How much T3

I have no thyroid gland. Removed 14 years ago due to papilliary cancer. Have had many problems with Levo over the years (probably on too high a dosage). I have been on 125's for years (reduced from 150mcg) howeve now my endo is worried it is too high (new research I understand), has reduced it to 5 x 100 and 2 x 125. I feel very tired on this dosage. I am not due to see her again until 2016. She also asked me to gradually reduce until I am taking only 100mcg daily. If I were to ask GP for some T3 - would it mean I would be able to take less Levo and would there be an advantage in this. Is T3 less likely to cause problems than Levo if the dosage is correct. On Levo I have had tremors, bone loss, vertigo and hip replacement. I understand why my endo wishes me to take less T4 , but I am confused as to whether taking less and some T3 will balance things out long term.

4 Replies

  • Pepekins, If you post your recent thyroid results and lab ref ranges members will advise whether you are optimally medicated. 100mcg would be a very small dose for someone without a thyroid. The addition of T3 to T4 can be very beneficial for thyroidless patients as even on high doses of T4 they often have difficulty in converting sufficient T3 which shows as low TSH + high FT4 + low FT3.

    Most GPs are reluctant to interfere with the treatment regime of endos but it may be worth asking if Liothyronine (T3) can be prescribed in addiition to T4. T4 should only be reduced if the T4 dose is optimal. If you aren't sufficiently medicated on T4 and reduce it to add in T3 you will still be undermedicated.

    Taking T3 usually lowers TSH. If your endo's goal is to ensure your TSH is not suppressed it won't help with that. There is research showing low (but not suppressed) TSH doesn't increase the risk of atrial fibrillation or osteoporosis.

    I also had thyCa and in 2013 was recovering on 60mcg T3 prior to RAI. After RAI I was switched to T4 and over replaced at 200mcg to suppress TSH. I felt poisoned. Dose was reduced over the year to 100mcg without improvement. FT3 dropped below range on 125mcg. Tremors, palpitations, pain etc on all doses until I was 90% bedridden. I was unable to tolerate T4 on it's own but the addition of T3 calmed the adverse effects T4 only causes me. I'm currently on 100mcg T4 + 30mcg T3 and TSH is suppressed between undetectable and 0.01. I had a DEXA scan last year showing mild osteopenia. I think that is likely the result of age, tall thin frame, low BMI, menopause <42, and severe vitD deficiency rather than 2 years suppressed TSH.

  • Thank you, that is very useful info. I see a GP next week and will get the latest results and post. Kind regards.

  • I, personally, don't like doctors to reduce their patients levothyroxine only due to their TSH. 150mcg is around an average dose. I will link you to someone who had her Thyroid gland removed and the consequences. She has now taken her case to the Scottish Parliament.

  • Thank you, that would be interesting.

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