Hypothyroidism and T4

[horsenflower]

I have Hashimoto's disease and am having heart palpatations.  I use a compound med of T4 and T3 and have been doing wonderful for about two years with occasional adjusting according to blood work and how I feel.   I had a blood test taken two days ago and it showed that my TSH was under 1 and my dr. thought we should lower T4 a bit.  There was another time about four years ago when I was using Armour that I had some arrythmias and put on a heart monitor, it showed nothing just the arrythimias. They finally did some blood work and my TSH was 40 and high was 15 at this lab.  Just wanted to give a little history. So could too much T4 cause palpatations I always thought it was too much T3.  Thanks

[Mark Lupo, M.D.]

Too much of any thyroid hormone can cause palpitations - T3 is more stimulating than T4 so that T3 more classic for palpitations.  Sounds like lowering the dose makes sense to see if that helps the palpitations - if decreasing the T4 doesn't help then try decreasing the t3 (and going back to previous t4 dose).

[Rella48]

I was taking T4 alone for a long time. Heart palps, aching joints, etc. I was miserable. Decreased T4, added T3 and the symptoms worsened. Rollercoaster. Switched to Armour and couldn't tolerate it either. The symptoms returned when I started taking 2 Grains (120mgs). I was desperately ill. I finally talked doctor #1 into ordering an ACTH test after the AM Cortisol test was low normal. Doc #1 said I had normal adrenal function. Doc #2 said the ACTH results proved adrenal fatigue. I couldn't recover from the slightest emotional upset for days, and any physical exertion sent me to bed for a week. Since I've been taking Cortef (natural cortisol like the adrenals produce), I've had no hyper or hypo symptoms and I've increased to 6 Grains. (I have no thyroid.)

There's a huge problem with how doctors read the ACTH test results and I believe the lab range is way off! I've heard (numerous times) that your adrenals need to be nearly dead to fail that test! Doctors #3 and #4 looked at my test results and disagreed just as the first 2 did! (The lab report clearly says "any increment over 7 is reassuring for normal adrenal function". Neither of my increments were over 3!) Most doctors don't believe adrenal fatigue exists and don't know that one must have sufficient cortisol before thyroid hormone can enter the cells (especially T3) to promote metabolism and allow one to tolerate thyroid hormone replacement - and be symptom free.
Here's an article about adrenal fatigue you should read:

http://www.medical-library.net/sitesd/_adrenal_fatigue.html

Horsenflower, I think you should consider getting an AM cortisol test and/or an ACTH test and see how well your adrenals are functioning. Then switch back to Armour if your doctor gives you an Rx for Cortef. The following article points out the importance of treating hypO patients' adrenal fatigue so their bodies can utilize thyroid hormone replacement. It also says that T4 only will be most tolerated by those with untreated adrenal fatigue. It doesn't say how well tolerated, though.
I hope you can get adrenal testing and proper treatment if that is what's causing your symptoms, and I hope you feel better  real soon!---------------------------------------------------
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This is a news release from the Anti-Aging Association of France dated Sept 29, 2005). It specifically rebukes the false ideas that most doctors have about natural thyroid hormone, Armour. It firmly states that the combination of T3 and T4 therapy is the International Hormone Society's Consensus Group of Experts on Hormone Therapies FIRST choice of therapy for treating hypOthyroidism providing the patient does NOT have untreated adrenal fatigue. It says T3 and T4 combined have widespread health benefits over T4 alone in those who have sufficient adrenal function. At the end of the article, a statement is made that stresses the importance that doctors have the option to treat with T3 and T4 combined, and not with - what seems to be the current "standard of care" in the US of T4 alone.

http://www.fsaam.com/article.php3?id_article=22

T3 et T4

Thierry Hertoghe
The International Hormone Society