Not necessarily. The first thing that side effects suggest is an unsteady T3 level. The whole trick to T3 therapy is keeping the T3 level steady. Granted, if the level is steady but is too high or too low, then a person may have side effects. But if patients’ temperatures are not above 98.6 then their T3 levels are not too high. And if their temperatures are not lower than they were before treatment, then any new complaints are not likely to be from the T3 levels being too low. If a patient is having side effects from the T3 therapy, it is usually because of T3 unsteadiness (c24, c25). This suspicion can be confirmed with a T4 test dose (p129). The most common side effects in order of appearance with increasing levels of T3 unsteadiness are fluid retention, achiness, dull headache, edginess, and then increased awareness of the heartbeat and/or increased heart rate. With T3 therapy it is important to start with steady T3 levels (c4), and then to keep the T3 levels steady thereafter with good patient compliance. When a patient begins having any side effects, the first question to be addressed is “Has the patient been able to take the medicine very much on time as directed?” Although unsteady T3 levels can develop even with good compliance, it’s important to rule out poor compliance which is a likely cause that is easy and important to address (c29). Stress can also contribute to unsteady T3 levels.