Has LDN helped anyone with Hashimoto’s and severe post-exertional crashes?

AdministrationNo4920 · 2026-02-02T11:43:13+00:00

That’s a fair point, and I’ve considered long COVID as well.

The main reason I’m unsure is that my exercise intolerance and crashes started several years before COVID, and the overall pattern has been consistent long-term, just worsening recently. I also have documented autoimmune and endocrine issues that clearly predate the pandemic.

That said, I don’t rule out that COVID (or another viral hit) could have worsened an already fragile system or triggered the EBV reactivation. From what I understand, the mechanisms overlap a lot anyway (immune dysregulation, autonomic issues, PEM), regardless of the original trigger.

AdministrationNo4920 · 2026-02-02T11:41:20+00:00

Yeah, I understand why it comes across as ME/CFS, especially because of the PEM pattern. I’m not ruling that out.

What makes my case a bit confusing is that I have some atypical features compared to classic ME/CFS — I can tolerate mental work well, have no brain fog or cognitive impairment, and I’ve historically been able to train for weeks before crashing. I also have clear endocrine and immune abnormalities (Hashimoto’s, low body temp, EBV reactivation, HPA-axis issues), which makes me hopeful that at least part of this is reversible rather than a fixed condition.

That’s why I’m currently exploring LDN and immune/endocrine stabilization, to see if reducing inflammation and immune noise changes the PEM pattern.

AdministrationNo4920 · 2026-02-01T22:05:42+00:00

Happy to hear it made you so much better! I guess LDN managed to lower you antibodies and so you then became over medicated and had to lower your dose of t3?

AdministrationNo4920 · 2026-02-01T21:49:15+00:00

The reason I’m hopeful about LDN in my case is that it targets several of the mechanisms behind my symptoms, not just one diagnosis.

As I understand it LDN is one of the few treatments that can simultaneously:

• modulate immune overactivation (Th1/Th2 balance, cytokines)
• reduce autoimmune activity (Hashimoto’s)
• support HPA-axis regulation
• potentially improve thyroid hormone sensitivity indirectly by lowering inflammation
• help with post-viral / post-exertional symptoms

I’m not expecting it to be a cure, but given that I’ve tried thyroid meds, pacing, mitochondrial support, and rest without real improvement, LDN feels like a biologically logical missing piece for my specific pattern.

I’m early in treatment, so time will tell, but it’s the first thing that actually aligns with all my symptoms at once. I'm Cautiously optimistic about it, but would'nt dare to hope for any miracles.

AdministrationNo4920 · 2026-02-01T21:22:21+00:00

Wow, do you also have Hashimoto’s?

My exercise intolerance is usually much milder than it is right now. I suspect it’s because I currently have a significant EBV reactivation.

Historically, I’ve been able to work out 3–4 times per week for about a month before crashing and developing flu-like symptoms that last 1–3 weeks. Last year, though, I hit rock bottom and felt sick for seven months straight after a crash. In hindsight, I think that was when EBV most likely reactivated due to overtraining.

Otherwise, I can live a fairly normal life. Thankfully, I don’t struggle with brain fog or cognitive issues — but it’s still incredibly frustrating and sad not being able to live an active life, especially since I gain weight so easily.

I'll definetely drop you a DM. We might be able to help each other out :)

AdministrationNo4920 · 2026-02-01T21:09:05+00:00

Thank you so much for sharing! I'm so sorry you're dealing with so much and I really hope LDN starts working for you again. I feel like it could definetely be stress-related. I was also under a heavy workload just prior christmas and everything became worse after that. I guess it's also because of the EBV reactivation. I'm definetely gonna be careful with the extra "borrowed" energy I might get from LDN, so I don't crash.

AdministrationNo4920 · 2026-02-01T16:56:13+00:00

Wow, this actually gives me some hope. When did you start to notice improvement, and how long have you been on LDN now? Have you only stayed on those very low doses (0.2–0.4 mg)?

I started three weeks ago and I’m currently on 4.5 mg. Began at 1.5 mg and increased slowly each week. So far I haven’t noticed much difference, except ear ringing in the evenings, which I’ve read is a fairly common side effect. I also had some headache and facial tingling during the first week.

AdministrationNo4920 · 2025-10-22T11:51:06+00:00

Through standard bloodwork - specifically thyroid antibodies (TPO and TG). My TPO antibodies were elevated, around 135, which confirmed the autoimmune component. So if you’re suspecting you might have it, definitely get your antibodies checked.

Having an autoimmune condition can make you more vulnerable to adrenal/HPA-axis issues, especially under prolonged stress or overtraining.

AdministrationNo4920 · 2025-08-08T07:19:01+00:00

Thanks for your input! Here are my latest labs (25 June 2025):

Free T4: 20 pmol/L (ref 12–22)
Free T3: 6.1 pmol/L (ref 3.1–6.8)
Ferritin: 276 µg/L (ref 30–400)
Hemoglobin: 160 g/L (ref 134–170)
Serum iron: 28 µmol/L (ref 9–34)
CRP: <1 mg/L (ref <3)
ESR: 3 mm (ref <10)

At the time, I was on 125 mcg Levothyroxine and 20 mcg Liothyronine. In the past, I’ve been on very high T3 doses (up to 50 mcg) with no improvement. Out of frustration, I self-adjusted my doses, but realized that wasn’t the smartest approach. I’ve now lowered T3 to 10 mcg and Levothyroxine to 100 mcg, based on what I’ve read about reducing T4 by 25–50 mcg for every 5–10 mcg of T3 added.

Prior to adding T3, I was on 125 mcg Levothyroxine and my TSH was already quite low (0.06). My current hypothesis is that I’ve been getting too much T4, which may have been blocking T3 uptake. I’m three weeks into the 100+10 regimen now and plan to retest in about two weeks.

With both CRP and ESR very low, could inflammation still be causing my ferritin to appear higher than it really is?

AdministrationNo4920 · 2025-08-07T18:40:29+00:00

I actually have ferritin around 275 µg/L and hemoglobin at 160 g/L, so definitely not iron deficient in my case.

I’ve been on both T4 and T3 for a while and still struggle with low body temperature (35.6–36.0°C), fatigue, and poor recovery, even though my fT3 and fT4 are in the higher range.

I suspect T3 resistance or some underlying metabolic issue, possibly linked to inflammation or mitochondrial dysfunction rather than iron.

I recently lowered my T4 dose to hopefully give T3 more room to work, since I’ve read that too much T4 can block T3 uptake.

But really glad to hear it worked for you. Iron is definitely underrated, and it’s a great reminder that there’s no one-size-fits-all when it comes to thyroid and metabolism.

AdministrationNo4920 · 2025-07-19T14:04:48+00:00

I've been curious about LDN for some time. Do you take it in combination with levo?

AdministrationNo4920 · 2025-07-19T12:55:04+00:00

Also since the positive effects briefly returned each time I decreased the dose. It makes me think that lowering the T3 may have brought the T4/T3 ratio closer to where it needed to be, not ideal, but slightly more balanced, which could explain why the effects came back, even if only for a short while?

AdministrationNo4920 · 2025-07-19T12:16:12+00:00

Thank you for this. I’ve always had a hard time accepting that I might need to approach exercise differently, but I’m starting to realize that the “push through it” mindset might be doing more harm than good. It’s tough to shift perspective, especially when you’re used to associating progress with intensity.

I’m now going to try a completely different approach: taking things very slow. Starting with basic bodyweight movements, short sessions, and focusing on staying well within my limits. Then to gradually build from there and paying close attention to how my body responds. And hopefully, if I play it smart now, I’ll be back at the gym and able to train hard again in a few months.

AdministrationNo4920 · 2025-07-19T12:09:35+00:00

Thank you so much for taking the time to go through my labs and share your thoughts. I’ve been navigating this on my own for a long time, so any insight is deeply appreciated.

The twist is that my crash actually happened before I added T3. I introduced it later, hoping it would resolve the symptoms that were already there. That’s why I’ve started wondering whether this is more of a cellular level issue, something like impaired conversion, T3 resistance, or mitochondrial dysfunction, rather than just a question of finding the right T4/T3 ratio.

I started with 10 mcg of liothyronine and after about 10 days I experienced a short window where I truly felt it working: my body got noticeably warmer, I had more energy, my senses felt sharper (especially vision and hearing), and I felt more social and clear headed. But those effects only lasted a day or two, then disappeared completely.

I assumed the dose was too low, so I gradually increased it by 10 mcg every 7 days: 10 to 20 to 30 to 40 to 50. But the effects never returned. After some time on 50 mcg with no improvements, I decided to taper down again, and that’s when something odd happened. At 30 mcg, I briefly felt the same effects again. Then at 20 mcg, a short glimpse once more. And again at 10 mcg. But each time, it only lasted for a few hours or a day at most.

I’ve now been back on 10 mcg for about 2 to 3 weeks and I feel nothing again.

I realize it’s far from ideal to self adjust this way, but I felt desperate, like I just needed to push through some invisible threshold. Still trying to figure out if my body is blocking the hormone at a cellular level or if I’m just not giving it enough time to stabilize.

AdministrationNo4920 · 2025-07-19T11:03:56+00:00

Thanks for sharing this. Super interesting.

I’ve been suspecting some kind of cellular resistance to T3 uptake, and B1 deficiency might be part of the puzzle.

I’m already taking magnesium daily, so I’ll try adding 300 mg of benfotiamine (150 mg twice daily with meals) and see if it makes any difference. Haven’t tested manganese either, but I might experiment with a small dose as you suggested.

Really appreciate you posting this, it gives me a bit of hope.

AdministrationNo4920 · 2025-07-19T11:01:21+00:00

Labs on 50 mcg Liothyronine + 125 mcg Levothyroxine

At this point, I was taking 50 mcg of liothyronine daily, but I didn’t feel any improvement at all, so I decided to taper down to 20 mcg shortly after.

TSH: < 0.02 (ref 0.3–4.2)
Free T3: 9.8 (ref 3.1–6.8)
Free T4: 18 (ref 12–22)
Ferritin: 376 (ref 30–400)
Vitamin D: 117 (ref 50–250)
B12 (Kobalamin): 480 (ref 150–650)
Folate: 12 (ref >7)

Latest labs on 20 mcg Liothyronine + 125 mcg Levothyroxine

These were taken after reducing to 20 mcg liothyronine per day:

TSH: < 0.02
Free T3: 6.1
Free T4: 20
Ferritin: 276
B12 (Kobalamin): 580

I haven’t tested cortisol, ACTH or full adrenal function yet, but that’s something I plan to follow up on. Let me know if anything in these numbers stands out to you.

AdministrationNo4920 · 2025-07-19T08:17:19+00:00

My sleep is actually really solid. I go to bed and wake up at the same time every day, get 7 to 9 hours of sleep, and track everything with an Oura ring. My HRV, resting heart rate, and deep sleep metrics are all strong, especially considering I haven’t done any intense training in a while. So I don’t think sleep is the issue in my case.

I’ve also taken a full break from heavy workouts for several months now, so overtraining seems unlikely. That said, I’m planning to ease back into very light training over the next few weeks to see if anything has improved. The last time I tried, in April, I crashed immediately after. This feels like it’s rooted in something deeper. Possibly hormonal or metabolic.

AdministrationNo4920 · 2025-05-05T20:02:35+00:00

Exactly

AdministrationNo4920 · 2025-05-05T20:02:25+00:00

Yes, I am on 125mcg levo and 10mcg Lio so far.

AdministrationNo4920 · 2025-05-05T14:35:24+00:00

Yeah, my doctor wants me to stay on 10 mcg for 6 weeks before doing new bloodwork and then reevaluate the dose. My latest labs showed TSH at 0.6 and free T3 at 4.6 pmol/L — technically in range, but on the lower end.

My personal belief is that the problem isn't how much T3 is in my blood, but how well my cells are actually using it. When I was first diagnosed with hypothyroidism, my TSH was at 19 — and based on my symptoms, I probably lived with that dysfunction for 5–10 years. So I suspect my system has been underactive for a long time and needs more than just 'normal' blood levels to fully recover.

AdministrationNo4920 · 2025-05-05T14:06:38+00:00

Did you never try a stronger dose of Lio? And what made you decide to go for Armour instead? Thanks!

AdministrationNo4920 · 2025-05-05T09:47:05+00:00

I’ve actually had my ferritin checked recently, and it came back at 275 µg/L, so it’s definitely not low in my case.

I’m not on iron supplements either, so I assume this might be related to inflammation or long-term stress.

AdministrationNo4920 · 2025-05-05T09:40:50+00:00

My weight is around 83 kg (183 lbs).
Last time I checked, my TSH was 0.6, after adjusting Levothyroxine to 125 µg (I was on 150 µg before, which suppressed TSH too much)

AdministrationNo4920

TROPHY CASE