T3 is the single most important thyroid hormone that your body creates.
It is also the most powerful and biologically active of all thyroid hormones.
But, like anything in life, too much of a good thing can be a problem.
In this article, we are going to explore T3 in more detail. I will walk you through the symptoms which may indicate that your T3 is too high, the various causes of high T3, how to test for it, and whether or not having a high T3 is dangerous.
Symptoms Of High T3
Let’s first discuss the symptoms that tend to be associated with a high T3.
Because T3 is the most biologically active thyroid hormone (1), it makes sense that having a high level can cause problems for the body.
And while that turns out to be true, it’s probably not as straightforward as you may think.
It’s possible for you to have a high free T3 or high total T3 and experience the symptoms of excess T3.
But it’s also possible for you to have a high free T3 or high total T3 and feel great!
In fact, many people who take thyroid medication find themselves feeling “optimal” as their free T3 rises higher and higher.
There are some people, however, who are more sensitive to T3 and may experience the symptoms of excess T3 at “normal” levels (more on that below).
What symptoms am I talking about? You can find a list below.
Symptoms that indicate your T3 may be too high:
- Jittery sensation
- Heart palpitations
- Stomach Pain
- Heat intolerance
- High blood pressure
- High blood sugar
- Hot flashes, hot flushes, or increased sweating
It’s important that you use the combination of your symptoms AND your T3 lab tests to figure out what is happening in your body.
If you are, however, experiencing ANY of these symptoms AND you are taking thyroid medication, then it’s possible that your T3 may be too high.
But, we are just getting started here, so let’s dive into a little more detail…
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Testing T3 in the Serum/Blood
Now that you understand the symptoms of high T3, it’s time to talk about how to actually go about testing for it.
If you are experiencing any of the symptoms listed above then you will want to get these tests:
- Serum Free T3 (triiodothyronine, free)
- Serum Total T3 (total, triiodothyronine)
- Reverse T3 (reverse, triiodothyronine)
These two tests help you understand exactly how much T3 is floating around in your body, but each tells you slightly different information.
The amount of free T3 circulating in your body is a measure of how much hormone is free and active.
Most hormones circulate in your bloodstream bound to certain proteins (2) which inactive them until a certain time and place.
If the hormone is “free”, it means that it is not bound to a protein and it is immediately available to be used by your body.
In endocrinology, we almost always prefer to look at free hormones (this includes free testosterone, and so on) because this measurement has more meaning than understanding the “total” amount of hormone available.
But this doesn’t mean that the other test, total T3, is any less important!
Total T3 gives you information about the total amount of T3 available in the body (both free and bound forms).
In this way, total T3 provides a more stable measurement of T3 in your body at any given time.
Free T3 tends to fluctuate on a daily, hour-to-hour basis while total T3 tends to be more stable over time.
Both tests are important, however, which is why you generally wouldn’t want to test one without also looking at the other.
It’s possible, for instance, for your free T3 to be high while your total T3 is normal.
In this setting, if you only looked at your free T3, without looking at your total T3, you might incorrectly think that your body is getting too much T3.
I also recommend that you look beyond your free T3 and total T3 and into other indirect measurements of T3 status in your body with lab tests like reverse T3.
Reverse T3 is a byproduct created when your body is not able to produce ENOUGH T3.
High levels of reverse T3 directly compete with and block cellular activation of T3 and having high levels are associated with several disease states including obesity (3), inflammatory states (4), the use of certain medications, and chronic illness.
Why do Some People Experience Symptoms While Others Don’t?
It’s very important to understand that the symptoms of excess T3 need to be separated from your absolute lab tests.
What do I mean?
I mean that it’s possible for you to experience the symptoms of high T3 even with normal T3 levels.
It’s also possible for you to not feel the symptoms of high T3 even though your labs show that your T3 is elevated.
But, how can this be?
Well, it’s not completely understood, but I have a theory as to why this exists.
It shouldn’t surprise you to know that each individual reacts differently to medications and hormones.
If I gave 100 people the same dose of thyroid medication we would find that not all 100 people would react the same way.
Some would feel great, others would feel poorly, and still, others would experience no change at all.
This shouldn’t surprise you.
But why does this happen?
Part of the reason has to do with how SENSITIVE your cells are to thyroid medication compared to others.
In order for thyroid hormone to work in your body, it must act on your cells via a nuclear receptor and make changes in your cells.
How well your body does this depends on a number of factors including your genetics (5).
So, there will always be some people who are MORE sensitive to the cellular effects of T3 and others who are more resistant to it.
The more sensitive you are to T3, the more likely you are to experience the symptoms of high T3.
People who are sensitive often find themselves experiencing heart palpitations or hair loss with small doses of T3.
The more resistant you are to T3, the less likely you are to experience the symptoms of high T3.
People who are more resistant to T3 find themselves needing a high free T3/total T3 to feel optimal.
The bottom line?
Don’t be surprised if you don’t conform to the “standard reference ranges” provided by the lab company.
You are an individual, and what your body needs is going to be unique.
The Two Causes of High T3
There are two main ways that may find yourself with a high T3 in your body.
It’s actually quite important to know which is causing the problem in your body because the two conditions that result in high T3 are VERY different.
The first cause of high T3 can stem from the use of thyroid medication.
Thyroid medication is often prescribed for those people who have an under-functioning thyroid gland or those who suffer from hypothyroidism.
The second group of people who suffer from high T3 is those who have a problem with thyroid production in their own bodies.
These people have a problem with the thyroid gland which results in excess production of thyroid hormone from their own thyroid gland.
Because these conditions are so different, we need to explore them in a little more detail.
From Thyroid Medication
You can get a high free T3/total T3 from the use of ANY thyroid medication.
It is, however, most common to find yourself with a high-free T3 when using medications that contain T3 thyroid hormone.
Medications that contain T3 include all formulations of Natural Desiccated Thyroid, T3-only thyroid medications, and sustained-release T3.
These medications are most likely to result in a high free T3/total T3 in your body simply because they contain that hormone!
Most people, however, are not taking these medications.
Most people use medications such as Synthroid or levothyroxine.
And these medications contain only T4 (thyroxine).
It’s still possible for your body to convert that T4 into T3 (at a high rate) which may result in a high free T3/total T3, but this is unusual and not seen unless you are taking doses higher than 200mcg per day.
Experiencing a high T3 from thyroid medication is VERY different from a high T3 which your body produces naturally.
When you take thyroid medication, you are effectively changing how thyroid hormone is processed and utilized in your body.
As you take thyroid medication, your TSH will start to drop and the cross-talk between your brain and your thyroid gland declines.
As this occurs, and as your TSH drops, you become reliant upon thyroid medication that you are taking by mouth to provide thyroid hormone to all of your body.
And this is completely different from instances where your body produces excess thyroid hormone on its own (such as Graves’ or hyperthyroidism).
This is one reason why people taking thyroid medication can have a high free T3/total T3 and NOT necessarily experience the symptoms of high T3.
People who have conditions such as Graves’ or hyperthyroidism will always experience symptoms because the etiology of these conditions is different.
It is important to note, however, that it is absolutely possible to take too much T3 and cause a hyperthyroid state in your own body.
Those in this state will find it hard to miss, however, because they will experience all of the same symptoms associated with hyperthyroidism.
Be sure that you avoid this scenario, especially if you are taking thyroid medication that contains T3 thyroid hormone.
From Your Own Body
People who have a high T3 as a result of excess thyroid hormone production are rarely ever missed.
If you have this condition then the chances are very high that you are experiencing all of the symptoms I listed above.
These people present to their doctors and are often found to have high free T3 levels and a suppressed TSH.
About 80% of people who fit this category have an autoimmune condition known as Graves’ disease (6).
I won’t spend much time talking about these people because they are rarely ever missed and this condition must be treated because if it isn’t then you run the risk of becoming thyrotoxic or going into a thyroid storm.
Is High T3 Dangerous?
The answer is not as straightforward as you might think.
The short answer is it can be in some cases, but not always.
I have found that it’s always ideal to try and mimic the normal healthy levels that your body produces naturally when it is healthy (7).
For your thyroid, that means attempting to keep your labs in the “optimal” ranges found in this article.
If you can keep your lab tests in this range then you will avoid any potential problems.
On the other hand, I also recognize that these ranges are not one-size-fits-all.
And for several reasons, including chronic disease states or genetics, it may be necessary for some people to go outside of those ranges.
So, for some of you, you may find that you feel “optimal” with a free T3/total T3 which is flagged as “high”.
If you fit into this category then you need to be cautious to prevent negative consequences.
Having a high T3 is dangerous if it is associated with the symptoms of hyperthyroidism.
Having a high T3 is probably not dangerous, as long as you are not experiencing these symptoms.
One study (8), for instance, found that after 20 years of T3 use there was no increased risk of death, no increased risk of atrial fibrillation, and no increased risk of cardiovascular disease.
This is very important because many doctors scare patients away from T3 by telling them that T3 will cause heart problems (atrial fibrillation) and osteoporosis (reduction in bone density).
These side effects can be avoided if T3 is used correctly!
How well your body tolerates T3 depends on how you are using it!
If your dose is too small then you won’t notice any positive side effects.
If your dose is too high then you may start to experience negative side effects.
Pay close attention to your symptoms as you titrate or adjust your dose and follow your free T3 and total T3 lab tests.
If you find that you are experiencing the symptoms of excess T3 then make sure to adjust your dose to avoid complications.
It is possible to cause damage to your body with excessively high doses, but this damage will always be evident because it will be associated with symptoms.
Dropping your dose should be enough to prevent this damage from occurring.
When in doubt, don’t be afraid to go to a cardiologist to get a complete workup!
This may include tests such as an EKG and echocardiogram (9).
In addition, be sure to monitor your bone health with DEXA scans (10).
If you get the “okay” from your cardiologist and you find that your bone health is not osteoporotic or osteopenic, then you are in a good position.
Monitoring your free T3/total T3 levels is important for everyone, but especially for those people who may be experiencing the symptoms of excessive T3.
If you fall into this category, make sure you take a look at the medication you are taking and make adjustments as necessary.
The combination of a high free T3/total T3 with symptoms is a sign that you are getting too much thyroid hormone and may be damaging your body.
A high free t3, in the absence of symptoms, does not necessarily mean the same thing!
Now I want to hear from you:
Are you experiencing the symptoms of high T3?
What is your free T3/total T3?
Do you feel better with a higher-than-normal T3?
Are you extremely sensitive to T3 medication?
Leave your comments or questions below!
35 thoughts on “High T3 Symptoms With Thyroid Medication (& Without)”
I take a thiroyd 1 and 1 half a day to raise my t-3 and my blood pressure has gone to 165/195 and no palpitations. I have t-3 of 1.8 and THS of less than 1. tired and loss of balance before taking thiroyd.
T3 medication can increase your blood pressure. You can read more about how it works and what to do about it here: https://www.restartmed.com/thyroid-medication-high-blood-pressure/
Hi Doctor may I ask you one question if you don’t mind my medication was propthyuracil 300 mg a day my thyroid levels was going up my doctor ignored my thyroid levels was going up !!!june 2015 TSH 0.01 freet3: 7.66pmol/L (3.6-6.5) freet4: 14.4(9-19) normal level nhs uk next blood test :1.09.2015:TSH was 0.01 freet3:8.63pmol/L (3.1-6.8) freet4: 16.2(12.0-22.0) nhs uk 14 December night time I was seriously sick I went to emergency department they put me heart monitor and doctor said nothing serious only anxiety he said I told him I got thyroid problem he ignored me 13 January 2016 blood test results: TSH :0.01 freet3: was going up 9.30pmol/L (3.1-6.8) doctor still ignored blood test results I told him my symptoms:low mood and anxiety!! February I was sick again my hands was numb I couldn’t open them I was panicked doctor said I had TIA ( mini stroke ) doctor said coincidence no connection with thyroid levels I don’t believe him because next blood test results my thyroid level still was going up 15 March 2016 :TSH was 0.01 freet3 was going up 11.86 pmol/L (3.1-6.8) freet4: was going up 19.3 (12-22.0) my question is why my thyroid levels was going up ? Overmedication or undermedication ??thanks
My GP see my last blood test results 15 March 2016 t3:11.86 pmol/L t4: 19.3 TSH :0.01 and reduced my antithyroid medication 150 mg a day (.PTU) ….
Hi Doctor Westin Childs ,if you don’t mind could you tell me why my thyroid levels was going up since June 2015 >>>>>>>>>March 2016 ? Is it possible too much Antithyroid medication (300 mg PTU ) or I was undermedicated sir ? Almost 9 months my freet3 and my freet4 was going up ?this is first time happened….thanks
Dear Dr Child’s
I was taking 0.25 mcg Tirosint and I felt great. Beautiful head of hair etc. Then I was a little chilled. My fled put me on Np 60 mg I felt great!! Within 5 weeks I started losing hair. She was t sure what to do. Then I went to another physician. She put me in cytomel 5 mcg. I started losing more hair!!!
I stopped for 4 weeks my hair was getting shiny and thick. So, she tried 10 mcg T3. Eotjing 1 month my hair is shedding and I have lost 70% of my hair. She also put me on lodoral 12.5!g. I want to stop this. I am on high iodine.. my adrenal function is great with other hormones. But I have 3 in if hair on my head now. Losing eyelashes as well. NP told me if I stop she will not treat me. I am in serious trouble her. I went from social function attending charity calls…. To becoming a shell of myself. I am very depressed . T3 is not fir me. My nutritionist wants me to take kelp iodine and that should be sufficient. He had been my nutritionist for 29 years. In business 45!yrs. what say you. I am sensitive to T3 . I can’t sleep anymore and irritable. Hair loss is horrific. My husband cried with me. Not to mention o have spent $$$$ and getting worse
Please see this article which explains more about the connection between cytomel and hair loss: https://www.restartmed.com/cytomel-related-hair-loss/
I would also recommend checking out these resources:
I believe sir, I know you don’t wanna talk about high free t3 levels in Graves’ disease patients but my thyroid levels were going up because too much Antithyroid medication in my blood PTU -300 mg a day high dose!!! next time My local doctor, not specialist see last blood test results reduced my Antithyroid medication 150 mg a day and my thyroid levels were going down……
This is proof it was too much Antithyroid medication in my blood. My GP reduced my Antithyroid medication when he saw this blood test instead of 300 mg a day PTU 150 mg a day PTU:
Next blood test results:28 June 2016 :TSH :0.01 (0.35-4.94)
Freet4: 16.4 (12-22)freet3:8.01 pmol/L(3.6-6.8)
19 August 2016 : blood test :freet3 :5.67pmol/L (3.1-6.8)
Freet4 was :10.00pmol/L,(12–22)
TSH 0.01 (0.27-4.94)
Next blood test results 14 December 2016: free t3: 4.99pmol/L
Freet4:13.6pmol/L (12-22)my TSH was 0.30(0.27-4.5) freet4 was dropped 10.00pmol/L (underactive thyroid)because 8 years endocrinologist looking only low TSH 0.01 and gave me medication…
Hi, I have Hashimoto’s disease and have in the past taken both levothyroxine and natural dessicated thyroid. I am currently on 50 mcg of levothyroxine daily. I was also diagnosed with adrenal insufficiency two years ago and have been taking low-dose Cortef. I am now experiencing symptoms of too much free T3, taking just levothyroxine. I cannot sleep. I cannot relax. I am stressed constantly. My latest thyroid labs are as follows: TSH 0.75, free T4 1.05, free T3 3.18. I feel that my TSH is too low and T3 too high. I don’t understand why this is happening while just taking levothyroxine. Doctor looks at labs and says they are great, while I am telling him I don’t feel right. Do you have any suggestions? This does not seem normal since I am not taking natural thyroid that contains T3.
Hi – very interesting article.
I am currently on 225mcg cytomel daily (75 x3/day) a high dose my doctor wants to increase me to 250 because I still feel a little hypo (constipated, tired) but my resting heart rate is about 76-78 and 85-92 during the day. I worry it’s too high. Otherwise I have no symptoms of high T3 – although my free T3 was 27 (2.2-4.5)!!!!
Should I worry? I feel better than ever. My reverse T3 is <5.
You are on quite a high dose of Cytomel. I’ve only ever put a handful of people on a dose that high but I never keep them there. Outside of genetic mutations of thyroid resistance, I don’t think doses that high are necessary/helpful in the long run.
hi Doctor can graves disease misdiagnosed or mixed other disease ?or lower serotonin or dopamine levels ?is it true anxiety biologically lower serotonin and dopamine levels ?thanks ….graves disease symptoms :anxiety ,low libido ,low mood ……
I have Hashis and am currently taking 180mg a day. I have been at that dose for about two years, after consistently upping it due to hair loss. I feel fine, except for persistent heart palpitations. My functional med dr says he isn’t worried about it after a couple of EKG’s and because they run in my family. But I don’t enjoy them at all! I’m fairly active, and eating mostly meat with a little vegetables to feel my best. Thoughts? T4 was at .98, TSH .006, reverse T3 18.3, and free T3 is 2.3. I have some weight I cannot lose despite exercise and diet, but lost 90 when going paleo ten years ago. Also, found out my omega 3’s were super low which may have contributed to hair and nail issues.
Eat organic meats, if you have to have meat. Meats have a lot of hormones and antibiotics, etc in them. Organic Prairie is a good company.
Please help! My thyroid has been mostly stable for years. I take 1.0 or 1.25 grains Naturthyroid/day depending on symptoms and have tended to have a low TSH (usually under 1.0) and low TT3 (usually 0.8) and low FT3 (usually 2.8 range).
In December my doctor put me on a gut healing protocol that included high dose mastic gum, zinc carnosine, and 32oz cabbage juice daily. I’ve been trying to heal my gut for years with many protocols. The main thing that differed here was the cabbage juice. I stopped the cabbage (after ten days) in December and finished the other protocol pieces 6 weeks ago.
My hair started falling out by the handful a week after I stopped the cabbage and hasn’t stopped since. Labs seemed pretty normal but T3 started climbing. All of the sudden my free testosterone spiked too. I lowered meds and noticed hyperthyroid, speediness and insomnia worsening more and more as I lowered meds. I have no idea what’s going on. Please, please, please help!
Thyroid results 1/15/20
Thyroid results 2/5/20
T4 4.8 (2.0-4.4)
T3 155 (71-180)
Reverse T3 8.6 (low)
FREE TESTOSTERONE 8.6 (0.0-4.2)
Dihydrotestosterone 16 (14-22)
Reduced Naturthroid to 1/2 and 3/4 grain alternating
Thyroid results 2/20/20
I take a small dose of thyroxine daily. When supplemented, I have normal T3 but very high reverse T3. My cortisol levels are also very high for most of the day (based on a test that checks it several times throughout the day).
I have gained about 40 pounds over the last 10 years without any changes to my diet. If anything, I eat less than I used to. My doctor doesn’t know anything about reverse T3 or what to do about my cortisol (I don’t have Cushings). What approach could I take?
It seems like you might be in the wrong article! High reverse T3 is not the same as high T3 (which is the topic of this article). I would check out this article which will help you understand what causes high reverse T3 and how to treat it: https://www.restartmed.com/high-reverse-t3/
Just recently I started having panic attacks and anxiety. My T3 was lowered to 2.5 twice a day and I’m still feeling weird side effects like I’m overmedicated but I can’t go much lower. I’ve stopped taking it for the last day just because I didn’t want another attack. My free T3 seems to be about 3.7 and the range here is 2.4 to 4.4. TSH is. 08.
I’m in range but yet I’m Having side effects that I have never had. Even in the beginning when I was diagnosed I never had these issues. I recently just changed to tirosint and liothyronine from NP thyroid about nine months ago. I’m at a loss.
My recent tests results show my TSH at .02 and my Free T3 is 6.3.
I have felt miserable for months. I am exhausted, headaches, hear races, shaky, jittery, nauseous, hair falling out, weight gain etc. I take 120mcg of Armour each morning one hour or more before I eat. What could be going on?
Hi Dr. Childs,
I’ve recently increased my dose to 3 grains (and felt relief from certain stubborn hypo symptoms, and have no symptoms of hyper other than hair shedding. My question is, Is it possible to have Increase in T3 be great except it can cause hair loss, or is it more likely that the loss is a result of something else? I’m experiencing All over shedding but I otherwise feel so much better on the higher dose of Armour.
TSH .01 (.40-4.50)
FT4. 1.1 (.8-1.8)
FT3. 3.7 (2.3-4.2)
RT3. 14 (8-25)
I do take BHRT and also just increased my T from 2 mg cream daily to 4, which resulted in higher DHT. 23 <20
I would have assumed it was the T but the only reason I’m wondering it hair loss can be one negative symptom from the increase is because of my suppressed TSH and it’s my understanding that thyroid hair loss is all over vs crown/temples typically for T vs all over loss, that I’m experiencing, for thyroid issues.
Thank you in advance!
Hi Dr Childs
My TSH level is -.01 and my T3 is 9.0
I,ve been taking 240 mg of Armour Thyroid for 3+yrs.
I’M a runner and weight lifter and have been for 46 yrs(I’m 75 yrs old.
I don’t have any other health, triglycerides, cholestrol levels all normal.
I take multi vitamin and mineral supplements. I recently had to change
Doctors. My new DR wants to cut my dosage in half. I think would be
too drastic..I’m looking for another Dr. Your advice..
I definitely wouldn’t make any changes to your thyroid medication without first looking at your free T3 and free T4 levels.
There would be no reason to change your dose unless you are suddenly experiencing negative side effects.
I have been on Synthroid probably 15 years I usually fluctuate between 100-125mg dosage. My doctor recently put me on Cytomel 25mg to raise my T3 levels. After my blood work, shown below, came back he kept me on the Cytomel and lowered my Synthroid for 125mg to 112.
Is my T3 to dangerously high?
Free, T3- 8.3
Not unless you are experiencing dangerous symptoms 🙂 https://www.restartmed.com/thyrotoxicosis/
I am in nova scotia and they do not do the t3 testing in the labs anymore. It is just a hit and miss with synthroid. I am having heart palpitations and fidgeting , sleep disturbances. Not feeling myself at all.
I know some people are able to send out their blood to other countries for certain tests which may be something to look into.
I have been taking T3 for 5-6 months
I was in 5mcg now 10mcg. My hair is falling out , still. Now, my eyebrows …… I am
In the Public , as I am apart of many charities…. It is horrible. I want my life back….I have spoken w physician amd all she keeps saying – I need more . I am prob going to have to stop….. I’m sure you will not recommend. But I am on Lodoral 12.5 mg
Any advice, is appreciated
I have tons of resources and information on hair loss that I would recommend checking out!
Just got bloodwork back a repeat due to low TSH level. Have Hashimotos and have for 30 years and have been on Thyroid replacement that long. Developed a nodule 2 years ago not growing hard and smooth edges rated a 3 on the Rad scale. Have all the symptoms of Hyper for the past year..hair is almost gone no eyebrows either. Heart issues a fib, Finally got a doctor to request an echo…you have no idea how hard I have to work to get any doctor to do anything. They Never LISTEN just in the door out the door. I fear a thyroid storm, and death due to no help here. I take NP 120 daily due to I almost died on the fillers in Levothyroxine a few years ago. Been on NP for 3 years now this hyper activity as been going on for 1 year and as I say no doctor gets it and they only test for TSH…until the last two times I said you have to test for free T3 I said reserse also but they didn’t. here are the most recent results…doctors are going to be the death of me. May 27, 2022
12:34 pm Thyroid Stimulating Hormone (TSH)
0.358-3.74 uIU/mL L
May 27, 2022
12:34 pm Free Triiodothyronine (T3) pg/mL
2.18-3.98 pg/mL H
The single most important thing you can do is find a doctor who is more willing to listen to you. Please see this resource: https://www.restartmed.com/how-to-find-a-doctor-to-treat-your-thyroid/
I’m proof that you can have a high free T3 of 6.7 and have no syptoms
Actually I’ve never felt better,but guess what Dr. insisted on changing my doses and now my tsh is 3.7 I am so tired I can sleep all day. Here we go again. 30 years I’ve spent trying to feel my best and i’ll keep fighting the fight. Thank you for all you do.
It can definitely be the case that some people feel better with higher levels of T3, no question about it. I would strongly recommend looking for a different doctor, though. You can use this resource to help: https://www.restartmed.com/how-to-find-a-doctor-to-treat-your-thyroid/
There’s no point in spending time with a doctor that isn’t willing to work with you, you are the one that suffers, not them.
Hi! Your work is so helpful and I am grateful for the amount of information you graciously share. In my most recent labs, my free T3 was high (5 ng/ dl) but T4 was normal (1.63).
My doctor wants to lower my T3 medication but I finally feel good with the current dosage and am scared to change it. Would you agree that I need to lower it? And how long would it take to see it go down if I were to go from 20 mcg of cytomel daily to 10 mcg?
Thank you so much!
Unfortunately, I’m not able to provide personal medical advice regarding what you should or shouldn’t do with your thyroid medication dosing.