My commiserations, anyone who has your issues do seem to have a bad time of it.

I don't know if you might find "Recovering with T3" by Paul Robinson helpful. He is writing from a Hashi point of view. He found he did better when he took his t3 as several doses spread through the day. He found slow release did nothing for him because it gave a flat level had his body responded to "regular" higher levels. He started his meds early to engage with his circadian rhythms. He likened the body's use of t3 as being, "like a stronger wave hitting the sea wall and splashing over", providing the impetus.

Our bodies are all different with our individual expressions of thyroid related problems. Is it possible you have and issues with your adrenal being "fatigued"? T4 to t3 conversion has so many points at which there can be issues. I have read those with Lyme's disease probably have conversion issues, relatively new information. Vit D deficiency, selenium even zink deficiency can be a problem, Finding good information relating to you alone is hard.

I'm pleased you have an endo who wants to work with you. All the best.

I exercise quite heavily. I get up in the middle of the night and take a combination of Synthroid and Cytomel. The Cytomel I take a middle of night is 50 MCG. My next dose is scheduled for around three or four in the afternoon. For the past several weeks, I have had a two hour ballet class every other day from 1:30 to 3:30 PM. I find that if I have a cup of coffee before class, I am fine until the end of class or close to the end of class. I usually take my next dose of Cytomel at about 3:30 to 4 PM, after class,nand I'm pretty good for the rest of the day. My dose on the second time is 100 MCG. I did try to break it up taking half before class and half after but that actually backfired. I have started taking Rhodiola before class as well and that does help. I do the same when I do my gym workouts. Those are done on the days I'm not in ballet class mostly.

Just for reference, today I had a two hour delay class. In that class about halfway through, I had to take one half of my Cytomel dose. I took the other half of the dose after class. I did make it through. It wasn't easy. I also took the Rhodiola before class.

I was mistaken in the MCG though. Apparently, if you check the bottle, it's really 5 to 10 mcg of the Cytomel. So I take a total of 15 mcg per day, in addition to synthroid. My doc said the same thing about the T3 absorption.

I've given up hope of any real help from the NHS. I've had enough of the tinnitus, chemical and salicylate sensitivity and the 101 other health issues I have. I have already stated my intention to seek my own salvation by what ever means. I was assured by an eminent Professor of immunology that my symptoms are consistent with long and untreated hypothyroidism. Using funds from my house, I'm now following up amalgam replacements with more sustained success than with any increment in t4. In parallel I consulted a Nutritionist in the hope of discovering the perfect supplements for myself and discovered so much more was available through her.

I'm throwing so much at this, I've only ever wanted to be really well. We will provide my NHS doctor and Endo all the test results we obtain and the opportunity to treat anything we can't address with supplements and anything more in her arsenal, more dietary changes added to those I've already made to achieve the health I currently have. If they don't take me seriously! I go the private road, I've already defined it. Then when I have my health sorted, and can move freely in public places without fear of being ill. I make a complaint through the Patient Liaison Service and more. Its the pits that as individuals we have to resort to this because there is a conspiracy supporting malevolent mistreatment of all thyroid patients from the top, diagnosed and those refused investigations as I was for years. I'm so very very angry.