I've recently added 5mcg T3. 6 weeks later I felt awful (exhausted, brain fog) and blood test confirmed my T4 had lowered so I increased my levo from 137.5 to 150 and kept the T3 at 5mcg.
At the same time, I increased my estrogen, which I now know was a mistake to do at same time because I don't know what's causing what.
The main reason for increasing T3 was to help me lose weight - I didn't think I had any other symptoms of low T3 although it was definitely low.
I haven't lost weight, in fact, I have gained. I feel fine with no more exhaustion or brain fog on 150 levo & 5mcg T3.
I just wondered if anyone else had lost weight adding T3?
Also, I've read on here that there are long term consequences of having low T3 so wondered if its worth raising T3 even if I don't lose any weight?
Thank you so much for any advice shared.
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HotelHurricaine
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6 weeks later I felt awful (exhausted, brain fog) and blood test confirmed my T4 had lowered so I increased my levo from 137.5 to 150 and kept the T3 at 5mcg.
Hi HotelHurricaine, I was given 10mcg of T3 and had my Levothyroxine reduced from 75mcg to 50mcg last year. I wasn't very overweight before, but I did lose about half a stone after my change in meds, which has stayed at the lower end since. I don't know whether that was due to adding T3 or reducing T4 though.
I did have some bad heart palpitations at first, which sent me to A+E, but they did settle down again. I think overall that I do feel better, although I'm still losing my hair, which I was hoping would stop. Maybe I'm not properly medicated yet.
Looking at your blood test and how it's changed, it looks a bit surprising. So my first question would be whether both blood tests were taken under similar conditions. Once you are taking T3 I find the timing of tests and make a huge difference, and can end up giving misleading results. Ideally you want a gap of 8-12 hours between your T3 dose and taking blood for the test. And then in future keep that gap as similar as you can. This might mean taking your T3 at a different time of day the day before the test.
The other big thing I'd say is that weight loss unfortunately varies a lot between people. Some people report the weight just dropping off once they get onto the right dose for them. But others are less lucky and can never shift the weight they gained while hypothyroid, no matter what they do. As you've discovered yourself, unfortunately a part of trying to adjust doses to improve health sometimes ends up causing extra weight gain, too
Looking at the recent blood tests that you've shown, with a freeT3 of 4 (3.1-6.8), clearly this is a very low freeT3. Ideally you would like to see this in the top half of the range, and the often quoted ideal is to have it in the top third.
At the moment yours is much lower than this, so this blood test is pointing towards a need to increase T3. You've got a bit of a situation, in that symptoms don't seem to currently match the blood test. This means you're in a bit if a mystery, or judgement call situation.
As I mentioned above, you should consider the possibility that the test might not be accurate, if a long gap was left between the dose of T3 and the blood draw, this might not be a good reflection of the amount of T3 available in your blood.
One side to this is that if you really have no symptoms at all, and feel comfortable on your old dose, then there is an argument you should perhaps return to that previous dose.
The other side is to perhaps ignore the symptoms and prioritise the blood test figures, and try increasing your T3 by another 5mcg, and seeing how you get on with that.
Making a decision between these two options is really a judgement call. There is no right or wrong answer. Trying an increased T3 dose is a more experimental route. There's a possibility you could eventually find you feel better than you did on your old dose, which could reveal you did have symptoms you didn't realise were caused by thyroid. I do think that with single dose changes often symptoms can be ambiguous, 5mcg of T3 is a pretty small change, so you could argue you won't feel much impact from T3 until you are on a more substantial dose. One of the principles I like to stick to is that when I am completely confused, I try to do the most straightforward option that is suggested by blood tests.
But on the other hand, I do think symptoms are the most important indicator. One thing about experimentation is that you may end up feeling worse than you did on the old dose, maybe for quite a few months, and it is even possible you might struggle to get back to where you were.
I just realised there is a third option I didn't mention before, and that is go stay on the current dose for a longer time. We can often be in a hurry to adjust doses after the minimum length of time. But in fact symptoms continue to develop for several months after a change. So you could perhaps stick with the 5mcg of T3 for a couple of months or even more, and see how you feel once it's settled. This could also give the option to drop the estrogen, if that's what's right for you, so you can tease out which symptoms are caused by which medication.
I would be a bit reluctant to increase T4 in this situation, as once you are taking T3 to some extent it doesn't matter as much how much T4 you are taking. Too much T4 in the system can also activate feedback mechanisms in your body that make T3 less effective. I also think it is good to thoroughly explore one concept, like introducing T3, and not mix and match between adjusting the two at the same time.
For me, all these options are judgement calls. It depends exactly how well you felt on your old dose, how bad you've felt on the T3, how much you trust the blood test was done correctly, and what you've gone into this adjustment process trying to achieve. Consider your whole health situation, and be careful not to prioritise weight gain too highly, as it can be one of those things that never really changes.
Thank you SilverAvocado for your long and detailed response. The T3 test was taken 12 hrs after dose. I made mistake of telling endo and he made me go back and take another test 4 hrs after dose which was unfortunate. This test showed FT4 at 18 (15-22) and T3 at 5.3 (3.1-6.8).
The most recent set of blood tests (for which I'm awaiting results) I did what I was advised to do on here and compromised - took 1/2 T3 dose 4 hrs before test. I think if I feel the same on T3 as I did without T3 then I may as well stop.
That said, I'd really like to know if there are benefits to having T3 optimal beyond symptoms experienced now - ie long term health benefits. If for example it's better for heart health and bone health to have T3 high in range then that would become part of what informs my decision too.
Sorry I haven't seen your reply before now! Seems like I didn't get a proper notification about it.
Yes, I think the question you ask there is a good one, 'If you don't feel any better on T3 is there any point in taking it?'
In the past, I have been a big advocate for saying symptom are the most important. They give us the full picture, whereas blood tests are just a snapshot that can always be misleading.
But I do think there is a bit of an argument that having rock bottom freeT3 is not good for our bodies, particularly not long term. An article about this was recently posted on the forum, but I'm sorry I don't think I could find it now. High in range freeT4 also brings a few issues, so if you're needing your freeT4 right at the top to feel well then it can be better to add some T3 to allow a lower freeT4.
There is definitely an argument both ways, so it puts you in the position again of having to make a judgement for yourself. I don't think there is a true right answer. It also depends a lot on just how well you are on your old dose. If you really felt as well as you ever have and could be happy with that long term, then it's easier to choose that old dose. Most people on the forum are here because they've never felt quite right and hope for some improvement. If you're more in that situation then it might be an argument to continue with the T3.
Another little note is whether your vitamins are optimal. We need good vitamin levels to properly process and make use of thyroid hormone. It's a good idea to work on those at the same time as making any changes to thyroid hormone. Almost everyone who has had long term thyroid illness will have poor vitamin levels. If those need improving, you may feel more of a change with the added T3.
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