T4 & T3 timings

[FoxyTed]

Hi everyone & thanks in advance.

I have just started T3 5mg my question is ‘ can I take this and T4 together say 7.30am please?

[SlowDragon Administrator]

your previous post shows you needed dose increase in levothyroxine as only on starter dose

healthunlocked.com/thyroidu...

Rather too early to be considering T3

Which brand on T3 is it

If it’s a tablet suggest you cut to only add 2.5mcg initially

Take early morning

Assuming that is ok, add 2nd 2.5mcg approximately 8-10 hours later

Retest in 6 weeks

Likely to see Ft4 dropped

[FoxyTed in reply to SlowDragon]

Tks SG

I am with good recommended thyroid doc, he recommended T3 after my latest bloods, he mentioned more T4 going into reverse. My T4 went up to 16 but my T3 went down from 4.1 to 3.7….. is this not an indication that it’s not converting but lowering the T3?

Now I don’t know what to do.

[DippyDame]

Were you prescribed the T3? If so why?

It looks as if you are taking T3 far to soon, it just adds a further complication if taken before it's proved to be reqsuired

( And that's from someone on high dose T3-only!)

First we usually aim to obtain adequate T3 from the conversion of T4.

It takes time.....unlike taking a paracetamol for a headache!

Why are you still on only 50mcg since February....you should have had another test after6/8 weeks and your dose increased to 75mcg with repeat test after another 6/8 weeks with your dose reviewed again.

Your GP does not appear to be correctly managing your treatment.....or are you self treating?

...and you were given some unhelpful advice ( wrong even, eg rT3 is excess T3) regarding T3, at the beginning of your medication journey.

I'd suggest you have to take time to sort of the confusion you are in and to learn more about your condition.

I'd start by dropping the T3, wait 2 weeks then increase your levo to 75mcg

Then wait 6 weeks and test again....you will likely need another 25mcg.....but let the results be he judge

Meantime work to optimise vit D, vit B12, folate and ferritin to support thyroid function/ conversion.

Once that is achieved your lab results will start to show how well you are converting ....and if you need T3

T3 is key to good health but first we have to try to achieve an adequate level from conversion.

I understand the hurry/need to feel well but you need to follow the correct route otherwise if you risk taking shortcuts and following wrong direcions you will end up down a blind alley!

Best to go back to the beginning, follow the correct signposts and proceed slowly and carefully.

[FoxyTed in reply to DippyDame]

Tks Dippy please see my reply to slow D

[DippyDame in reply to FoxyTed]

FT3 3.7 (3.1-6.8) = 16.22% through the ref range

FT4 16 (12-22) = 40% through the ref range

he mentioned more T4 going into reverse.

Excess FT4 will become rT3 but your FT4 isn't even close to that happening, it would need to be over the ref range

Your FT4 above is likely a false low reading....caused by the addition of T3, which also naturally reduces TSH

You need to optimise key nutrients and slowly increase your FT4 ( by T4 only) to approx 75% through the ref range before establishing conversion status.

Once T3 is added to the T4 you can no longer compare FT4 with FT3 to try to establish conversion status.

My T4 went up to 16 but my T3 went down from 4.1 to 3.7….. is this not an indication that it’s not converting but lowering the T3?

No! That's not how it works

When you changed your dose the thyroid detected the replacement T3 hormone and stopped production so your FT3 dropped....and is still too low.

You need to raise your levo/ T4 which hopefully will convert and increase your T3 again

Others may disagree but I still suggest that you introduced T3 far too soon

My suggestion above stands

I don't think your thyroid doctor is fully conversant with thyroid hormones .... and rT3 is a red herring here

 SlowDragon

[FoxyTed in reply to DippyDame]

Thanks for reply. I

had not started T3 at that stage.

I only started T3. 3 days ago.

My T3 went down from 4.1 to 3.7’after starting T4 50mg. The T4 went up to 16 but T3 reduced (all before starting T3 three days ago. Now I’m concerned

[DippyDame in reply to FoxyTed]

Best to see what your next set of labs indicate.

PS Had another think/look and noticed the following results.....those labs don't suggest poor conversion.

Have you had thyroid antibodies TPO and Tg tested

You needed replacement T4 so I've no idea what your thyroid doctor is trying to do!

My Jan labs (NOT on treatment)

TSH 3.22 (0.27-4.20

FT3 4.1 (3.1-6.8

FT4 11.5 (12-22.0

[Easylover]

Good job Foxy!

[Sleepman]

How do you feel? That is just as important as numbers.

I wonder if thyroid doc has seen enough to say try it? I think taking T3 lowers T4 blood readings.

I went into T4 a little over range but T3 stayed right at the bottom even then.

That's when I self medicated with T3 in the morning with T4.

Your change in T3 reading was quite small, it's a tough messurement. I would call them the same based on what I've seen.

Good luck

[FoxyTed in reply to Sleepman]

Thank you sleep man, yes I think you’re right re my T doctor, I do still have a lot of symptoms. What I don’t understand and I never thought to ask him is - if taking the 50mg T4 never budged my T3 then does this mean I am poor converter now? surely it should be up a bit? but instead has gotten lower after T4 treatment. He is very experienced in treating thyroid and has a personal interest, I do trust him, I just feel worse since starting 5mg of T3, my headaches have increased and I feel more anx but I know it’s early days and doc did say this could happen, what I didn’t ask was does it subside/improve with time.

Thanks

[Sleepman]

Sorry you are unwell, been there

T3 is strong stuff and takes a week or so to get used to in my case. I am no expert.When I went from 6 to 12 mg my blood sugar was dropping.

Things swing around in early days (6 months) .

I would call the assistant to the doctor and ask a couple of clarrifications?

[FoxyTed in reply to Sleepman]

Thanks Sleepman, how did you remedy the blood sugar?

My doc said I could feel worse but it’s horrid when it’s real!!

I will see how I feel in a weeks time. He said to stick with each dose for 2 weeks at a time.

How are you now?

[Sleepman]

I split the 12 in to 6 with levo and 6 3 pm ish . This sorted blood sugar.After a few weeks I took all at once with levo.

Everyone is different though.

I am fine been mostly good from 3 or 4 months in. I had tsh of 79 at start.