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Need help - Low TSH, High Free T4

Waldoj

Member
Joined
Mar 5, 2021
Messages
10
I'm a 40yo male, 6', 144 lb

I've always been thin/underweight but also always had hypo thyroid symptoms: cold hands/feet/nose, fatigue, anxiety. When I found Ray Peat's ideas about 2 years ago I implemented diet changes but only found minor change in these symptoms.

My pulse and temps were lowish at this time: 97.2 F and 60-64 bpm. I decide to give thyroid medication a shot and in July 2021 I started taking Cynoplus... 1/8 tablet, then slowly working up to 3/4 tablet over three months. I now realize that was a lot and probably went too high.
The Cynoplus improved my pulse, probably too much, to 90-95 bpm upon waking. (My pounding heart was making me uncomfortable) Curiously my temps did not rise that much, only to 97.6ish.

I tapered off Cynoplus completely in November due to feeling uncomfortable with headaches and pounding heart. So it's been about 4-6 weeks since stopping and my pulse is still high (for me) 90-95 bpm.

Just got a thyroid panel and everything is outside normal ranges:

TSH: <0.01
(LOW - range 0.40-4.50)

T3 uptake: 40
(HIGH - range 22-35%)

T4, Total: 19.3
(HIGH - range 4.9-10.5 mcg/dl)

Free T4 Index (T7): 7.7
(HIGH - range 1.4-3.8)

Can anyone help me interpret what it means? I understand it mean HYPERthyroidism but what does it mean in my context of a history of hypo symptoms and taking Cynoplus for 4.5 months. Is my body not able to use the T4?

The T4 values are alarming because they are so high (double the high reference range) and I'm worried about occasionally chest pain I'm having. I just read that high Free T4 puts you at higher risk for heart attack.
 

xeliex

Member
Joined
Feb 10, 2016
Messages
425
I think it just means that your dose of "thyroid" is too high as you mention.

It could also mean that you might need extra t3 with your t4/t3 to alter the ratio. This might be due to factors limiting your t4 conversion to t3, one of which is stress and malnutrition.

A third explanation could be the thermometer's accuracy and time of testing.

For me, my morning temps are always low but day temps are good. Along with resolution of symptoms, I don't worry about morning temps being low. My feel good TSH seems to be around 1.

Go back to the basics. Eat well. Eat frequently. Calm the heck down. Enjoy what life has to offer. Best of luck to you.
 

Waldoj

Member
Thread starter
Joined
Mar 5, 2021
Messages
10
Thanks xeliex.

In order to get T4 back to "normal" levels (pre-cynoplus), I was wondering if I should kind of do the opposite of "eat well" and eat goitrogenic foods (nuts, beans, raw veggies). Would that be a bad idea?

I have Cynomel. Would taking T3 alone help in bringing down my T4 levels? Or is it better to just stay off all thyroid supplements?

Basically I just want to reset and go back to my pre-cynoplus levels. I understand likely I just have to just wait this out. I'm just wondering if there is a way to facilitate the process.

It's been about 6 weeks since I stopped Cynoplus (I read that 6 weeks is how long it takes to notice changes in thyroid medication) and my RHR is just now starting to come down. I wear an Oura ring so I have good data. I'm attaching my monthly chart. My avg RHR peaked and plateaued at 79 bpm. As you can see it is quite a change from the 50 bpm starting point. I know that a 70-90 bpm is desirable but I've found it uncomfortable. Contrary to what RP says, that when people are temporarily hyper they feel best they ever felt. And that is with a bpm of 130.

While on Cynoplus I felt warmer (even though temps didnt rise much) but in the past week my cold feet symptom has returned. It's strange since my blood values indicate I'm very hyperthyroid.
 

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xeliex

Member
Joined
Feb 10, 2016
Messages
425
I've been there. I found out that when I tried to "enjoy" that nervous feeling, the angst resolved. Distract yourself. You've done what needs to be done, now let your body deal with it.

I'd just relax and try some buteyko breathing, going outside, eating well, and have faith that everything will be alright.
 

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