about being over medicated. Would you split the dose? I am used to taking the lot in the morning.

[greygoose in reply to Icicles]

Folic acid not the best form of folate. Methylfolate is better.

If you're taking vit D are you also taking vit K2-MK7 and magnesium?

How about ferritin?

Whether or not you need to split the dose only you can tell. I take my 75 mcg T3 only all in one go. That's what's best for me. But it's all trial and error to know what you need.

Being slightly over-medicated is not the end of the world. It's easily rectified. And some people need their FT3 a little over-range, anyway.

[Icicles]

thank you, I’m putting an order in ♥️