Have you ever felt like T3 in your treatment wasn’t working…whether a working NDT, or T4/T3, or T3-only? Or you got a bad reaction when raising? We as hypothyroid patients figured out why that happens. Check out the information below and see what you think. ~Janie, hypothyroid /Hashimoto’s patient and site creator

Here are examples expressed by certain patients pertaining to having T3 in their treatment:

  • It does nothing for me. 
  • It just stopped working.
  • It felt no different than just being on T4.
  • I feel worse on it!
  • It makes me anxious, shaky, or nervous.
  • My heartrate or blood pressure goes too high.
  • I get heart palps on it.
  • My hair falls out since on it!
  • I’ve had panic attacks! 
  • I get headaches.
  • My T3 is high but I still feel bad. 
  • I’m having insomnia and trouble sleeping now.  

We, as patients, have found there are TWO very explainable and correctible reasons why T3 in our treatment doesn’t seem to work for us, below.

1) Staying on too low a dose

This is all too common because you still believe the lie (or have a doctor who does) that falling “anywhere” in the so-called “normal” range is fine and dandy. NOPE. When we have T3 in our treatment, and our free T3 stays too low / not optimal, we can feel better for awhile, but then it all backfires with a return of symptoms. Instead, we have to achieve an optimal free T3. Below midrange is not optimal. Midrange is not optimal. A bit above midrange is not optimal. All the latter WILL eventually backfire with a return of symptoms, and/or stressed adrenals. The individuality is when it backfires. READ about optimal. Read the ENTIRE page. No skimming. No jumping around. Read it ALL. YOU have to become informed and try to inform a doctor. You have no choice since they tend to believe it their horrible, pitiful training.

2) Having what appears to be a good level of free T3, or just having any amount of T3 in our treatment, but we are having “hyper-like” symptoms like palpitations, higher heartrate, anxiety, etc.

That is not the fault of the T3 in your treatment. Nope. And doctors are POORLY trained about this. It’s about what the T3 is REVEALING. T3 will REVEAL either low cortisol, high cortisol, or low aldosterone via what we call “hyper-like symptoms: anxiety, shakiness, fearfulness, racing mind, simply feeling racy, heart palps, high heart rate, sleep issues, or any strange problems. No, you are not hyperthyroid. You just have the symptoms. The latter three are related to your adrenals being stressed. And that will cause you to pool. Click on the underlined word right before this and READ THE PAGE. All of it. i.e. cortisol isn’t getting to the cells well due to that adrenal issue, and can cause the Free T3 to go high in the blood. AKA pooling. What to do about it?? READ Chapter 6 in the STTM 1 book. READ it. Here’s what the STTM I book looks like: https://laughinggrapepublishing.com/product/sttm/ Expect to find a doctor you can teach. You have no choice.

NOTE: yes, a small minority could have taken way too much T3, and not have an adrenal problem being revealed. With that, you will definitely have problems and a free T3 way over range.

But most are NOT on too much, and the above two reasons explain why T3 may not seem to be working for you, or causing problems. It’s usually one or the other.

IMPORTANT POINT #1: Nope, it’s NOT a case of “everyone is different” which is a poor and weak explanation. It’s usually about either of the two reasons above.
IMPORTANT POINT #2: Need to know if you have a cortisol problem and how?? It’s NEVER about blood testing, which only measures what is bound (to proteins) and mostly unusable. And blood is only a one time test. It’s about ordering your OWN saliva test which measures what is usable! Click on graphic below.
IMPORTANT POINT #3: When I, Janie, first started with T3 in my treatment, which was NDT, I had palps with each raise. That was due to me having a sensitive nervous system. Those palps all went away for ME. For you? Look at your adrenals with the saliva test, NOT blood (click on graphic below to order), and blood for aldosterone testing.

Click on the graphic to the left to order a reliable saliva test if you are in the US or Canada. Once you get your results back, compare to what’s on the lab values page. If you are in other countries, ask around where you can order one there. Note that doctors are courted to use all sorts of different brands of a saliva test. This one is proven to be more reliable, or have far better ranges to understand your results. YOU WILL ALSO NEED TO DO THE BLOOD TEST FOR ALDOSTERONE, another steroid. If not in the top numbers, it can also cause pooling and/or a bad reaction with T3

3) What if your free T3 is where it should be without pooling, and you STILL have problems?
Read about Reverse T3. Yours could be going up and it should NOT. There’s mention of this in the STTM 1 book, too. Click on the link and READ it. Don’t skim. Read it all.
Next read about iron. Yours could be too low. Read it all. Don’t skim. Also consider testing for EBV, aka Epstein Barr Virus, which can reactivate if you are under a lot of stress. You want to do the EBV test that shows what’s going on right now, not the one that shows you were exposed to it in the past.


STTM graphic How cortisol can cause problems when raising NDT
Summary: Being undiagnosed, or treated with T4-only like Synthroid or Levothyroxine, or undertreated with NDT or T3, stresses the adrenals, resulting in too high cortisol, low cortisol, or low aldosteron–all which cause problems when working to raise NDT or T3 to find our optimal dose. Problems include pooling (T3 going too high in the blood & not making it to the cells. High cortisol can cause rising RT3 the inactive hormone. Symptoms of a cortisol issue include, but are not limited to, insomnia, waking up often,  feeling unrefreshed when getting up in the morning, anxiety, fearfulness, paranoia, shakiness, etc.

Two important truths about cortisol testing

  1. We can’t go by blood. Blood results are measuring a combination of bound and unbound cortisol, and gives no clue what’s in our cells, looking high when it’s not (or even low when it’s not, as reported by some patients).
  2. We have to do the 24 hour adrenal saliva test as explained right hereYou can order your own saliva cortisol test here. And again, these results have nothing to do with “falling in the normal range”. They have to do with WHERE they fall, as explained here.

As far as cortisol, a person can fail to correctly treat their cortisol issues as follows:

  • thinking that taking only adaptogens can do the job (they frequently aren’t enough if you have low cortisol).
  • not understanding how to use cortisol (many take too little, or dose it wrong, or fail to do Daily Average Temps to find the right amount, or fail to stress dose once they do find the right amount…plus more details (Chapter 6 of the revised STTM book has the best details anywhere on how to use cortisol-containing products)
  • thinking that avoiding stress can do the job (helpful, but often not enough)
  • thinking that a change in your diet can do the job (it’s not enough)
  • failing to understand where your saliva cortisol results need to fall as explained here (for those who aren’t on anything yet)
  • not understanding the correct way to do the T3CM or that it’s mostly just for low morning levels
  • and more….

    READ CHAPTER 6 IN THE STTM 1 BOOK!! I can’t stress this enough. It’s got more than on the website. READ. Highlight important points. Expect to guide a doctor.

What about Lyme disease and tolerating your thyroid treatment?

There are some with Lyme who report doing much better on T3-only due to T4 converting to too much RT3.

You just have to learn what T3 in your treatment is telling you when it doesn’t work well, and treat those issues correctly. Because unlike T4 with its history of problems, you may not want to miss out what T3 can do for you…whether T4 and T3, T3-only or even a natural thyroid supplement like Thyrogold, et al.

*** Need a good doctor to work this information with? Go here. But you have to be informed and expect to teach even the slightly better doctors.

     Get the STTM books! Read at your own leisure, highlight, underline, book mark!!

Important note: STTM is an information-only site based on what many patients worldwide have reported in their treatment and wisdom over the years. This is not to be taken as personal medical advice, nor to replace a relationship with your doctor. By reading this information-only website, you take full responsibility for what you choose to do with this website's information or outcomes. See the Disclaimer and Terms of Use.