Hi, I would like to share experience using NDT and T3. Maybe helpful to people with palpitations on T3/T4.
To avoid misunderstandings, I explicitly emphasize that I do not argue against using thyroid. In my specific case, however, possibly owing to nutritional deficiencies yet to be identified (e.g., vitamin A?), thyroid hormone failed to raise my basal body temperature, although it had noticeable (side) effects on my cardiovascular system.
Background: I have been having palpitations in irregular intervals for about 13 years. Long story short: Most of the time I had extrasystoles. Over time I found out that magnesium and potassium can do a great job to alleviate the palpitations (long before I came across Ray Peat's science).
As described elsewhere, in late 2014 I started my "pseudo" Peatish diet. Since my basal body temperature still had not increased at all after 7 months of excess carbohydrates, I was convinced I should try NDT. Before, I had read Broda Barnes' "Hypothyroidism - The unsuspected illness", Janie Bowthorpe's "Stop the thyroid madness", Paul Robinson's "CT3M handbook" and "Recovering with T3", and of course, Ray Peat's articles on thyroid function, functionalps, as well as numerous threads on this and other forums. All in all, partly very conflicting information. I knew that treating oneself with thyroid medication would be a challenge. I considered the pros and cons and finally decided to take NDT, otherwise no progress could be achieved.
Since T3 is well known to be able to cause heart fibrillation, I worried a bit. However, I thought fibrillation would manifest as fast arrhythmias, and not as prolonged delays between beats. This was a crucial misunderstanding.
So, in June 2016 I started using a very low dose of NDT (0.25 grains), worked my way up to 1 grain, and then mainly followed Bowthorpe's suggestion to raise NDT by about 0.5 grains every two weeks and to wait a bit longer in the area of 2-3 grains. Well, I should have become suspicious about the fact that my basal body temperature did nothing but remain stable (about 97.2° F). So I raised the dose again, up to about 5 grains. Right from the beginning of this thyroid journey I often had palpitations of the slow type (a longer than usual delay between two heart beats). However, given the long history of arrhythmias, I ignored the current palpitations. I was convinced that they were completely unrelated to taking NDT. Also, in the first months there were always some days in succession without any palpitations. I favored the explanation that my palpitations were caused by excess potassium from orange juice which I upped to replace refined sugar. I knew that potassium decreases heart excitability, so excess potassium would probably be able to prolong the delay between two beats. This theory did not really fit with my observation that periods of cutting back on OJ did not really alleviate symptoms. Nonetheless, I did not have an alternative explanation. Over time, the arrhythmias became a daily companion. From October until end of January, there was hardly any day where I was completely devoid of palpitations. But still I did not consider NDT and/or synthetic T3 (in December) to be the cause. On the contrary, I even thought that too low an amount of T3/T4 might cause my problems. So I slightly increased my dose further. In late December, after abandoning T4 and running on 70-80 mcg T3 there was one single week without palpitations again. I was lucky to have found the seeming cause: T4. (By the way this was a week with very good weather: I consumed sunlight every day for about an hour, I do not know if there is a direct link, via cytochrome c oxidase?). I took this experience as further showing that using thyroid is not related to my heart problems. Unfortunately, on the dot of New Year's Eve (starting around 10 p.m.) there were a few palpitations again. What a step backwards
In the following weeks until the end of January 2016, the problem had gotten worse and worse. The delay between heart beats tended to increase and sometimes there were frightening breaks (maybe 2 seconds?), accompanied by noticeable (and literally visible) alterations in blood pressure. Also, I suddenly developed muscle twitching, a phenomenon I had not known before. The twitching was largely restricted to legs and arms, and lasted very long, and I had it everyday starting in the middle of January. I felt I needed to urgently find out what was going on. I heavily read on this forum and other sources, and the take home message was that it might be a shortage of magnesium, a shortage of B6, an excess of B12, or a problem with too little or too much calcium. I also measured blood pressure and was frightened (although I now know that the device does not function properly). It told me that blood pressure was 160/110, sometimes higher. "Resting" pulse was above 90 most of the time. (The quotation marks refer to the fact that I felt overdriven almost all the time but I could not tell anymore whether it was just steady worrying or T3.) For comparison: In summer (on about 1 grain NDT) blood pressure was pretty low: about 115/60, and 60-65 beats per minute. So, back in January, I worried a lot and decided to do blood work. In parallel, I took more than 1000 mg magnesium, plus magnesium footbaths per day. At first it seemed magnesium greatly decreased the frequency of my palpitations but after a few days the connection seemed more and more elusive. The appointment with the physician took place two days after supplementing magnesium. Of course, blood parameters were confounded, but I felt I needed to stick on supplementation to survive the weekend. Unfortunately, only a few blood parameters were measured. Calcium was at the top, but within the reference range, potassium was also high, magnesium was rather low given the new supplementation regimen. TSH was about 0 as fully expected. Blood pressure measured by the physician was 150/70 and 150/80, but I am always excited in the physician's artificial environment, plagued with fears...
Well, here is the happy end In the final weeks running on T3 I had frequently recognized a coincidence between the daily onset of my palpitations and T3 use. The palpitations often started about 15 to 30 minutes after swallowing my T3 dose (irrespective of whether it was 5 or 10 mcg; btw I know that 10 mcg is an unphysiological dose). On the other hand I neglected this observation due to the fact that the very first (albeit few) palpitations on a given day started directly after waking up before ingesting any new exogenous T3, so in my opinion this precluded the relationship between T3 intake and my palpitations. However, I developed quite a strong aversion towards T3, and one day it was all the same to me: I just took my initial morning dose, and, then, two hours later when the next dose was due, I just waited, and waited, and waited, and the palpitations stayed away. So I took just another two doses in the afternoon and in the evening. To my surprise, the palpitations re-occured after the later doses but spared me in between. I tried this another day. Same result. I eventually drew the conclusion that T3/T4 might be causing my palpitations. I planned to get rid of medication in the course of one or two *months*. However I was so lucky to find relief that I tried to get rid of it much faster. I remembered Peat saying that the thyroid can dynamically respond within one or two *days*. Other opinions were in the range of one to two *weeks*. So, I waned thyroid supplementation within six days. Luckily I had decided to take a bit of NDT two weeks earlier so my expectation was that the long half-life of T4 might help to protect from a sharp fall in basal body temperature. My temperature remained quite stable while waning but then it dropped. Well, this was about 2.5 weeks ago. In the meantime, my body temperature has come back but is still slightly below the level as before and during treatment. I am lucky that at least this time I made the right decision. The alternative would have been further increasing T3.
After waning T3/T4, palpitations rapidly disappeared within a few days. I have not been experiencing any palpitations for about two weeks now. My resting pulse is back in the 60s again. I assume that blood pressure is also much lower but have not tested it. I do not feel overdriven anymore.
In retrospect I was so stupid. I should have recognized my problems with T3/T4 earlier. In the battle I was blind and overrode my intuition.
I simply did not want to understand that body temperature might be low while simultaneously developing symptoms of hyperthyroidism. I was aware of having a "high" pulse, which is normal in the Peat community, however. I thought I was on the right track and temperature would rise later.
Besides learning that basal body temperature versus pulse and other cardiovascular stuff may sometimes dissociate, I now think my cellular problems are probably bigger than I had expected.
Please see attached charts for the time course of T3/T4 dosage and basal body temperature.
To avoid misunderstandings, I explicitly emphasize that I do not argue against using thyroid. In my specific case, however, possibly owing to nutritional deficiencies yet to be identified (e.g., vitamin A?), thyroid hormone failed to raise my basal body temperature, although it had noticeable (side) effects on my cardiovascular system.
Background: I have been having palpitations in irregular intervals for about 13 years. Long story short: Most of the time I had extrasystoles. Over time I found out that magnesium and potassium can do a great job to alleviate the palpitations (long before I came across Ray Peat's science).
As described elsewhere, in late 2014 I started my "pseudo" Peatish diet. Since my basal body temperature still had not increased at all after 7 months of excess carbohydrates, I was convinced I should try NDT. Before, I had read Broda Barnes' "Hypothyroidism - The unsuspected illness", Janie Bowthorpe's "Stop the thyroid madness", Paul Robinson's "CT3M handbook" and "Recovering with T3", and of course, Ray Peat's articles on thyroid function, functionalps, as well as numerous threads on this and other forums. All in all, partly very conflicting information. I knew that treating oneself with thyroid medication would be a challenge. I considered the pros and cons and finally decided to take NDT, otherwise no progress could be achieved.
Since T3 is well known to be able to cause heart fibrillation, I worried a bit. However, I thought fibrillation would manifest as fast arrhythmias, and not as prolonged delays between beats. This was a crucial misunderstanding.
So, in June 2016 I started using a very low dose of NDT (0.25 grains), worked my way up to 1 grain, and then mainly followed Bowthorpe's suggestion to raise NDT by about 0.5 grains every two weeks and to wait a bit longer in the area of 2-3 grains. Well, I should have become suspicious about the fact that my basal body temperature did nothing but remain stable (about 97.2° F). So I raised the dose again, up to about 5 grains. Right from the beginning of this thyroid journey I often had palpitations of the slow type (a longer than usual delay between two heart beats). However, given the long history of arrhythmias, I ignored the current palpitations. I was convinced that they were completely unrelated to taking NDT. Also, in the first months there were always some days in succession without any palpitations. I favored the explanation that my palpitations were caused by excess potassium from orange juice which I upped to replace refined sugar. I knew that potassium decreases heart excitability, so excess potassium would probably be able to prolong the delay between two beats. This theory did not really fit with my observation that periods of cutting back on OJ did not really alleviate symptoms. Nonetheless, I did not have an alternative explanation. Over time, the arrhythmias became a daily companion. From October until end of January, there was hardly any day where I was completely devoid of palpitations. But still I did not consider NDT and/or synthetic T3 (in December) to be the cause. On the contrary, I even thought that too low an amount of T3/T4 might cause my problems. So I slightly increased my dose further. In late December, after abandoning T4 and running on 70-80 mcg T3 there was one single week without palpitations again. I was lucky to have found the seeming cause: T4. (By the way this was a week with very good weather: I consumed sunlight every day for about an hour, I do not know if there is a direct link, via cytochrome c oxidase?). I took this experience as further showing that using thyroid is not related to my heart problems. Unfortunately, on the dot of New Year's Eve (starting around 10 p.m.) there were a few palpitations again. What a step backwards
In the following weeks until the end of January 2016, the problem had gotten worse and worse. The delay between heart beats tended to increase and sometimes there were frightening breaks (maybe 2 seconds?), accompanied by noticeable (and literally visible) alterations in blood pressure. Also, I suddenly developed muscle twitching, a phenomenon I had not known before. The twitching was largely restricted to legs and arms, and lasted very long, and I had it everyday starting in the middle of January. I felt I needed to urgently find out what was going on. I heavily read on this forum and other sources, and the take home message was that it might be a shortage of magnesium, a shortage of B6, an excess of B12, or a problem with too little or too much calcium. I also measured blood pressure and was frightened (although I now know that the device does not function properly). It told me that blood pressure was 160/110, sometimes higher. "Resting" pulse was above 90 most of the time. (The quotation marks refer to the fact that I felt overdriven almost all the time but I could not tell anymore whether it was just steady worrying or T3.) For comparison: In summer (on about 1 grain NDT) blood pressure was pretty low: about 115/60, and 60-65 beats per minute. So, back in January, I worried a lot and decided to do blood work. In parallel, I took more than 1000 mg magnesium, plus magnesium footbaths per day. At first it seemed magnesium greatly decreased the frequency of my palpitations but after a few days the connection seemed more and more elusive. The appointment with the physician took place two days after supplementing magnesium. Of course, blood parameters were confounded, but I felt I needed to stick on supplementation to survive the weekend. Unfortunately, only a few blood parameters were measured. Calcium was at the top, but within the reference range, potassium was also high, magnesium was rather low given the new supplementation regimen. TSH was about 0 as fully expected. Blood pressure measured by the physician was 150/70 and 150/80, but I am always excited in the physician's artificial environment, plagued with fears...
Well, here is the happy end
In the final weeks running on T3 I had frequently recognized a coincidence between the daily onset of my palpitations and T3 use. The palpitations often started about 15 to 30 minutes after swallowing my T3 dose (irrespective of whether it was 5 or 10 mcg; btw I know that 10 mcg is an unphysiological dose). On the other hand I neglected this observation due to the fact that the very first (albeit few) palpitations on a given day started directly after waking up before ingesting any new exogenous T3, so in my opinion this precluded the relationship between T3 intake and my palpitations. However, I developed quite a strong aversion towards T3, and one day it was all the same to me: I just took my initial morning dose, and, then, two hours later when the next dose was due, I just waited, and waited, and waited, and the palpitations stayed away. So I took just another two doses in the afternoon and in the evening. To my surprise, the palpitations re-occured after the later doses but spared me in between. I tried this another day. Same result. I eventually drew the conclusion that T3/T4 might be causing my palpitations. I planned to get rid of medication in the course of one or two *months*. However I was so lucky to find relief that I tried to get rid of it much faster. I remembered Peat saying that the thyroid can dynamically respond within one or two *days*. Other opinions were in the range of one to two *weeks*. So, I waned thyroid supplementation within six days. Luckily I had decided to take a bit of NDT two weeks earlier so my expectation was that the long half-life of T4 might help to protect from a sharp fall in basal body temperature. My temperature remained quite stable while waning but then it dropped. Well, this was about 2.5 weeks ago. In the meantime, my body temperature has come back but is still slightly below the level as before and during treatment. I am lucky that at least this time I made the right decision. The alternative would have been further increasing T3.After waning T3/T4, palpitations rapidly disappeared within a few days. I have not been experiencing any palpitations for about two weeks now. My resting pulse is back in the 60s again. I assume that blood pressure is also much lower but have not tested it. I do not feel overdriven anymore.
In retrospect I was so stupid. I should have recognized my problems with T3/T4 earlier. In the battle I was blind and overrode my intuition.
I simply did not want to understand that body temperature might be low while simultaneously developing symptoms of hyperthyroidism. I was aware of having a "high" pulse, which is normal in the Peat community, however. I thought I was on the right track and temperature would rise later.
Besides learning that basal body temperature versus pulse and other cardiovascular stuff may sometimes dissociate, I now think my cellular problems are probably bigger than I had expected.
Please see attached charts for the time course of T3/T4 dosage and basal body temperature.
