Which is better for determining correct dosage: temperature or pulse?

[hose1975]

Of course, a blood test in some form is probably the gold standard but if I'm trying to work out pre-bloods being done whether my current T3/T4 combo is okay then would I be better to go by pulse or temperature? I don't feel too hot nor am I having hot flushes. My pulse is around 80bpm but that's not unduly high for me (my pulse skyrockets when I stand up and it takes a while to come back down again once seated; I stand up and sit down a lot).

Or is there any other way I can gauge my over- / under-cookedness (as my GP puts it)?

Was taking 150 mcg T4, now on 12.5 mcg T3 and 125 mcg T4. All taken at the same time of day.

Many thanks

Jo

[shaws Administrator]

I think the main question is 'how do you feel' on this dose of thyroid hormone? You are taking equivalent of 200mcg levo with the combination.

[hose1975 in reply to shaws]

I feel about as tired as I did before I started on the T3 but slightly better. I'm understandably reluctant to ramp up the T3 on this basis; I don't know whether the tiredness is just me not going to bed early enough (and having trouble with palpitations sometimes, something that has been happening for years, but the buggers do keep you awake), or the hypothyroidism. I certainly don't feel any worse. My tympanic body temperature rarely goes above 37.1C.

I thought 12.5mcg T3 and 125mcg T4 would be the equivalent of 175mcg or so T4? Dunno if it's a high dose: I'm 5'1" and weigh 8st 2lb. Lost a lot of weight over the last four years (deliberately, as was very overweight) and found that T4 only therapy never needed a dose change down, only up. All very odd.

[shaws Administrator in reply to hose1975]

If you don't feel overstimulated, very high pulse, too hot (thus high temp) and uncomfortable that you'd decide to reduce dose yourself you're not on too much.

I also had palpitations on levo as you appear to have had also. From my own experience the more I reduced levo and increased T3 the better I became.

25mcg of T3 is equal 'in effect' to around 100mcg levo.

[hose1975 in reply to shaws]

Interesting. I'll see how the next batch of bloods goes and see about reducing T4 a little more as an experiment. The palpitations are not every night but they are damned annoying!

Thanks

[SilverAvocado in reply to hose1975]

Interesting to hear you say you're feeling "about as tired but slightly better". I'm just about to see the doctor and taking stock of my symptoms from the last medication change.

I think I've also been feeling a bit better, but no actual additional energy to do things.

[diogenes Remembering]

My wife has no thyroid and has been on T4 for 45 years + and over the last 4 or 5 years has developed periodic AF. She takes low-dose bisprostol (a beta blocker) before going to bed. This has reduced but not totally eliminated the nighttime AFs. Perhaps yr doctor might prescribe.

[QUE6T-33]

Hi, I would say both are indicators. My HR shows an increase just prior temp

Starting to climb. Waking temp, for me is good indicator thyroid too.

[hose1975 in reply to QUE6T-33]

I wear earplugs overnight in order to sleep. Would my tympannic temperature be artificially higher for a few minutes after removing them?

[QUE6T-33 in reply to hose1975]

What is tympannic temp? Never heard of it. Presumably ear ?

[hose1975 in reply to QUE6T-33]

That's right. Why use two words when you can use one fancy one?

[QUE6T-33 in reply to hose1975]

Ok. Well Hose, I've not used ear, only under tongue

3 mins or armpit 10 with thermometer. And I'm

guessing if you use ear plugs they might warm the

ear, so perhaps wait few minutes to be regular temp.

I don't know if your aware but there is plenty of

guidance on using temp/pulse for monitoring

meds on Thyroid sites. Hope this helps.