Thyroid - Am I overdosed or Underdosed?

So i've been on 3 grains daily for a few months.
Lately (few weeks) ive had pretty bad insomnia and my hands shake. They sometimes shake so much that it's hard for me to align the needle into the vial for my T shot.

Ive done some reading and as usual come up with conflicting information.
According to this site I am over medicated. It says that if your TSH falls below the range (.3 - .5) and having symptoms you're over medicated. I have the symptoms and my TSH is .04.
https://www.verywell.com/could-you-be-overmedicated-on-thyroid-drugs-3233271


Then according to this site, I could be having a cortisol issue, which I very well might anyway
https://stopthethyroidmadness.com/ndt-doesnt-work-for-me/

"poolingRT3

Sounds likely that you are feeling hyperthyroid. And yes, this can be related to cortisol as well. Possible too that you're sensitive to that level of DHEA.

https://www.endocrineweb.com/conditions/hyperthyroidism/hyperthyroidism-symptoms

Appetite change (decrease or increase)
Difficulty sleeping (insomnia)
Fatigue
Frequent bowel movement—perhaps diarrhea
Heart palpitations
Heat intolerance
Increased sweating
Irritability
Light menstrual periods—perhaps even missed periods
Mental disturbances
Muscle weakness
Nervousness
Problems with fertility
Shortness of breath
Sudden paralysis
Tremor/shakiness
Vision changes
Weight loss-but perhaps weight gain
Dizziness
Thinning of hair
Itching and hives
Possible increase in blood sugar

To add:
I stopped the Shea couple weeks ago to see if any help but it hasn't

What have you been on for 3 months and most do better when their Free T3 is in the high range.

Vince said:

So i've been on 3 grains daily for a few months.​

What have you been on for 3 months and most do better when their Free T3 is in the high range.

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My free T3 is 3.4 out of 4.4.....not high enough?

I've been on NP Throid for a while now. Started at 1 grain daily and felt great for a few weeks then bottomed out so Dr raised to first 2, then 3 grains daily where i've been for a few months.

http://www.tiredthyroid.com/optimal-labs.html

Another case where strict interpretation of numbers may not represent the individual. Agree that Rhino's T3 and T4 are in great range by charts and numbers, but Dr Saya told me to beware of these exact kinds of symptoms on thyroid and I have had similar passing symptoms adjusting to just 1 gr/day. A lot of people have trouble adjusting to different levels, and replacements NDT vs synthroid or combinations can provoke unwanted symptoms in different people.

i just don't think it as simple as basing it all on numbers. the symptoms really count.

In other words, This blows.

rhino5169 said:

In other words, This blows.

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You can try taking 1/2 dosage (1.5 grain) first thing in AM and the other 1/2 dosage (1.5 grain) in the early afternoon (say 12-2PM). Trick is they should BOTH be on empty stomach at least 30min prior to food.

It is possible the 3 grains all at once could temporarily spike your levels too high.

Dr Justin Saya said:

You can try taking 1/2 dosage (1.5 grain) first thing in AM and the other 1/2 dosage (1.5 grain) in the early afternoon (say 12-2PM). Trick is they should BOTH be on empty stomach at least 30min prior to food.

It is possible the 3 grains all at once could temporarily spike your levels too high.

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Thanks Dr Saya,

I actually did not take any today to see what happens.
I was actually taking 2 in the morning and 1 in afternoon (with no food in proximity) for a couple weeks. That was about 3-4 weeks ago though and stopped because it was too inconvenient so ive been back at 3 grains in the am.
The reason we tried splitting it up was that my energy (whatever i had) was waning in the afternoon. To be honest I felt a little better the first couple of days but then after a few days it felt the same as I had been taking the 3 grains in the am. Since there was no noticeable effect, plus it was inconvenient I went back to the 3 grains in the am.

Question is though - When I first started many months ago it was great at first and then tailed off to maybe 50%. Only recently have I had the shakes and the bad insomnia.

Anyway - as of today I figured I wouldnt take any for a day or 2 and then go to 1 grain in the am. I dont like to take shots in the dark but experimenting, but thats what all of this seems like anyway.

It's hard to believe that your overdosed when your FT3 is 3.4 I'm suspecting you may be short of cortisol. RT3 should tell you this. With TRT and any form of T3 your body needs more cortisol for that and if it cannot make it then you are left with a shortage. I used to shake like crazy before I was put on cortisol. Now that I am on cortisol I shake before I take my morning dose and than I'm fine until I wake up in the morning. I know lots of people keep their FT3 at the very top of range (I do too) and not many report it being too much. However as we know everyone is different. If you reduce your NDT or T3 then your body doesn't need to make as much cortisol so some of your symptoms should subside. This could be because of less cortisol alone. Actually with your FT3 at 3.4 I'd suggest adding another grain to your protocol and see what happens. Taking T3 or NDT is like testosterone there is a feedback loop and after a while you typically need more to keep feeling well. Perhaps you were in the honeymoon stage when you last felt good. Since you are at 3.4 you have room to go up to observe the result.

Another alternative is to use hydrocortisol cream 1%... available OTC, you can google this to determine how much to use but you can use it for 3 days without it hurting you. If you rub in 10mg of hydrocortisol cream and you feel much better than you know you have a cortisol problem.

ratbag said:

Another alternative is to use hydrocortisol cream 1%... available OTC, you can google this to determine how much to use but you can use it for 3 days without it hurting you. If you rub in 10mg of hydrocortisol cream and you feel much better than you know you have a cortisol problem.

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That seems brilliant!

ratbag said:

It's hard to believe that your overdosed when your FT3 is 3.4 I'm suspecting you may be short of cortisol. RT3 should tell you this. With TRT and any form of T3 your body needs more cortisol for that and if it cannot make it then you are left with a shortage. I used to shake like crazy before I was put on cortisol. Now that I am on cortisol I shake before I take my morning dose and than I'm fine until I wake up in the morning. I know lots of people keep their FT3 at the very top of range (I do too) and not many report it being too much. However as we know everyone is different. If you reduce your NDT or T3 then your body doesn't need to make as much cortisol so some of your symptoms should subside. This could be because of less cortisol alone. Actually with your FT3 at 3.4 I'd suggest adding another grain to your protocol and see what happens. Taking T3 or NDT is like testosterone there is a feedback loop and after a while you typically need more to keep feeling well. Perhaps you were in the honeymoon stage when you last felt good. Since you are at 3.4 you have room to go up to observe the result.

Another alternative is to use hydrocortisol cream 1%... available OTC, you can google this to determine how much to use but you can use it for 3 days without it hurting you. If you rub in 10mg of hydrocortisol cream and you feel much better than you know you have a cortisol problem.

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Once
Once again ratbag you come through with solid knowledge. I thank you much for taking the time to respond, as well as everyone else alse.

So, since I do believe, and heave believed for a while that I have an adrenal and cortisol issues this seems entirely logical.
I'll be doing a lot of reading tonight and I'm going to give your suggestion a try.
You think issues should take my normal dose tomorrow?
does timing of the hc cream have adrenal dynamic influence? Would I take at night or in the morning?
Thanks again

So what I'm seeing is that maybe 10mg should be split 3 or 4 times during the day, starting larger dose in the morning and tapering down to bed time.
thoughts on that?

More importantly, how the hell do I know how much cream to use, how many mg is in a drop the size of a dime compared to size of a quarter....etc.?

Well people who take cortisol usually take 25mg or upwards daily. I take 15mg when I wake up. I take 10mg at 1:00pm and I take 5mg at 6:00pm. This is 30 mg /day and is the average for those who have serious adrenal issues. That amount is enough to live on even if your adrenals don't recover or some HPTA effecting it.

When someones adrenal rhythm goes off and they have too much cortisol at night and it's low in the morning, they fix that rhythm by giving you the necessary amount in the morning... then your adrenals adjust their circadian clock to match and your there. So this is definitely the way I'd go about it. Because I don't see any other way for your system to change. I recall seeing that a teaspoon of hydrocortisone cream = X mg's of cortisol cream, so just Google that it's there. If your going to try it remember morning cortisol is highest. Also they say if you do this for more than 3 days your supposed to wean yourself off cortisol slowly. So there is that 3 days period you can try cortisol and then drop it without any consequence.

If you feel better in that 3 day period with cortisol then stop after the 3 days and get yourself some diurnal cortisol saliva labs and find out whats happening and then get Defy to help if you can. It can't be emphasised enough that you still need a competent MD you can call to get your protocol correct, most of us are not good at self management.

ratbag said:

Well people who take cortisol usually take 25mg or upwards daily. I take 15mg when I wake up. I take 10mg at 1:00pm and I take 5mg at 6:00pm. This is 30 mg /day and is the average for those who have serious adrenal issues. That amount is enough to live on even if your adrenals don't recover or some HPTA effecting it.

When someones adrenal rhythm goes off and they have too much cortisol at night and it's low in the morning, they fix that rhythm by giving you the necessary amount in the morning... then your adrenals adjust their circadian clock to match and your there. So this is definitely the way I'd go about it. Because I don't see any other way for your system to change. I recall seeing that a teaspoon of hydrocortisone cream = X mg's of cortisol cream, so just Google that it's there. If your going to try it remember morning cortisol is highest. Also they say if you do this for more than 3 days your supposed to wean yourself off cortisol slowly. So there is that 3 days period you can try cortisol and then drop it without any consequence.

If you feel better in that 3 day period with cortisol then stop after the 3 days and get yourself some diurnal cortisol saliva labs and find out whats happening and then get Defy to help if you can. It can't be emphasised enough that you still need a competent MD you can call to get your protocol correct, most of us are not good at self management.

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You have raised a interesting question from me. Since my 20's (43 now) I have had Eczema, this came on suddenly with no warnings at all. It appeared solely on my face, mainly in the "puffs" of my cheeks. I used 1% Hydrocortizone Cream, and used it for years (about 20 years)! My Eczema seemed to increase in times of stress, and sometimes would require a stronger steroid, Triamcinolone. Once the Eczema got under control I would go back to the Hydrocortizone. Recently I was broken out bad, for quite a long time, nothing seemed to work at all. I was on TRT at the time, just beginning in fact (on TRT for 1 year now). My Dr sent me too a specialist of Dermatology who told me I have Rosacea. Looking at pictures, it appeared I may have had Rosacea this whole time, until the Rosacea cream did nothing for me, in fact I got worse. Back to this Dermatologist I went and he decides I do have some sort of Eczema and thinks I need a non-steroid cream, Elidel. Elidel has worked great, it is a little expensive, as my insurance does not cover it. But now that I have the Eczema under control I only need to apply the cream every few days.

Now comes the question...Could my use of Hydrocortizone cream for 20 or so years be the main factor in my fatigue? My cortisol swabs are pretty wild, spiking at 3 AM (circadian rhythm is trashed!), and dropping a huge amount by 11 AM. I wonder if I might have damaged my Adrenal Glands by using Hydrocortizone for so long. I will be giving this a try, the rubbing of cortizone cream onto my skin (legs) to see if I feel any better throughout the next few days.

1/4 Teaspoon = 10mg

also, found a guy who is EATING 1% hydrocortizone cream

http://onibasu.com/archives/amc/7921.html

This might seem kind of strange but vinegar worked for me.

https://homeremediesforlife.com/vinegar-for-eczema/

cleverusername said:

Now comes the question...Could my use of Hydrocortizone cream for 20 or so years be the main factor in my fatigue? My cortisol swabs are pretty wild, spiking at 3 AM (circadian rhythm is trashed!), and dropping a huge amount by 11 AM. I wonder if I might have damaged my Adrenal Glands by using Hydrocortizone for so long. I will be giving this a try, the rubbing of cortizone cream onto my skin (legs) to see if I feel any better throughout the next few days.

1/4 Teaspoon = 10mg

also, found a guy who is EATING 1% hydrocortizone cream

http://onibasu.com/archives/amc/7921.html

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I don't think this is possible because if you read all the adrenal sites and how everyone gets treated they say that you can go on cortisol full time and they claim it allows your adrenals to heal (should they be weakened and not a HPTA problem) and that you just ween yourself off it and your own adrenals take over just as they were before. Also keep in mind a lot of sick people live on huge amounts of hydrocortisone and it doesn't affect you. So I would say the answer to your question is no, taking it here and there would not have compromised your system.

Are you absolutely sure your thyroid labs are good because low thyroid can cause skin problems and allergies etc. I had psoriasis and once my thyroid got treated effectively it went away and so did all my allergies. Originally my endo claimed my thyroid was fine yet when I got hooked up with a HRT specialists he said my FT3 was lowish and if I raised it that it could help a lot of my symptoms. He was so right and that when I learned mainstream medicine's endo's were not helpful.

Took no thyroid med yesterday and had no shaking.
Took 2 grains this morning (instead of usual 3) and i'm shaking now.

Unfortunately I'm not sure that's telling you anything. Perhaps you should keep your dose the same and add cortisol for a few days and see how you feel. If it's the same then you would have to conclude you have issues with your thyroid meds. But if it improves then you could assume you were low on cortisol and taking the thyroid meds made the cortisol problem worse