Thyroid UK


Hi guys.

I've been taking t3 with 50mcg Levo for just over 3 weeks.

While feeling brighter I'm still symptomatic - digestion issues, weight and such. I'm working out a good bit but still very calorie restricted.

I'm taking 20mcg of liothyronine. Any recommendations for dosages? Should I increase to 30mcg?

Thanks in advance. I'm just sure my meds aren't optimised yet.

21 Replies

How long have you been taking the levo? Were you previously on a higher dose or was the levo kept the same when the t3 was added?

It is also important to check serum iron, ferritin, folate, B12 and vitamin D as deficiencies in these can cause similar symptoms as well as reduce the effectiveness of your thyroid replacement hormones. Iron/ferritin in particular can leave you feeling hypo with normal blood results as the thyroid hormones aren't getting used in the cells as much as they should (a very simplistic view, admittedly).

Restricting your calories may also be having an adverse effect by putting stress on the body, especially if you are working out at the same time. Getting your cortisol levels checked may be a good idea because levels can affect how well your body can use the levo and T3 leaving you feeling hypo.

Are you taking T3 as prescribed by your doctor? Has your doctor tried increasing the T4 component at all?

Because everyone is so different it is difficult to know whether you should increase your T4 or T3. For me, T4 caused me to feel very unwell so I knew T3 was the way to go. I still have problems with weight but feel relatively well otherwise. I am starting to think there are additional issues such as B12 or estrogen dominance that are affecting me. These are definitely things worth looking at for you too.

Sorry I couldn't give you a definitive answer.

Carolyn x



My iron levels are pathetic

Vitamin level

(PRC) - normal

B12 600 ng/L (191-663)

Serum folate 12.1 ug/L (4.6-18.7)

Serum iron tests

(PRC -Low iron stores)

R serum iron LO. 4 umol/L (10-30)

Serum transferrin HI. 3.80 g/L (2.0-3.6)

Serum ferritin 5ug/L

R transferrin saturation 4%

So. Those are all my results!!


Wow! Your iron is extremely low! Are you prescribed anything to help with this? You are unlikely to feel well on Thyroid hormones until your iron and ferritin are better. This can make a huge difference to how you feel. Your body cannot use thyroid hormones properly with iron this low. No wonder you still feel ill :(

Personally I would make raising your iron and ferritin the priority for now and then see if you need your thyroid hormones changed.


Could it be worth asking my doctor about iron infusions?? X


I'm afraid I don't know much about them. You could ask but I don't know what doctors think about it.


He lowered my t4 from 75mcg to 50mcg but also wanted me to go totally t3. No t4?

Thank you for replying x


I personally would not change anything right at the moment other than to raise your iron and ferritin. You will need to take iron, vitamin c and possibly vitamin b complex too.


T3-only is an option if nothing else works. I am on T3 only as I don't seem to convert well. It is probably my least favourite option. I'm sure I would be more stable if I could tolerate some t4.


You shouldn't change the dose again until you've been on it for about 3 months. It takes time for the body to change in response to the increase. Then get your blood tests done.

What do you mean by digestive issues? If you restrict your diet too much, then your guts don't have anything to work on. You should not target more than a 1 pound weekly weight loss. Any more than that, you will be losing muscle mass not just fat.

Make sure you get enough soluble fibre in the diet so your digestive tract gets in good shape too. Oftentimes when people go on a weight reduction diet, they don't eat enough soluble fibre and the colon muscles atrophy.


Wloren, I'd advise staying on your current dose for another 6/8 weeks and having a thyroid blood test before increasing dose. 3 weeks isn't long enough for much metabolic improvement, it takes months. If your T3 is low over exercising will deplete your T3 levels and fasting/lack of calories can inhibit T4 to T3 conversion as your body will think it's in starvation mode and will slow your metabolism further and hang on to any fat.


Everyone is disheartening me by saying If weight hasn't changed in 3 weeks it won't?! X


Rubbish (in my opinion ;) ). Your iron is too low for the t3 and t4 to work properly. Some people don't lose weight until they are optimal. Others start losing weight before that. I can't emphasise enough how important it is to start working on sensibly raising your iron and ferritin.

I can't lose weight with low iron and ferritin. I can if it's optimal :)

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Thank you so much! I've taken 610mg of iron and just finished the course. I've been taking it with vit C but I'm going to ask for another course on Tuesday :) x


Wloren, no-one's said that. We've said that 3 weeks isn't long enough to have restored your normal metabolism in order for you to be able to lose weight. You didn't gain weight in 3 weeks and you're not going to lose it because you've been on hormone replacement for 3 weeks. Hopefully, being on replacement means you won't continue to gain and will be able to lose weight gradually and steadily.


No no no I know! That's why I came here. You guys are great people outside of this said that. I'm so sorry that's not what I mwant x


Wlorenm, tell them you are replacing lacking hormone not scoffing fat burners and if they want to make stupid remarks about losing weight in 3 weeks or being stuck with it forever they should shut up and butt out ;)




First, the advice above is excellent. Weight gain is such a big issue with many on this forum and world-wide generally if hypo.

You are relatively newly diagnosed and it takes quite some time for you to, gradually, increase your dose of thyroid hormones sufficiently which will also increase your metabolism to an optimum level, i.e. one that makes you feel normal health and well.

Hypo (means slow) so hypothyroidism means everything in our body slows down, i.e. heart rate, in particular, and pulse. We have to concentrate on getting these raised to normal too (they don't always come back to what you used to have but as near as). Everything, vitamins and minerals have to be optimum and this is a link:

You have to read and learn as much as possible if you want to recover your health as many doctors may not increase the dose of thyroid hormones if our TSH becomes within the normal range. It has to be very low or even suppressed in some of us.

T4 is the inactive hormone and is converted into the Active Hormone T3 (also called liothyronine) which drives our metabolism. If you aren't on optimum medication exercising will reduce what T3 you have so the first thing is to get medicated optimally but it is a gradual process. If we take too much T4 or T3 we will feel ill and overstimulated and will have to reduce dose down.

In the link above there is lots of information.



Yes, your ferritin is terribly low. I've been taking 4 iron capsules a day now ( 18mg each ) and eating more red meat including liver. But you must remember your gut health! You can't absorb iron and other nutrients if you don't work on that. Probiotics, etc..... and it can take months for your gut to get better.

Often along with everything else is candida over-growth and adrenal fatigue. There ends up being many things to deal with.

I'm glad you're going by how you feel, but you must be getting lab work done also to monitor things as you find the right dose.


I can't get my ft3 tested tho x


Wlorenm, you can order private tests from Blue Horizon or Genova

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