# Elevated T4,hyper symptoms on synthroid



## Jefhrn (Nov 6, 2014)

Hello all, I am now just over 5 weeks post surgery and started having hyper symptoms again, but worse than before the total thyroidectomy. Labs were done as follows:
TSH 1.11 range 0.40-4.50
Free T4 1.7 range 0.8-1.8
Free T3 2.6 range 2.3-4.2

My endo had me stop the synthroid 88mcg that I started postop and lowered it to 75mcg after 2 days. She also gave me atenolol for the palpitations and racing heart, which have helped. She said my system must be sensitive to the synthroid and wants to retest in one month and that the high T4 is the culprit for all these horrible symptoms.Can anyone give me any estimates on how long it takes for the T4 to drop and that I don't feel so jittery and shaky? My other symptoms include terrible insomnia, very emotionally labile,no energy. She plans to adjust the dose based on free T4 and free T3,and symptoms


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## Andros (Aug 26, 2009)

You could still be dumping thyroxine and also, did I mention before for you to check your Ferritin?


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## Lovlkn (Dec 20, 2009)

I would think you would start feeling better - in 2-3 days.



> My endo had me stop the synthroid 88mcg that I started postop and lowered it to 75mcg after 2 days.


So what is your prescribed T4 dose now? 88 or 75?

You have low FT-3. Ask your doctor to prescribe 5mcg of Cytomel to get your FT-3 up.

Has your doctor said anything to you about that? Once your FT-4 falls into mid -3/4 range you will begin feeling the effects of your low FT-3.


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## Octavia (Aug 1, 2011)

Ditto what lovlkn said above. Your Free T4 is too high (the lower dose of Synthroid will help with that), but your Free T3 is too low.


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## joplin1975 (Jul 21, 2011)

Yup, you are a non-converter. You need to be on t3 meds.


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## Jefhrn (Nov 6, 2014)

Thank you for the quick replies. My ferritin level was checked (result 97 range 18-160)and my new dose of Symthroid is 75 mcg. We talked about adding cytomel once I get past this current situation, she agreed that the free T3 was lower than it should be, but when my T4 was lower my T3 was higher. Could my T4 have stopped converting as it got higher?


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## Lovlkn (Dec 20, 2009)

Jefhrn said:


> Thank you for the quick replies. My ferritin level was checked (result 97 range 18-160)and my new dose of Symthroid is 75 mcg. We talked about adding cytomel once I get past this current situation, she agreed that the free T3 was lower than it should be, but when my T4 was lower my T3 was higher. Could my T4 have stopped converting as it got higher?


I personally think "conversion" doesn't necessarily stop - the issue is that is never actually gets high enough - before the FT-4 gets too high. Issue: when your FT-4 gets into high range, reverse T3 may occur. Then when you add Cytomel - it feels like you are spiking hyper. It may be good to be on the reduced dose for a week or 2 before you add the Cytomel.

How long does your doctor suggest waiting?

I might also suggest, when you add cytomel, ask for 5mcg and buy a pill splitter. Split your dose in 1/2 to start. Take each 1/2 about 6 hours apart. I struggled adding cytomel and got to the point of 1/4 ing my pill, spacing it out over the day. My FT-3 had been suppressed for many many years - I figure that was my issue. I now take 12.5mcg in 3 doses during the day without issue.


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## Jefhrn (Nov 6, 2014)

Thanks again, I'm finally starting to feel better and the information here has been very helpful. My endo wanted to wait a couple of weeks and start a low dose of cytome 2.5 mg twice daily. After that's added I will get labs done again and she will adjust the doses of both. Is reverse t3 something I should include? In previous lab draws, I had total T3 levels, is that the same as reverse?


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## jenny v (May 6, 2012)

Total T3 is different from Reverse T3 (rT3). The "good" labs to have run each time are Free T3 and Free T4 (most docs will also insist on TSH). Reverse T3 isn't usually run by most docs but it can be a good test if you're having continuing problems with high FT4 or high FT3 and still feeling hypo. My doc runs it every time because I have adrenal problems that cause my body to not utilize T3 properly and it builds up in my system as rT3.


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