My psychosis situation and raising Levothyroxine.......developments!!

Well as you all know everytime I raised my levo by 12.5 mcgs I got psychosis which would last a few hours for a few days then subside.

I have since seen the NHS Endo who was VERY sympathetic and decided enough was enough!!

We are keeping the levo at 75mcgs and he has added 5mcgs of T3 x twice a day.


What I'd like to know is......

1) Should we keep raising the levo too until i reach the top third of the 12-22 range ie 17/18?

Last bloods FT4 was 15.2 so room for improvement.

2) And how long after starting T3 can one have bloods done? I know it has an immediate effect but does it take longer to register on bloods?

I am by the way delighted that I've managed to get to 75mcgs levo. It's taken since November 2014!

3) Also...will the addition of T3 help me convert the T4 better? I do seem to convert but soooooooooooo slooooooowly!!


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  • Great news joesmum,

    I have followed your journey with interest as have experienced psychosis myself.

    Sorry I can't advise on meds as am still on Levothyroxine but just wanted you to know I am really pleased and happy for you.

    I hope it all goes a little easier for you now,


  • Hi flower007,

    I'm so sorry that you've experienced psychosis too. It's just the most awful thing isn't it. I was supposed to raise my levo to 87.5mcgs from 75mcgs and found my myself terrified at the thought of a recurrence of psychotic symptoms.

    My Endo was truly sympathetic. He believes that raising the levo will eventually become much easier as the ratio of dose increases lessens. I am too battered and bruised by all this now. I need a break and so he very sensibly said hold the T4 and let's add some T3. Praise be!!

    Something clearly shuts down in the brain when I raise dosages whether it's pituitary, hypothalamus, pineal , serotonin .....who knows?? all I know is that it has been a tremendous up hill battle to get this far.

    One interesting thing is that the psychosis also happened with NDT.

    My body is hugely sensitive. And slowly is the only way for me but I am hoping that the addition of T3 will allow me to start living my life again. I would have been happy to stick to T4 but my dose increases are so small it will take another year to even function.

    I hope you feel some improvement soon. Thinking of you.x

  • I had a psychotic episode after taking glandulars. I am not doing well on just Levothyroxine but am too scared too add anything else now.

    My endo is lovely and works with my nutritionist who has Hashimotos herself. They are doing loads of tests to try and determine why T4 isn't working and why the glandulars had such a detrimental effect.

    Watch this space


  • Joesmum, 10mcg T3 is equivalent to 30mcg T4, so you have had a dose increase. I found the addition of T3 calmed adverse effects I had on Levothyroxine only, I hope it does the same for you.

    Adding T3 can actually cause FT4 to drop a bit. Taking oral T3 means there is less need for higher levels of T4 to convert to T3, plus oral T3 can stimulate better conversion of T4 to T3. The 'ideal' top 75% of FT4 range is for people on Levothyroxine only.

    T3 doesn't have an immediate effect. You may *feel* a dose more than you would T4, heart rate and pulse may rise an hour after ingestion but should drop back within another hour or so. It takes 24/48 hours for T3 to enter the cells from the blood to start working and up to 6 weeks to get the full impact. Blood test should be 6-8 weeks after starting T3. I found that FT3 responded less quickly than TSH and FT4 to dose adjustments and symptoms lagged behind good FT3 levels by around 7 weeks.

  • Thank you Clutter,

    That's VERY helpful. I'll keep you posted. One more thing........

    What is the benefit to continue taking any T4 at all?

    How will I ever know if taking the 75mcgs of levo is the right number for me?


  • Joesmum, I feel there's a bit of security in having T4 in my system to tide me over should I be unable to take T3 for a couple of days.

    Your next blood test will show whether your combined dose of 75mcg T4 + 10mcg T3 is optimal or insufficient. If not optimal, either T4 or T3 will be titrated until you are optimally dosed. Your blood test doesn't care which thyroid replacement you are taking, it just shows the levels.

  • Got it! Xx

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