Taking levothyroxine and just added t3 by endo, contra-indications?

[DawnieB]

All my symptoms along the way have been extreme brain fog, dry skin, dry burning eyes, hair falling out, cold hands and feet and cold to the core. Taken at least 10 years to get diagnosed. House move and new GP facilitated this as previously all my results were "within range". Was on 100mcg levothryoxine last summer. New endo increased it by 50% as my levels were very low (with the exception of thyroid antibodies which were rocking up at +1100) as my body was producing T4 but not converting to T3. On check up, tests showed the conversion but too much T4 so levothryoxine reduced to 125mcg per day. Saw Endo last week, T3 level 0.03 so been prescribed T3, 5mcg twice a day and reduce levothryoxine to 100mcg per day. I had what I can only guess at being "cold turkey" like symptoms...........nausea, clammy, colder than usual hands/feet/body, brain fog, extreme exhaustion (12 hours uninterrupted sleep and could have had another 12). Spoke to endo and he has put me back on the 125mcg dose of levothryoxine plus the 5mcg twice a day of t3. This is day three of the 125mcg does and now barely able to sleep, feel extremely anxious/jittery about everything/near to tears (just not my kind of thing). Have read this could be due to overdose. Am wondering if I should wean myself back to the 100mcg per day of levothyroxine and continue with the t3 rather than just straight drop from 125mcg to 100mcg per day? Anyone else had these problems? What did you do? Thank you.

[Parbrook]

My FT3 was low (but not as low as yours) with a high FT4.

My GP finally agreed to a trial of T3 tablets (Liothyronine) last December.

I started with 5mcg T3 and reduced my T4 (Levothyroxine) from 112.5mcg to 75mcg.

I slowly declined over a few weeks (in-time for last Christmas), so it was a disaster.

I tried increasing the T3 to 10mcg per-day, but things did not get any better.

So, in order to get back to a previously known state, the T3 was stopped and T4 increased to 125mcg, which is i knew was too high, but did get my FT3 up to the bottom of the range.

After a couple of weeks, I re-started 10mcg T3 per-day, with 100mcg T4 and have started to feel better after one week, especially mentally, so it is going in the right direction.

My GP has just agreed to let me try 20mcg T3 daily, with 75mcg T4, so it will be interesting to see what happens over the next few weeks.

From my experience, a change in T3 dose will be noticeable in a few days. A change in T4 dose will be noticed slowly over several weeks (which is why there is normally a 4 - 6 week period between a T4 dose change and the next blood test).

[DawnieB in reply to Parbrook]

thank you.

[Clutter]

Try splitting your levothyroxine 25mcg tablet in half so that you're taking 112.5mcg daily. It may be easier for you to tolerate a smaller decrease initially, and drop to 100mcg in a couple of weeks.

If you feel jittery it may be that you're adjusting to T3 after being so depleted. You could split 5mcg into 2 doses for a week or two, then increase it to 5mcg twice a day. Try making your last T3 dose mid/late afternoon if its interfering with your sleep.

[DawnieB in reply to Clutter]

Thank you. Splitting the 25mcg tablet sounds like a good plan and the same for the T3 meds. Supposed to see the endo again on 19 March, might move that to a week or two later so everything settles more before my next set of blood tests. Just out of curiosity, did your GP/endo recommend the route you took or was it your own trial and error? If your own, did you tell them what you did?!!

[Parbrook in reply to DawnieB]

One more suggestion.

Make sure that you stick with a single manufacturer for your Levothyroxine.

I felt a little better when I stopped using Mercury Pharmacy 25mcg and cut a 50mcg Actavis in half to go with an Actavis 50mcg.

(Actavis = Almus if you get yours from Boots.)

[DawnieB in reply to Parbrook]

I did mention a change of brand to the endo but he seemed unconcerned. My repeat prescription used to be dealt with electronically via Boots but they kept messing it up so switched to a local individual pharmacy and they are giving me a different brand. The Boots meds are in a gold box, red writing. The meds from the local pharmacy are different, bigger flat white boxes with 28 tabs to a strip rather than the 14 x 2 that are in the ones from Boots. The brain fog is currently BAD, no way could I tell what brand they are!

[Parbrook in reply to DawnieB]

It sounds like you may have switched from Actavis/Almus to Mercury Pharma.

A number of people have reported feeling worse/side-effects with Mercury Pharma, but others have not had any problems.

The best advice is to avoid mixing brands when you are taking more than a single tablet, but it sounds like you are only taking a single brand.

[DawnieB in reply to DawnieB]

Just checked. Current meds are in a blue, white and green box with Wockhardt as the marketing authorisation holder. Anyone heard of these/used them and if so, got any info please?

[nightingale-56 in reply to DawnieB]

Started using Wockhardt a week ago as a change from Mercury Pharma and so far the change has been very much for the better.

[Clutter in reply to DawnieB]

Don't move your endo appt. You've plenty of time for everything to settle before your next TFTs. Taking T3 lowers your TSH and FT4 but it is quick acting and you should hopefully see an increase in your FT3. You should feel considerably better in a week or two. FWIW I take my T4+T3 together before bed.

I haven't told my GP or endos that I'm adding T3 to T4. My next endo appt is Monday. I stopped T3 a couple of days before my blood test, but am undecided about discussing it with them. I'm still awaiting a response to emails I sent in November asking for help.

If it 'feels' right I may broach a T3 scrip but I've found them to be TSH fascists and don't think they'd consider anything other than T4 monotherapy.

[DawnieB in reply to Clutter]

I consider myself to be lucky with my endo (third time lucky: first one said that I needed to swim regularly to improve my mental health so ditched him, second one disappeared off sick for months and found out from his secretary nobody was covering his case load; this one is private and founder of a clinic in London). It was this one that mentioned T3 as a possibility at my first appointment but wanted to try changing my Levo dose a few times to try and manage things.

[DawnieB in reply to Clutter]

Clutter, thank you for the advice, which I followed. It is making a difference. Am wondering if I should drop the last half of the levothryoxine this weekend and increase to the full dose of T3 at the same time? I've got a few days holiday booked so if I feel horrid, can hide under my duvet for a day or two but not sure if this is the right way to go.

[Clutter in reply to DawnieB]

Hi, I'm glad it's working for you. Yes, try that. You probably won't notice the difference dropping out T4 but should notice the T3. Skip a dose if you fee over medicated.

Have a nice break

[Clutter]

3rd time lucky then Sounds like you found a good 'un at last.