Paul Robinson
Paul Robinson is a British author and thyroid patient advocate. The focus of his books and work is on helping patients recover from hypothyroidism. Paul has accumulated a wealth of knowledge on thyroid and adrenal dysfunction and their treatment. His three books cover all of this.
Great interview! I was very interested to hear about the cortisol connection.
I’m at the 8 week stage of T3 only protocol and also take Hydrocortisone.
I wake naturally between 7am and 8am each morning and take my first dose of T3 on waking.
Should I be keeping the time more consistent? If so, would it better to wait until 8am each morning, or set an alarm for 7am every day? Many thanks
Hi Liesha,
Always sticking to the same times helps people to be able to assess the T3 doses using symptoms and signs:
https://paulrobinsonthyroid.com/tracking-thyroid-symptoms-and-signs-vitals/
If you haven’t got Addison’s proper then you should consider using the full protocol in my Recovering with T3 book and also incorporate CT3M – which can help a lot of people to raise cortisol levels. Taking T3 at 7am or 8am is not a CT3M dose.
Best wishes, Paul
Thanks for your reply, Paul – your book is my bible at the moment 😊!
I think I understand correctly that I should get to the right T3 dose, before then trying the CT3M to reduce/cut out the Hydrocortisone? (I don’t have Addison’s just low cortisol).
Hi Liesha,
Ideally yes, but sometimes low cortisol symptoms get slightly worse as the T3 dosage goes up, as getting closer to the right level of thyroid hormone can require more cortisol. If this happens you’ll feel like you have more adrenaline and find it harder to get the dosage right. In that case, trying CT3M can help.
Good luck!
Paul
Thank you so much, Paul
Liesha,
I usually only help people in detail through 1-1 coaching but I can give small ‘steers’ via email – which is easier than via the website.
So, if you need more help, please contact me via the ‘Contact’ section on the homepage of this website and it will initiate an email connection that we could use.
Take care.
Best wishes, Paul
Hi Paul,
Where can I find what symptoms you dealt with before finding this therapy?
My system collapsed two years ago and while I’m improving I seem to be in a plateau. I have severe muscle weakness, and a diurnal increase in symptoms (increased cognitive issues, weakness) that follows the same pattern every day. I used to get adrenaline surges in the evening that were just terrible, but those have subsided a bit. After reading your information I’m thinking that maybe it’s lower cortisol. Taking a DUTCH test showed that my cortisol is in fact “technically” within range, but very much on the low side, especially in the afternoon where there’s a significant drop (this is when my symptoms typically appear.) I’ve bought two of your books, but would love to hear first-hand what your symptoms and their progression looked like. As you know with any kind of mystery condition the symptoms have a lot of overlap. It’s easy to say “that’s what I have!” when in actuality, it’s not even in the right camp. Thanks!
Hi Dave,
Edited to add this: I was originally diagnosed with Hashimoto’s. I had a high TSH (about 70), FT4 and FT3 well below range and high autoantibodies in the 100s. It was absolutely clear hypothyroidism and symptoms. On T4 therapy, I still had most of the symptoms and it was this stage that took longest to resolve and was more difficult to resolve as none of the doctors or endocrinologists believed that it could still be hypothyroidism. I discuss this history in the Recovering with T3 book.
On T4 treatment my symptoms were still classic hypothyroidism symptoms and hypocortisolism symptoms as I had proven low FT3 levels and low cortisol on blood tests and 24 hour urinary cortisol collection of free and total cortisol (no saliva testing was available back then). I passed a Synacthen test (ACTH Stim. test) but that just meant my adrenals themselves were functional. Daytime cortisol was definitely extremely low though and this was consistent with weakness, muscle loss, hair loss, weight loss (in spite of hypothyroidism).
So, I did have the right testing to show this is what I had. Which was a TSH, FT4 and FT3 test (no rT3 testing available then) and the cortisol testing mentioned. FT3 was in range but low in the range.
My Recovering with T3 book explains the progression and the information I unearthed to understand it and the protocol I developed to fix it.
Here are some blog posts that might also help:
https://paulrobinsonthyroid.com/why-paul-robinson-needed-t3-only-medication/
https://paulrobinsonthyroid.com/symptoms-of-hypothyroidism/
https://paulrobinsonthyroid.com/symptoms-of-low-cortisol-high-cortisol-and-aldosterone-issues/
I wouldn’t want to rely on only urine or saliva testing for cortisol. You need blood tests too.
Hope the above helps.
Best wishes, Paul
I edited my reply to add an important part.