# Small NDT increase making me feel hyper?



## evej13 (Dec 28, 2015)

Hi All,

I was taking 150mg NDT and feeling very hypo even though my blood numbers appear to be decent, with extreme exhaustion, freezing cold, nausea, dizziness.

Latest Blood Results

FT3: 5.89 (ref 3.9 - 6.7)

FT4:18.1 (ref 12.0 - 22.0)

3 weeks ago, I increased my NDT to 157.5mg. I am now feeling somewhat hyper in the afternoon - resting pulse of 95 and higher blood pressure than my usual. Is it normal to feel hyper for awhile when increasing NDT, even by such a small amount? How long could I expect to continue feeling this way?

I'm confused. I can't stay at 150 because I feel so hypo, but a tiny increase has made me feel hyper. Do I stay the course, or is this a warning that I should back off?

Thanks,

Eve


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## joplin1975 (Jul 21, 2011)

While your TSH is really high, you have to test free t3 is you are taking any mess with t3 in it. Have you ever had that lab run?


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## Pamzilla13 (Sep 9, 2013)

Yes, this happened to me...I backed off for a couple of days and then took one every other day. At some point I was able to take them everyday.

Hope you feel better soon!


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## Lovlkn (Dec 20, 2009)

> Latest Blood Results
> 
> FT3: 5.89 (ref 3.9 - 6.7)
> 
> ...


So - you increased your dosage by yourself? Your lab's posted do not suggest need for an increase , sometimes hypo symptoms come from having too much hormone circulating which was likely your situation. Your current symptoms suggest your being hyper. Probably best to go back to your original dosage.


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## jenny v (May 6, 2012)

Have you ever had reverse T3 tested? Sometimes when you have hypo and hyper symptoms your rT3 is high.


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## creepingdeath (Apr 6, 2014)

I had problems sleeping so I thought it was the Armour so I cut back by 15mg. I take 90mg and 15 mg together once a day.
Within a week I had bad stomachaches which is one of my hypo symptoms so I bumped it back up.
Almost immediately I started having heart palpitations...........a lot of them.
Took me a month or so to straiten things out to where I was before......
The sleeping issues are gone and were probably from something else like stress.....
I learned a lesson.........don't mess with your dose or do it very slowly so it don't throw your body into shock.


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## evej13 (Dec 28, 2015)

Hi all,

Thank you for your responses, and sorry for the late reply.

Joplin, I am testing T3, and yes I take ERFA desiccated thyroid. My TSH is suppressed at < 0.1.

Pamzilla, thanks. I am on Day 3 back at 150mg.

Lovelkn thank you. I increased based on my doctor's suggestion that I was having hypo symptoms.

jenny, I've never had rT3 tests, as I've never been able to get a doctor to do it. Do you have any references I could bring her?

creeping, I also have nausea as a hypo symptom. My heart palpitations started about 3 weeks after increasing my dose. I thought I was doing it slowly - an increase of just 7.5mg per day seems like a TINY amount. What did you do when you were having palpitations - did you just go back to your original dose?

I broke my arm in early January. Could that have caused me to feel hypo? I'm so exhausted I can hardly think straight, which is a hypo symptom for me, yet the small increase of 7.5mg NDT has made me feel hyper symptoms.

My hypo symptoms include feeling cold, fatigue, diarrhea, nausea, panic. My hyper seem to include palpitations, a sore shoulder blade, chest twinges, feeling like there's a lump in my throat.


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## jenny v (May 6, 2012)

Here's a quick overview of rT3 I found buried on a Mayo Clinic page. Maybe this could help explain it? If she still refuses to order it, you can order your own lab tests (if you're not in certain states like NY, CA, etc.). A lot of us here order our own labs when our doctors won't or in my case when it was actually cheaper than insurance covering it.

The *Reverse T3 (RT3) test* measures the inactive form of the hormone *T3 or Triiodothyronine*. Certain conditions may cause the body to convert T4 into Reverse T3 instead of active T3 as it normally does. Elevated levels of Reverse T3 are common in people with *hypothyroidism*. Reverse T3 is not regularly checked as often as other thyroid hormones but may be tested when someone is experiencing symptoms of low thyroid production but shows normal results from other thyroid tests.

Production of Reverse T3 is typically triggered when the body is under significant stress. Conditions which can lead to RT3 production include but are not limited to:


periods of prolonged stress
extreme dieting
insulin dependent diabetes
exposure to certain chemicals or toxic metals 
liver or kidney disease
serious injury
surgery
chronic alcohol ingestion
abnormally low levels of certain nutrients
aging

While a reverse T3 test can be ordered at any time, it is typically used when someone is experiencing symptoms of hypothyroidism, especially if they have see normal results from other Thyroid tests.


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## evej13 (Dec 28, 2015)

Thank you jenny. I am in Canada, so may have to see if I can find a doctor that'll order it, although pharmacists can now order certain blood tests. I would assume rT3 would not be one of those but will check.

I went to see a doctor at my clinic yesterday and she was very unhelpful, saying she "couldn't help me". If I had a nickel for every time I've heard that! Anyway, she wouldn't order B12, D3, the irons or antibody tests.

I guess I'll have to see if i can find someone else.

I suspect my adrenals may be acting up and have ordered a saliva test. The reason I think that is because my heart rate is high in the morning. I have had significant stress in the last few years.


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## creepingdeath (Apr 6, 2014)

Hey yea~
I went back and forth from hyper to hypo till I am back to the original dose.
I got palpitations, anxiety & no sleep for like a month..........
You got to remember the difference between one person and another........everyone's different.
My first symptom was tingling in my finger tips and legs........
My stomach problem is my gallbladder.
I have no stones but it just gets inflamed when I'm hypo.................It's absolutely horrible.....


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## evej13 (Dec 28, 2015)

Hi creepingdeath,

Sorry to hear that. I guess that's where I'm at right now. I have reduced to 120mg for one day, 135mg for one day and will try to take 150mg today.

My first hyper symptom seems to be a very tight back, especially around the shoulder blade and some very slight chest twinges.

I don't have gallbladder problems, but that does sound horrible!

Take care and thanks for responding.


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## evej13 (Dec 28, 2015)

Hi all,

I am on day 6 of a reduced dosage and am having lots of hyper symptoms. I don't understand why today would be this much worse. The last 5 days, I would only feel hyper symptoms about 2 or 3 hours after taking my NDT, and then would feel better. Today I have had hyper symptoms all day, including high heart rate, high blood pressure, tingly, overly warm and feeling panic. I can't seem to tolerate y NDT at all. I've only managed 60mg to this point - it's 4pm and normally this time of day I would have taken 120mg. What should i do?


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## creepingdeath (Apr 6, 2014)

If you still have your thyroid, when you stop or reduce the dose what's left of your thyroid starts working again, trying to straighten everything out.
It's a slow process.
If you cut back it takes a few days to a week for you to feel it.
same if you increase.....
So it's hard to get to a place you feel your best.
Most people including me are impatient and keep fooling with the dose.
It takes time for your system to stabilize to one dose.
I still get symptoms when as stable as I can get..... but very minor ones.
Thyroid hormone replacement is a treatment not a cure .


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## Lovlkn (Dec 20, 2009)

Have you ever been on just T4 hormone? I wonder if that might work better for you as your original lab results showed your FT-4 slightly over 1/2 range while taking NDT. Most people have a FT-4 much lower while on NDT.

Have you ever had labs prior to the NDT showing both FT-4 and FT-3 levels? You might just need a smaller dose of T3 hormone added to your T4 hormone replacement. Sometimes synthetic works better for some people.


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## evej13 (Dec 28, 2015)

creepingdeath, I have had only 60mg day before yesterday, 30mg yesterday and nothing today. When I took the 60 and 30 last few days, I felt much worse. This reduction is based on advice from a doctor. I feel horrible. Heart rate around 100 and BP around 14/90. I am starting to feel quite desperate as to what to do.


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## evej13 (Dec 28, 2015)

Lovlkn, I tried synthetic several years ago and did not do well on it at all. It never got rid of my hypo symptoms. I have been on NDT for 15 years, and have had hyper problems in the past, but this seems much worse than usual. I thought FT4 should be at about the half-way point, with FT3 at the top 1/3. Is that not correct?

I don't have any labs from prior to the NDT at all, as this was about 15 years ago.


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## evej13 (Dec 28, 2015)

I have my blood test results.

FT3 3.94 (ref 3.9 - 6.7)
FT4 15.9 (12 - 22)

Please keep in mind that this is after one day of 0 NDT, 1 day of 30mg NDT, 1 day of 60mg NDT. I had raised my dose from 150mg to 157.5mg for three weeks.

I think should try 90mg today and see what happens?

Has anybody used beta blockers and ativan temporarily?


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## jenny v (May 6, 2012)

How long between your last dose of NDT and the labs? Both of those Frees are low so you definitely need the meds but if your reverse T3 is really high or if you've got a lot of antibodies, you may not be able to tolerate them. I'm not sure how healthcare in Canada works but can you demand those tests or pick a new doctor?


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## creepingdeath (Apr 6, 2014)

Try a different brand of desiccated thyroid hormone...............


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## evej13 (Dec 28, 2015)

So I increased back to 150mg and felt ok for about two weeks, except I felt a heat rush and higher heart rate / BP about 2 - 3 hours after my dose.  Today I've felt that heat rush, higher heart rate and BP pretty much all day. Did I go back to 150mg too fast?


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## Pamzilla13 (Sep 9, 2013)

Are you female? If so, are you over 30? Peri-menopausal?

Have you thought about other hormones such as progesterone, estrogen, and testosterone contributing to your issues?

Having hypothyroidism impacts other hormones in your body and you MAY have an imbalance...

How is your gut health?


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## evej13 (Dec 28, 2015)

jenny,

I do have some test results.

B12 1476 (ref 138 - 781)

D 103.5 (no reference range)

Ferritin 70 (20-120 ug/L)

Iron 20 (10-29 umol/L)

TIBC 59 (45-72 umol/L)

Iron Saturation 34 (14-51%)

ATP Antibodies 33 (0 -34)


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## evej13 (Dec 28, 2015)

Pam, yes female. Postmenopausal so do I still need to test female hormones? Gut health is probably not great right now. I'm on antibiotics for UTI. Am supplementing probiotics, but still.


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