Help and advise would be great Re Liothyronine


I'm new to this site and would greatly appreciate some advise

I've had an UAT for about 15 years, I've been on 200mcg of levothyroxin for years, I've just had my yearly blood tests and the results were abnormal as always, my reg GP normally says to me if I feel ok on the 200mcg just to stay on that dose, he's off sick... So I saw a locum doctor, he said I HAVE to reduce to 175 levothyroxin and has prescribed me 20mcg of Liothyronine

I told him I had tried to reduce the levo before (about 7 years ago) but it just makes me feel dreadful... He said it was dangerous for me to stay on 200mcg and after looking at my TS3 recommend the Liothyronine but only to take it when I started to feel bad

I reduced to the 175 last Thursday and started the Liothyronine yesterday as I couldn't stand it another day... I am actually fighting my way through the days, I feel totally shattered, I can not afford to be feeling this way as I'm a carer for my elderly mum

My T4 was 23(+)

Serum TSH <O.01(-)

Serum free triiodothyronine level 4.4

I feel like I'm rambling... But he did say (the locum) that there is a lot of controversy over the Liothyronine ?

Can anyone explain this to me?

I have an appointment to see an endocrinologist in January

Any help or advise would be so much appreciated

Thank you

10 Replies

  • You are very lucky to have had T3 added to a reduced T4. It is usual to reduce levo when adding T3. As you were on 200mcg and he reduced to 150mcg, because he's added 20mcg of T3 (equal to approx 60mcg of levo). I would take 125mcg of Levo plus 20mcg T3.

    I always take my dose of whatever they've been (i.e. T4/T3, NDT, T3 only) once daily. Don't only take T3 when you feel bad. I think you will find a big improvement and if you feel.

    Don't chop/change. We have to keep on a daily stable dose otherwise we will never reach a plateau of feeling well.

    I hope you feel the benefit in a couple of days.

    The only controversy about liothyronine is that the guidelines state it hasn't to be prescribed. They really don't understand, I think, about how hormones work in our body. I am absolutely fine on T3 only and was dreadful/awful on levothyroxine. Improved a lot when T3 was added inititally.

    Your TSH is suppressed but some feel better although doctors don't like it. They think some harm will come to us.

    Did you leave about 24 hours between your last dose of levo and the test. Did you fast also (you can drink water). This allows our TSH to be higher and doctors usually adjust according to the TSH only.

    p.s. T3 (liothyronine) is the active hormone requested by the billions of receptor cells in our body so that we can function, but if T4 (levo) isn't converting adequately into T3, we remain unwell.

    So, next blood test make the appointment as early as possible, fast and leave about 24 hours between dose of hormones and the test. Always get a print out with the ranges for your own records and so that you can post if you have a query.

  • Welcome to the forum, Sammys19.

    The locum might as well have left you on 200mcg and let the endo decide what to do in January. I think he wanted to reduce Levothyroxine dose to 175mcg because TSH is suppressed and FT4 slightly over range but by adding T3 he's increased your dose. 20mcg T3 is equivalent to 60mcg Levothyroxine.

    Locum patently doesn't know what he is doing if he told you to take 20mcg Liothyronine (T3) 'when you feel bad'. It's not a pick me up, it should be taken daily, as Levothyroxine is.

    Your FT3 4.4 is fairly low so T3 will be helpful. I think you ought to reduce your Levothyroxine dose to 150mcg though, else you are likely to feel overmedicated in a few days when T3 level increases.


    I am not a medical professional and this information is not intended to be a substitute for medical guidance from your own doctor. Please check with your personal physician before applying any of these suggestions.

  • Thank you both so much for replying, I have to admit that although I've had an UAT for 15 years I'm embarressed to admit I know very little about it, this is now about to change...

    I may not have been very clear n my original post

    I have reduced levo to 175 daily (was told to wait till I felt "crap")and then take the 20mcg of Liothyronine daily along with the levo

    I have never been told to fast before having my TFT

    I live in Norfolk and to be honest the doctors aren't the best

  • Sammys19, early testing and fasting are tips for people who are close to diagnosis and they may help others avoid dose reductions if TSH is a bit low. Your TSH is so suppressed it isn't likely to make any difference to your TSH result.

    I'm glad you cleared up what the locum meant. I hope the T3 will be helpful in improving fatigue.

  • Thank you Clutter

    I'm only on day 2 of the Liothyronine, so maybe should feel the Benifit in a week or so (fingers crossed)

  • Sammys, you may find that the T3 is making you feel much more normal. That is the difference between Levo and Armour is that NDT includes T3 and was the only treatment 100 years ago. You should try to learn more about your condition if possible.

    Your metabolism has far reaching effects on your health now and your future health.

  • With a free t3 of only 4.4 i am surprised you felt well on 200mcg thyroxine

    I think the gp is correct to lower your t4 /thyroxine and give you t3/ liothyronine instead

    The t3 should very quickly make you feel better

  • You may find that the full 20mcg of T3 taken all at once can be powerful. It is often suggested on this forum that you split the dose taking 10mcg in the morning and another 10mcg later in the day - away from food of course.

    Hope you soon feel stronger.

  • Yes, split into two halves. Once at breakfast and once before bedtime. I've found the bedtime dose can improve the quality of your sleep (deeper with more dream) and hence improve your alertness during the day.

  • A lot of people wold pay to see your locum!

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