What are you taking? How long have you been taking it? and what were your last labs? (Date, Ranges and Results)?

Read my history haha. Surely you remember or my latest results arent that far down the page. I hate that question because when you have had this for 10 years you tend to know when your bloods are not important.

I appreciate you are trying to help like always MButterfly, so Ill dig up my last post.

Ok to recap

"My latest results are

210mg NDT
TSH 0.01
Free t3 5.6 (3.0-6.0)
Free t4 12.8 (10-20)

previous was

180mg NDT
TSH 0.01
Free t3 5.3 (3.0-6.0)
Free t4 14.0 (10-20) "

As you can see a raise in NDT drooped my t4.

Prior to this I added 25mcg of synth t4 to 180mg NDT but it didnt raise my t4, someone here suggested I should have tried raising the t4 higher instead of more NDT (powdered whole thyroid).

What I am really concerned about is, can a 30mg shot of t3 in the morning be detrimental to a person with anxiety issues, ie does it drive any adrenalin or neurological responses as its absorbed so quickly. And if so whats the normal theraputical dose of t3 for someone with anxiety issues.

I know I can balance my bloods with a combo of both, i just want a gauge of how I manage the titration backward of NDT. Dropping to say 90mg NDT and adding 75mcg synth t4 might startle the thyroid.

Forgot to add Im currently back at 180mg whole thyroid and nothing else as its been the most stable dose.

I actually did try to look up your last labs, but I can only see "so much" of someone else's posts/profile if we're not listed as "friends" on the site. Weird, I know. So, thanks for providing the labs and info. It gives me a better idea as to what might be going on with you. :)

10 Years, huh? I know the feel. After quite some time with this blasted issue, I tend to get "thyroid tired". Meaning, I get tired of even -thinking- about my thyroid health. But, as much as I hate it, I -have- to stay on top of it...or before I know it, I'm in a bad way. I also HATE having my blood drawn every four-six weeks, but alas - it's a small price to pay to try and stay functional/optimal. Without them, I'd be flying blind. The symptom journal alone isn't enough, just as we're not our labs results - lol.

Now, on to what's important: YOU

Your labs jogged my memory - I think it was me and CD who suggested that you add more synthroid instead of NDT.
There's a few reasons why (if you're intersted) As you can see from your latest labs:
1. Your Free T4 is much lower (percent of range 28%) than your Free T3 (percent of range 87%)
2. When you increased your dosage of NDT from 180 to 210, your Free T4 actually fell from 14 to 12, and that's fairly common when you get to the "tweaking stage" - and you're there. Here's why (if you're interested) NDT has a higher ratio of T3:T4 than what a "typical" human thyroid would make. That higher amount of T3, signals the body, "Hey, we don't need any more T4 to convert to T3, so please don't make any more." And, that would be fine if you're Free T4 levels were at a remotely acceptable range (75% of range or greater). But, it's not. And, there's two ways to overcome it -
A)taking muuuuch more NDT (which I do NOT recommend) to get your Free T4 up
B)Add synthroid to increase your Free T4 level (simplest solution and most healthy)
However: BE AWARE THAT THE FIRST DOSAGE OF SYNTHROID OFTEN WON'T BE ENOUGH ESPECIALLY IF YOU HAVE HIGHER FREE T3 LEVELS - AND YOU MUST WAIT FOUR TO SIX WEEKS TO DRAW LABS BEFORE ADJUSTING ANYTHING, K? If you change things up mid-stream (before 4-6 weeks) it's an act in futility I'm afraid.
The reason stated above is why your synthroid addition didn't increase your Free T4 levels and actually decreased. I know that seems counter-intuitive, but it is what it is.

Now, to answer your concerns:
"What I am really concerned about is, can a 30mg shot of t3 in the morning be detrimental to a person with anxiety issues, ie does it drive any adrenalin or neurological responses as its absorbed so quickly. And if so whats the normal theraputical dose of t3 for someone with anxiety issues. "
High dosages of T3 -can- spike glucose and insulin in -some- people, and it can also slow thinking in -some- people just as hypothyroidism can. That could account for anxiety on either end of the spectrum HYPO or HYPER.

The question is: What's causing YOUR anxiety?
Labwise: Your Free T3 isn't over the top of the range and your Free T4 is scraping the bottom of the range, so if you were only your labs - I would say that it's your lack of Free T4 that's causing your anxiety. However, we're not our labs alone -
Check your symptoms journal - do you feel more anxious when your Free T4 level is low? Or when your Free T3 level is high? etc.

For me (and it took a symptom journal for me to figure it out): If my Free T4 levels are low - I'm shaking like a chihuahua trying to crap a peach-seed, nervous as a cat in a room full of rocking chairs, and can't stand anyone - including myself. :) But that's ME and the source of MY anxiety. FreeT3 levels don't affect my nervousness at all - it actually calms me down, but if it's too high - it does affect my cognitive function and problem solving abilities.

So, what's your journal show? (you don't have to share with me, you'll see a pattern, I'm sure).

"I know I can balance my bloods with a combo of both, i just want a gauge of how I manage the titration backward of NDT. Dropping to say 90mg NDT and adding 75mcg synth t4 might startle the thyroid."

Dropping NDT AND adding 75mcg synthroid WOULD freak a thyroid out. That's too much adjusting at one time.

For what it's worth, I've been exactly where you are now. I added synthroid - started at 25 mcg, then increased to 50 mcg, then lowered my armour by 1/2 grain- each adjustment was made six weeks apart not all at once.

So, I would only change one thing at a time, and at this point I would not decrease NDT. Here's what I would suggest:
Add 25 mcg of synthroid and that's ALL
Get labs done/keep journal in/for four weeks
If your Free T4 isn't above 75% of range, increase to 50 mcg

Once you "optimize" your Free T4 level (75-100% of range), then I'd see where you are about cutting the NDT (you may not need to).

The most important pc of advice I got was: DO ONE THING AT A TIME. And take it one step at a time.

That's my advice, for what it's worth. That's what worked for me...and many others.

Keep me posted!

thanks for that.

i did add 25mcg of T4 when at 180mg NDT (my current and most stable dose). but it didnt raise the t4. i should have upped it to 50mcg?

one other issue here is ranges, one part of the country has a range i think of 8.0-16.0 which would make my original t4 of 14 very good, but thats not where the blood test was taken, i just know this because ive had it taken out of my main city before.

so what do you take as a guide when your country has multiple ranges?

Different labs have different ranges. The result is based on that range (the lab the drew it). So, it won't "vary" the percent of range.

If you were on 25 mcg of synthroid for the whole 4-6 weeks, then, yes - go up to 50 mcg or if you're "sensitive" ask for 37.5.

PS See reasons above as to why 25 mcg didn't raise your Free T4.

Psychiatrists that really know what they're doing will offer T3 to their patients dealing with depression.

Anxiety is more common in hypothyroidism.

However, to answer the question posed in the title of this thread....Yes , T3 can be too stimulating for some people - if they're taking too much.

Blood work *is* important.....as long as it's interpreted within the context of symptoms.

Sorry to tell you this, HipHappy, but you've never had labs that would be "comfortable" for most people.

Your FreeT4 needs a LOT of help. MB did her usual great explanation of this.

We need both levels to be optimal to be free from thyroid symptoms. One without the other isn't good enough.

And, without a doubt, please make one, logical change at a time.

You will get there as long as you do this.

Best of luck to you moving forward!!!

Oh, I forgot to mention....

There is no "normal therapeutic dose" for anyone.

The therapeutic dose is the one that optimizes levels...

And, the dose necessary to maintain those optimal levels will most likely change.....a little.

It's not uncommon for people to need slightly higher doses in the winter (if they live in a cold climate since it takes more energy to keep the body warm).

And, it's not uncommon for someone to need a dose adjustment if there's been a change in activity or stress levels, weight, intake of certain food, etc.

It's all about maintaining optimal levels.....not the meds we take or the doses of them.

Thanks CD, yes you guys are all beautiful support, gage, CD, butterfly and co. Really appreciate it otherwise id have given up long ago.

So you do not think my t3 of roughly 27mcg in the Whole Thyroid is enough to be over stimulating?

Im so scared of taking 180MG WT and 50mcg synth t4. When I swapped from 157mcg synth t4 they told me 90MG WT is the equal, it wasnt close to equal. Now my T3 is so high Im scared taking more meds might spin me out of control mentally.

But then part of me wants to know, am I optimal, can I feel better, because Ive never felt better at any of ranges low or now.

Speaking of weight, Im going to try and knock of 50lb first, then lastly another 10lb to get to a thin weight as I have chronic back pain from disc bulges which epidural steroid needles do nothing to help.

In fact I think this is where it started, I took Voltaren for years, then got GERD and was on a PPI for 13 years, suddenly I have hashimotos, but what I think really happened is my digestion lining died. I suffer extreme IBS.

Oh Geez, Honey, you have enough to make you anxious: Back issues, Gerd, IBS(chronic), steroid usage (which can cause anxiety along with other issues like IBS) - losing weight can only help.
http://www.healthcommunities.com/back-pain/steroid-injections-benefits-risks.shtml
The injections can occasionally cause
"steroid flush," a flushing of the face and chest with a feeling of warmth and increase of temperature over several days
headache
sleeping difficulties
anxiety
nausea
diarrhea
water retention
a temporary increase in pain for a few days

However, I don't think the addition of synthroid will cause more anxiety - not at the 25 mcg level. If anything, it should improve your anxiety some what. Why? Because your Free T4 levels are quite low. And, your T3 levels are not out of the range (or high). They're within range. So, you're good to go for adding 25 mcg of synthroid.

If you start with 25...then in six weeks if you're Free T4 is STILL low, THEN add 25 more (to 50 mcg). Do NOT start out at 50mcg if you already have anxiety issues. Remember: Slow but steady.

I started 25mcg before, my t4 and t3 stayed about the same after 6 weeks. Im thinking of trying the 50 because of that. I dont really get anxiety from t4, it seems t3 is the one that makes me a bit jumpy if I try too much too soon.

Just got some new tests before adding the 50mcg t4.

Strangely going back to 180MG of whole thyroid hasnt increased my t4. Its stayed where it was on 210mg at 12 and prior to that on 180MG it was 14. So I expected it to at least get back to 14 (10-20 is the range). So now im running at 20% of my range with NDT for free t4, while t3 remains around 65-75%

I am new here and not sure how to start a new post. But am wondering about NDT. I took 1/4 grain and it made my anxiety go off the chart. After 3 days I gave it up. I have very high cortisol so that may be the problem. But I havent been successful in getting it down. Any ideas?