Very confused.....still!

I have had under active thyroid for 2 years now, and have gained a lot of weight.

After stamping my feet and being very demanding I have finally been prescribed Liothyronine @ 20mg combined with Levothyroxine @ 50mg per day.

My recent bloods were TSH 1.19, Free T4 21.5, which means nothing to me!!!

I have only been prescribed T3 for 3 months to see if I lose weight.

So what does all this mean? Thank you

12 Replies

  • How are you feeling? That is the most important point. Even if you don't lose weight on this dose but you feel better, that is a good enough reason for persevering with it. You might need a slightly higher dose of T3 if you are still not right. It is fine for TSH to be lower than that which means it is ok for your doctor to increase your dose of T3 if needs be. You will have to monitor yourself though, pulse and blood pressure, to make sure you are not overdosing on T3 if you do increase the dose.

    It may be that you are like me and need mostly T3 an only a very small amount of T4 (levothyroxine). I find the more T4 I have, the worse I feel. I seem to do best on T3 only.

    Carolyn x

  • Hi Caroline, I don't really know how I feel....I've been plagued by acute migraines for the last 18 months and generally feel rubbish. My biggest issue is weight lose I can't live with being over weight and its becoming more of a problem, I've already had a tummy tuck and am now considering liposuction if the T3 combo doesn't work.

    As for the headaches/migraines no-one knows why I'm getting them, my gp says my thyroid function is fine now, so it isn't that causing them. I'm trying hard to watch what I eat, and am confused about whether I should exercise or not as reading some of the posts on here it suggests exercise is not good? I like to swim and do a few abdo exercises....


  • Exercise is not a bad thing at all, as long as you don't overdo it and listen to your body. In fact, sensible exercise can help you to feel better but you do need to listen to your body.

    Although your thyroid tests are within range, some experts in this field have found that many people are at full health only when their TSH is reduced below 1 and some say below 0.5. Your TSH is above 1 which means that you might benefit from an increase of either levothyroxine or liothyronine. It is also best not to take these two medications at the same time of day.

    It is also important to get the following tests; serum iron, ferritin (best for most people is 70-90), folate (around 12), vitamin B12 (above 500) and vitamin D.

    Ferritin is stored iron. Iron is needed for your body to use thyroid hormones and is important if you are trying to lose weight. Folate and B12 are also important and tend to be low in hypothyroid patients. Vitamin D deficiency is also very common.

    If your GP is insisting your thyroid treatment is adequate, he shouldn't object to doing these tests. After all, if it's not your thyroid he needs to find out what it IS. The above are the most likely reasons.

    If he does the tests, you will find he won't prescribe anything unless your levels are below the NHS ranges. The NHS ranges are far too low for ferritin, folate and vitamin B12 which is why I have put levels to aim for in brackets above.

    I hope you have some success. Your GP seems better than most in that he was prepared to try T3. Perhaps you can get a copy of Dr Toft's booklet "Understanding Thyroid Disorders" where he states on pg 88 that some people need lower TSH levels. Perhaps it is more that he is unaware of this fact rather than being awkard (like some GPs!).

    Let us know how you get on.

    Carolyn x

  • Oh doc didn't mention taking them separately..... I take them together in the morning! What would you recommend please?

    Dionne x

  • Well, I'm not medically trained but if I were in your situation I would take my T3 in the morning and levothyroxine at night because I know that is what works better for me. Other people find different times work better for them but this is a good place to start.


  • On another note I have just read somewhere that, as long as you don't overdo it, exercise can help improve cellular sensitivity to thyroid hormones. Basically, if you exercise sensibly, your cells will be better able to use thyroid hormones :)

  • OK thank you I will try this :-)

    Dionne x

  • Also, if you do exercise you enjoy, it has other beneficial effects on body and mind. Even when you are not exercising, try to do things you enjoy when you are resting. It can help the adrenals recover from the stress of chronic illnesses like hypothyroidism :)

  • I've read it can help convert T4 to T3 which makes sense if you see it as the bodys' call for enegy and T4 would be called up for use. If not being converted or getting into tiissues efficiently, maybe this is not going to work so well [or at all in unlucky cases].

  • Yes, that is true but the reverse happens after the exercise. Basically the body likes to keep the status quo, which is why it is so difficult to lose weight and keep it off using diet and exercise unless you do it slowly and change your lifestyle for the better. Studies have shown that, when people add exercise to their daily regimen, they have longer periods of doing less at other times of the day so that the amount of activity they do during the day is fairly constant unless an conscious decision is made to increase daily activity. The body basically compensates. Other studies show that although conversion to t3 increases during exercise, it reduces after exercise to levels below those before the exercise session. I do think that the increase in conversion is advantageous though, even though it is short lived. I suspect there are much more far-reaching consequences of these biochemical changes (and others we are not aware of) that result in a healthier and more efficient body.

    Perhaps the increase in conversion during exercise is why the cells become more receptive over time, in a similar way that B12 receptors that have switched off from severe deficiency are reactivated when B12 injections are administered. Perhaps this is also part of the reason that some people can go back to having some T4 after they have spent some time on t3 only. I'm sure adrenals do play some role here but not everything.

    Exercise, particular something you enjoy, does have many health benefits though so is definitely worth pursuing if the body is able. I enjoy karate. It's extremely hard work as you get to the higher grades but it's so enjoyable that I still do it and feel great afterwards! :D

  • tigger, you are still on a very low dose for someone who has been treated for two years. I'm not sure you are getting enough T3 even if you are converting well and I guess that it questionable. Even your headaches can be related to being low. I am not a doctor but I disagree with yours anyway because I begin with a headache when I need my next dose of T3. Naturally this is only my opinion but I don't know if doctors are that reliable about the nuances of this condition.

  • Hi, I've only just started the t3, and that's only cos I was a complete pain and insisted! I've only been given a 3 month trial as well, so am hoping I see some improvement. Thanks for your comment will keep all this in mind :-)


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