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Hypothyrodoism symptoms. Slow respiration, slow heart rate. Have primary empty sella. How to take T3 without anxiety?

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General & Family Physician
Practicing since : 2009
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I am 55 year old female 58 kg. Not losing and not putting on weight. Not taking any drugs not drinking, or smoking. Healthy food and health conscious.
I have all the classic hypothyroid symptoms and they are worsening.
I feel very cold all the time, extremities are very cold. Lightheadedness , memory problems, foggy thinking, slow thinking, slow movements, and walking. Indigestion.
Temperature 35.4C at night then steadily rising to 37C by lunch time. But even then I feel very very cold even in the tropics where I live, the weather is very hot. I am wearing pullovers, sleeping with thick blankets on even on my head.
Heart rate is slow at night around or less then 60/minute. It’s normal during the day or elevated when I have anxiety.
My respiration is very slow and shallow and this is I am most concerned about because it is still slowing and I sometimes wake up not breathing at all. Not having the breathing reflexes. Is it in connection with hypothyroidism?
I have anxiety too which is worsened as the hypothyroidism has worsened. What’s causing the anxiety? The hypothyroidism?
There is one more symptom. My joints becoming more and more flexible. I wonder if it is it in connection with hypothyroidism?
There a strange thing I don’t know if it is in connection with hypothyroidism. I have paradoxical or adverse drug reaction to most medication. I had to stop Hrt because estrogen made me very sleepy. It can be because, as I read, that estrogen increases reverse T3. The drug sensitivity worsened lately. Even vitamin supplements make me either sleepy or anxious.
One more unusual thing, my eyelids are more and more sunken looking. I never have fluid retention. Fluid retention would be “normal” with hypothyroidism.
I also have primary Empty Sella. But all my pituitary hormones are normal in the tests and not causing symptoms. Can’t see connection with the reverse thyroid problem but what do you think?
I realized I always had hypothyroid symptoms in all my life but in the last few weeks they became much worse. I never thought I had hypothyroidism because the thyroid tests were always normal but the Reverse T3 never was checked.
I have positive test result for Serum Reverse T3 (459). The TSH test is in normal range 1.6 also most of the other blood tests are ok. Only some Ferritin (transferritin 80) and B12 issues. Triglyceriides 2.5, Cholesterol 6.3, LDL 3.41
I tried to take Triiodothyronine for 2 weeks. I couldn’t raise the dosage above 5mcg (it’s one tenth of the dosage) and feel much worse than before I started. It makes me extremely anxious, fearful, and sometimes panicky. Blood pressure goes up to 160/90. Heat rate around 120. Symptoms worsened with taking T3 feel even colder. I think it’s because it causes stress and stress increases reverse T3. Why does Triiodothyronine increases stress for me, tell me please?
Tried to take cortisol ((cortate) thought low cortisol caused the anxiety but immediately felt worse, colder etc. so I stopped it
Tried Clonidine to reduce norepinephrine, cortisol but it caused even more anxiety.
I would be happy if you could come up with a solution. How can I take the T3 what my body needs without the anxiety? What else can I take? Is there maybe any other underlying condition that needs attention?
Posted Mon, 23 Apr 2012 in Thyroid Problem and Hormonal Problems
Answered by Dr. Aparna Kohli 43 hours later

I am Dr. Aparna. As promised I could get an opinion from an Board Certified Endocrinologist, Dr Shehzad Topiwala. Please read his suggestions here.



Thank you for posting your query.

First of all, your interpretation of the concept of reverse T3 is incorrect. It is a complex laboratory test which can be safely interpreted only by an Endocrinologist. The test has a limited role in practice. In order to resolve whether or not you truly have Hypothyroidism, the following tests will be more useful: free T4, total T4, total T3, T3 resin uptake. I have not mentioned TSH (Thyroid Stimulating Hormone) as you have already had that done.

Typically the diagnosis of (primary) Hypothyroidism is not difficult to make, especially for an endocrinologist but with your stated history of empty sella syndrome, extra caution needs to be exercised in interpreting thyroid function (laboratory) tests.

You must see an Endocrinologist who will likely want to know your serum prolactin levels and possibly even an 8 am serum cortisol level, along with FSH (Follicle Stimulating Hormone) and LH (Luteinizing Hormone). It is not safe for you to self experiment with T3 and cortisol, as these are potent hormones, which if used injudiciously, have the potential to do significant harm.

T3 is anyhow not the recommended agent of choice for treating hypothyroidism.

For more information you may wish to peruse WWW.WWWW.WW and WWW.WWWW.WW

Hope I have answered your query. Please accept my answer in case you do not have further queries.

Dr. Shehzad Topiwala
Above answer was peer-reviewed by
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