Nervousness, racing heart, sweating, shaky hands

Hi everyone :)

I'm looking for some help interpreting some symptoms I'm having lately, and how I might adjust my thyroid dosage. Just fyi I have half my thyroid gland left and have been taking T3/T4 meds for just over a year now.

Since about Christmas time I've been on a dose of 2 Cynoplus per day, which helped me feel warmer and happier in the winter - although it didn't seem like quite enough as my morning temperature during menstruation was around 36.2-36.4.

Around March I noticed that during times of stress (like having to talk to a doctor -ugh) I would get a racing heart and feel more nervous - like I could tell my body was feeling quite stressed, whereas in the past I could control my nervousness and basically overcome it. I also felt this way when I would be rushing to get somewhere - eg. walking really fast. I don't know if it was caused by the physical activity or the mental state of feeling like I was going to be late. (I gave up exercising so I don't really know if that would bring on the same symptoms.)

I've never had these issues before even when I was severely hypothyroid, so I'm confused why they would appear after 2 months on the highest dosage I've ever taken of Cynoplus. I was wondering if maybe they were actually hyper symptoms, even though my waking temperature (and other symptoms like many allergies) still indicate hypothyroidism.

A practitioner I've been consulting with recommended to me trying 1/6 Cytomel tablet every hour and then 1/4-1/2 a Cynoplus before bed - she said she sees more progress in her clients when they take it that way. I decided to try it, keeping the same level of T3 as in my previous dosage, but reducing the T4 so it was a 1:1 ratio. (So basically 2 Cytomel with 1/2 a Cynoplus.)

Since then I feel like the nervousness symptoms are still happening (maybe even worse), and I've been sweating and flushing way more than is normal (although hands feel a bit colder). I also noticed shaky hands and air hunger if I have to speak and it's the slightest bit stressful. I'm not a super shy person so this is all really weird for me.

One other factor - I started reducing starch around the time these symptoms first came about (and am now on zero starch) - so possibly there is a connection? I noticed the nervous feeling can be worse when I haven't eaten enough. I do get my 80g of protein and lots of sugars but I have mostly OJ and milk instead of the heavy potato/rice/meat meals I used to have before. The reason I don't eat the starches is because I got a huge improvement with my allergies once I cut them out.

I did measure my temperatures before and after eating (in the evening) and I was around 36.8 before, and then it dropped to around 36.4 after a meal which I think indicates stress hormones?

I'm really confused about where to go from here with my thyroid dosage, and how to control these annoying symptoms. Does anybody have some ideas about my situation? Thank you :)

ilovethesea said:

Around March I noticed that during times of stress (like having to talk to a doctor -ugh) I would get a racing heart and feel more nervous - like I could tell my body was feeling quite stressed, whereas in the past I could control my nervousness and basically overcome it.

Click to expand...

How long have you been on your new dose when that happened? Maybe you haven't gotten used to it? (the adrenalin sometimes takes a few weeks to come down after changing the dose, if I recall correctly)

j. said:

How long have you been on your new dose when that happened? Maybe you haven't gotten used to it? (the adrenalin sometimes takes a few weeks to come down after changing the dose, if I recall correctly)

Click to expand...

I started taking 2 Cynoplus late December. The reason being I noticed I was feeling cold. Before that I was on 4 grains of Erfa.

So it was about 2 months later I started noticing the adrenaline symptoms. What does that mean?

You did not mention your pulse. I think it would be good idea to ask RP about your
current dose. It seems like you are probably overdosing on your current regimen.
Aspirin can also increase metabolism. RP has also mentioned people needing
more thyroid hormone during winter.

Mittir said:

You did not mention your pulse. I think it would be good idea to ask RP about your
current dose. It seems like you are probably overdosing on your current regimen.
Aspirin can also increase metabolism. RP has also mentioned people needing
more thyroid hormone during winter.

Click to expand...

My pulse seems to have gone up to mid 80s in the last few weeks and the sweating has come about... before it was always stuck in the 70s.

I should also note that during the past month of a lower thyroid dose and the nervous symptoms, I noticed my fingernails have been in the worst shape they've ever been. Thin as paper, weak, splitting and peeling - they peeled right down to little stubs. Isn't that a hypo symptom?

Also the fact that my temperature now goes down after eating... I am confused.

How can it be that a lower thyroid dose makes me feel warmer yet more stressed/anxious with worse hypo symptoms like the nails? Yet on the higher dose I was taking before I didn't have these symptoms as bad?

I have not been taking aspirin regularly for the last couple months. Today I took 2 without dissolving them in water and then had the worst allergic reaction I've had for a long time. I wonder if that is somehow related to my stress symptoms.

I live in Canada so warm weather has not kicked in yet.

Does the list of ingredients of the aspirin have anything unusual?

j. said:

Does the list of ingredients of the aspirin have anything unusual?

Click to expand...

What's funny is it only lists the medicinal ingredient. Kind of disturbing they're not required to list the other junk.

I wish aspirin came in liqui-gels. Is there a safe pure powder that anyone knows of?

I am bit unclear about your previous dosing.
Is it the same temperature now as it was 2 months ago?
I am assuming that in previous regimen you
took 4-5 divided doses of cynoplus. Now you are taking same amount of total
T3 but divided over every hour. I do not think these two have same effects.
In every hour taking 1/6= 4 mcg which is almost equal to physiological dose.
This way you are getting full effect of T3. If you were taking cynoplus
4 times a day, you were getting 15 mcg of T3 in each dose.
It is possible body did not use all the 15 mcg and inactivated some of it.
Increased metabolism increases need for calories and nutrients.
You have also changed your T4 to T3 ratio.
Your change in diet can play a big role here. I have noticed when i remove
starch completely my metabolism increases and i lose some weight.
I also noticed my metabolism increased with extra calcium intake and
regular use of niacinamide. I think one of the major problem with
thyroid supplement is adjusting dose. I think measuring temp and pulse
several time through out the day will be more useful, especially 1-2 hours after meal.
Having a small drop after breakfast is not a big deal, as long as it goes up later.
It is also possible that you are not making enough T3 from T4 through out the night
and that can make you bit hypo in the morning. RP has mentioned that problem with
T3 only dosing is that one can not take T3 doses in the sleep.
I think you can figure out the right doses with little experimentation.
Do not get fixated with one number.

ilovethesea said:

Mittir said:

You did not mention your pulse. I think it would be good idea to ask RP about your
current dose. It seems like you are probably overdosing on your current regimen.
Aspirin can also increase metabolism. RP has also mentioned people needing
more thyroid hormone during winter.

Click to expand...

My pulse seems to have gone up to mid 80s in the last few weeks and the sweating has come about... before it was always stuck in the 70s.

I should also note that during the past month of a lower thyroid dose and the nervous symptoms, I noticed my fingernails have been in the worst shape they've ever been. Thin as paper, weak, splitting and peeling - they peeled right down to little stubs. Isn't that a hypo symptom?

Also the fact that my temperature now goes down after eating... I am confused.

How can it be that a lower thyroid dose makes me feel warmer yet more stressed/anxious with worse hypo symptoms like the nails? Yet on the higher dose I was taking before I didn't have these symptoms as bad?

I have not been taking aspirin regularly for the last couple months. Today I took 2 without dissolving them in water and then had the worst allergic reaction I've had for a long time. I wonder if that is somehow related to my stress symptoms.

I live in Canada so warm weather has not kicked in yet.

Click to expand...

Those are all classic symptoms of hypothyroidism and high adrenalin. In fact, your temperatures going down after eating tells you that your body runs on adrenalin most of the time and it only relaxes after you eat. Ray wrote about that and said that in very stressed out people he typically sees eating and/or taking thyroid to bring temps down. My advice would be to increase your salt intake by at least 5g daily (one teaspoon) and potentially take some pregnenolone to bring your adrenalin under control. Until you calm the adrenals almost any dosage of thyroid will send you over the edge. Casein protein (cheese, strained yogurt) will also calm you down.

Symptoms of high adrenalin can be also due to increased sensitivity to adrenalin from thyroid supplementation.

I remember that you had very low total cholesterol.
Were you able to raise cholesterol level with extra sugar?
Low cholesterol can mean that your thyroid function is real real good
and you are using up cholesterol to make all the protective hormones.
Another possibility is that you are not eating enough sugar to make
cholesterol or your liver is not making enough cholesterol.
Hyperthyroidism can also lower total cholesterol.
RP mentioned that one should have at least 160 mg/dl
which is equivalent to 4.13 mmol/L and preferably around 200 mg/dl
which is equal to 5.17 mmol/l. There is some interesting overlap
between symptoms of hyperthyroid and hypothyroid, making things
bit confusing. You can compare the list of hypo and hyper symptoms.

Mittir said:

I am bit unclear about your previous dosing.
Is it the same temperature now as it was 2 months ago?
I am assuming that in previous regimen you
took 4-5 divided doses of cynoplus. Now you are taking same amount of total
T3 but divided over every hour. I do not think these two have same effects.
In every hour taking 1/6= 4 mcg which is almost equal to physiological dose.
This way you are getting full effect of T3. If you were taking cynoplus
4 times a day, you were getting 15 mcg of T3 in each dose.
It is possible body did not use all the 15 mcg and inactivated some of it.
Increased metabolism increases need for calories and nutrients.
You have also changed your T4 to T3 ratio.
Your change in diet can play a big role here. I have noticed when i remove
starch completely my metabolism increases and i lose some weight.
I also noticed my metabolism increased with extra calcium intake and
regular use of niacinamide. I think one of the major problem with
thyroid supplement is adjusting dose. I think measuring temp and pulse
several time through out the day will be more useful, especially 1-2 hours after meal.
Having a small drop after breakfast is not a big deal, as long as it goes up later.
It is also possible that you are not making enough T3 from T4 through out the night
and that can make you bit hypo in the morning. RP has mentioned that problem with
T3 only dosing is that one can not take T3 doses in the sleep.
I think you can figure out the right doses with little experimentation.
Do not get fixated with one number.

Click to expand...

Thanks Mittir, I always appreciate your responses. You may be on to something here about my body not using the T3 when I was getting it from Cynoplus. You are correct, I was taking 1/2 a pill each dose, 4 doses per day - so 15mcg of T3 per dose.

And yes I do think I am more hypo in the morning when I'm coming off not having T3 all night. I never feel too hot or start sweating abnormally until the afternoon.

My morning temperatures don't seem to have changed at all with the different thyroid doses (still about 36.2). Unfortunately I didn't measure before and after a meal until recently so I don't have anything to compare on that. I'll start tracking my temperatures and pulse throughout the day and come back with that info.

Do you know if it is indeed better to take thyroid the way I am doing now - T3 in the day and T4 at night? Does anybody else do that? It would certainly be cheaper/easier to continue this way, as I'm using less of it and I already have huge problems getting my hands on it.

haidut said:

Those are all classic symptoms of hypothyroidism and high adrenalin. In fact, your temperatures going down after eating tells you that your body runs on adrenalin most of the time and it only relaxes after you eat. Ray wrote about that and said that in very stressed out people he typically sees eating and/or taking thyroid to bring temps down. My advice would be to increase your salt intake by at least 5g daily (one teaspoon) and potentially take some pregnenolone to bring your adrenalin under control. Until you calm the adrenals almost any dosage of thyroid will send you over the edge. Casein protein (cheese, strained yogurt) will also calm you down.

Click to expand...

Interesting thank you. That would make sense seeing as I don't feel like any hypo symptoms got cured by being "hyper".

Why do you think this has become apparent now - is it the no-starch diet or from lowering my thyroid dose? It's really confusing because symptoms weren't as bad on the 2 Cynoplus per day split into 4 doses - I'm surprised to hear going back to that would send me over the edge...

Here I thought my hypothyroidism was steadily improving and now it's a bit shocking to realize I'm running on stress hormones worse than ever. (The funny thing is I don't feel stressed aside from these certain situations. I sleep fine and it's not like I'm worrying about anything.)

I'll try to get down the salt, ugh. Now that I don't eat starch I don't have a vehicle for it. I do have a lot of Greek yogurt. What about the casein protein from milk? Or is it higher in cheese?

Have started on 100mg of LEF pregnenolone, unless you think the dosage should be higher?

Thanks!

Mittir said:

I remember that you had very low total cholesterol.
Were you able to raise cholesterol level with extra sugar?
Low cholesterol can mean that your thyroid function is real real good
and you are using up cholesterol to make all the protective hormones.
Another possibility is that you are not eating enough sugar to make
cholesterol or your liver is not making enough cholesterol.
Hyperthyroidism can also lower total cholesterol.
RP mentioned that one should have at least 160 mg/dl
which is equivalent to 4.13 mmol/L and preferably around 200 mg/dl
which is equal to 5.17 mmol/l. There is some interesting overlap
between symptoms of hyperthyroid and hypothyroid, making things
bit confusing. You can compare the list of hypo and hyper symptoms.

Click to expand...

Yes that's me :) I think it was in the 130s. I haven't had it tested again because I don't want to go back to my doctor yet - she's making me get a thyroid panel at the same time and will use that as her basis for lowering my prescriptions. (has no concept of seasonal variations or how I'm still trying to find the right dose. So I just don't want to go through that conversation yet until I have a better idea myself.)

As for sugar I eat over a cup of white sugar per day. I hope that's a good start at least :) I also try to have a litre of fresh orange juice, plus the yogurt and milk.

It seems like I have many of the hyper and hypo symptoms. It's funny, even though I can be sweating I also noticed a couple times a slight shivering/chill for a couple seconds, which probably does not make sense.

ilovethesea said:

Thanks Mittir, I always appreciate your responses. You may be on to something here about my body not using the T3 when I was getting it from Cynoplus. You are correct, I was taking 1/2 a pill each dose, 4 doses per day - so 15mcg of T3 per dose.

And yes I do think I am more hypo in the morning when I'm coming off not having T3 all night. I never feel too hot or start sweating abnormally until the afternoon.

My morning temperatures don't seem to have changed at all with the different thyroid doses (still about 36.2). Unfortunately I didn't measure before and after a meal until recently so I don't have anything to compare on that. I'll start tracking my temperatures and pulse throughout the day and come back with that info.

Do you know if it is indeed better to take thyroid the way I am doing now - T3 in the day and T4 at night? Does anybody else do that? It would certainly be cheaper/easier to continue this way, as I'm using less of it and I already have huge problems getting my hands on it.

Click to expand...

Your condition is quite unique and complicated. RP always talks about adjusting dose based
on how you feel to small dose of T3. The T4 part of your cynoplus can slowly build up over month
which depends on the rate of conversion from T4 to T3. I have heard him talking about nibbling on T3.
I am not sure he recommended anyone taking physiological dose of T3 every hour.
Your regimen does make sense that you are taking T3 when you are awake and taking T4+T3
when you are asleep. I really do not like this adjusting part of thyroid supplement.
You corresponded with RP. what kind of dosing did he recommend?
You can quickly ask him if your current dosing is good or not.
If i were you i would have have lowered the daily T3 sligtly,
for 1-2 hours and see how pulse and temperature changed .
If it lowers anxiety then it is most likely over dosing of T3.
You have to keep T4 as part of your regimen, when RP was using T3 only
his heart beat skipped every few seconds when he missed a dose.
Since T3 is used up quickly, you can always go back to your original dose
if it was too low. Sugar itself increases metabolism and T4 to T3 conversion.
I have noticed when i avoid starch it is hard to get salt without consciously
supplementing it. I always take small pinch of salt whenever i drink anything, even coffee.
Increasing intake of all 4 alkaline mineral is very very helpful in reducing all kind of
symptoms. These minerals compensate for each other to a great extent.
You can also check your total T4 to see if T4 is building up or being used.
We all are little bit hypothyroid in the morning.
I would not do any sudden and big change in dosing. I know how bad it feels
when you try to lower dose and then realize it is too low and it takes
several days to reach a correct dose. Please be patient and careful.

You're definitely overdosing.

Just taking thyroid doesn't guarantee heat production... You have to have food with thyroid so your cells have something to burn, and also can take time for your body to be able to return to normal temperatures even with thyroid. Thyroid also makes your body more sensitive to adrenaline, so if you don't have adequate thyroid and/or salt in your blood stream and you take thyroid or too much thyroid, you are going to get a pronounced stress response, which is not what we want. So, cut back on your dose significantly, test a small dose with carbohydrate (and salt). Your pulse should increase and likely but not always your temperature. The goal is to take as little thyroid to produce this sensation, and it should not at all make you feel angst or discomfort.

You're definitely overdosing.

Just taking thyroid doesn't guarantee heat production... You have to have food with thyroid (and enough of it) so your cells have something to burn and your probably prematurely went to too high a dose, and it can also take time for your body to be able to return to normal temperatures even with thyroid Thyroid also makes your body more sensitive to adrenaline, so if you don't have adequate carbohydrate and/or salt in your blood stream and you take thyroid or too much thyroid, you are going to get a pronounced stress response, which is not what we want. The same thing happens when you drink coffee without proper blood sugar--the shakes. Id cut back on your dose, test a small dose with carbohydrate (and salt). Your pulse should increase and likely but not always your temperature. The goal is to use as little thyroid to produce this sensation, then stay at that dose 2 times a day (maybe three if it doesn't interfere with sleep) and it should not at all make you feel angst or discomfort or shaky. Shaky is definitely a sign of low blood sugar.

Your situation sounds very similar to mine. I've had a total thyroidectomy so completely dependent on thyroid medication.

I take NDT and T3. It's taken years to get the dose working ok.

I get very hypo taking smaller doses. My current regime is:

2 grains NDT on waking
25mcg T3 around lunch
1 grain NDT late afternoon
12mcg T3 30-40 mins before bed

This seems to work for me at the moment. I got some of the symptoms you described (particularly getting really stressed when rushed or just being challenged a bit - felt like adrenaline) when I wasn't taking enough T4. Three grains of NDT seems to do the trick.

As the others have said in this thread - and I can't stress this enough - more food/nutrients are required. I have needed lots more food to support my metabolism, and I take a couple teaspoons of salt each day (sometimes more - I find this essential). I also add sugar to my OJ, and do better if I have some starch - sourdough bread and potatoes work for me.

I've been experimenting with having OJ/salt/sugar or similar milk drink just before bed, and at my bedside to be drunk if I wake up for any reason. This has done wonders for reducing adrenaline in the morning, and has stopped my temps and pulse dropping after I have breakfast. Maybe that is something to look at?

I hope in the future, as I heal, that I only need NDT, as dosing with T3 is very tricky, but required at the moment. Also, I was taking a compounded NDT (in Australia) and it did not work half as well as they pimpom NDT Thiroyd (I think that is the correct spelling).

Mittir said:

Your condition is quite unique and complicated. RP always talks about adjusting dose based
on how you feel to small dose of T3. The T4 part of your cynoplus can slowly build up over month
which depends on the rate of conversion from T4 to T3. I have heard him talking about nibbling on T3.
I am not sure he recommended anyone taking physiological dose of T3 every hour.
Your regimen does make sense that you are taking T3 when you are awake and taking T4+T3
when you are asleep. I really do not like this adjusting part of thyroid supplement.
You corresponded with RP. what kind of dosing did he recommend?
You can quickly ask him if your current dosing is good or not.
If i were you i would have have lowered the daily T3 sligtly,
for 1-2 hours and see how pulse and temperature changed .
If it lowers anxiety then it is most likely over dosing of T3.
You have to keep T4 as part of your regimen, when RP was using T3 only
his heart beat skipped every few seconds when he missed a dose.
Since T3 is used up quickly, you can always go back to your original dose
if it was too low. Sugar itself increases metabolism and T4 to T3 conversion.
I have noticed when i avoid starch it is hard to get salt without consciously
supplementing it. I always take small pinch of salt whenever i drink anything, even coffee.
Increasing intake of all 4 alkaline mineral is very very helpful in reducing all kind of
symptoms. These minerals compensate for each other to a great extent.
You can also check your total T4 to see if T4 is building up or being used.
We all are little bit hypothyroid in the morning.
I would not do any sudden and big change in dosing. I know how bad it feels
when you try to lower dose and then realize it is too low and it takes
several days to reach a correct dose. Please be patient and careful.

Click to expand...

Yes that was my understanding too - that RP recommended using the hourly T3 only at the beginning to figure out what you felt best on and then adding the T4 to that in a proportion somewhere between 4:1 or less. That's basically what he told me when I wrote to him last year about my dosing - I had been confused since I was coming from a T4 regimen already. I never actually did the T3 dosing until now because I could only get my hands on Erfa at the time.

The reason I changed now is because I felt like I "plateaued" on the 2 Cynoplus per day regimen and wasn't getting less hypo (and yet my doctor was freaking out that I'm "hyper" on blood tests). I decided to try the 2 Cytomels throughout the day and 1/2 a Cynoplus at night, at the recommendation of a practitioner (who follows RP too). This was to keep my T3 at the same level.

I decided the last 2 days to try just 1 Cytomel per day with the same 1/2 Cynoplus at night. I noticed somewhat less of the nerves/adrenaline but maybe still some sweating, and I got a pimple and my feet and nose have been cold. So, I think I must need more thyroid - I just don't know how to adjust from here without getting those symptoms again.

natedawggh said:

You're definitely overdosing.

Just taking thyroid doesn't guarantee heat production... You have to have food with thyroid (and enough of it) so your cells have something to burn and your probably prematurely went to too high a dose, and it can also take time for your body to be able to return to normal temperatures even with thyroid Thyroid also makes your body more sensitive to adrenaline, so if you don't have adequate carbohydrate and/or salt in your blood stream and you take thyroid or too much thyroid, you are going to get a pronounced stress response, which is not what we want. The same thing happens when you drink coffee without proper blood sugar--the shakes. Id cut back on your dose, test a small dose with carbohydrate (and salt). Your pulse should increase and likely but not always your temperature. The goal is to use as little thyroid to produce this sensation, then stay at that dose 2 times a day (maybe three if it doesn't interfere with sleep) and it should not at all make you feel angst or discomfort or shaky. Shaky is definitely a sign of low blood sugar.

Click to expand...

Is it considered overdosing when I was taking 2 Cynoplus per day before, and then lowered to 2 Cytomels + 1/2 a Cynoplus? That is the same amount of T3 and less T4.

On the 2 Cynoplus dose I didn't have problems with being cold, or the adrenaline symptoms, until I started lowering starch the last couple months, and that's when the nerves started acting up.

Now I tried the last 2 days going down to 1 Cytomel + 1/2 a Cynoplus and now I've got cold feet, cold nose and a pimple, with moderately better nerves/adrenaline.

No idea where to go from here - I do think I need more thyroid. Wondering if I should just go back to Cynoplus only... it was easier to dose with that... but I feel like I got more effects of the thyroid from T3. (Although maybe some of those are just stress symptoms.)