Was on 1.75 grains of NDT. Now on 125 mcgs levo plus 15 mcgs T3 ......is that equal?

Just asking for advice on this. It doesn't feel equal........?

I still feel under-medicated?

By the way......I had to raise really slowly again with my last 25mcgs of levo because major depression set in again.....so, it's still seems to be happening with the dose increases.

I thought this might get easier the more levo I got in my system but clearly not. Hey- ho......I'll battle through. I'm obviously very weird. I wish I could find some literature about this?

All I know is that people who have had myxoedema madness sometimes have to be raised REALLY slowly?

X

[shaws Administrator]

It is a little lower 15mcg of T3 is equal to around 30mcg of levo + 125 = 155mcg levo.

[Hidden]

I have always multiplied my T3 ...MP Liothyronine x 3 so 15 mcgs would be 45 + 125 mcgs T4 equal to 170 mcgs T4

1 grain of Armour NDT contains 38mcgs T4 + 9mcgs T3 which is stronger and in patient leaflet is multiplied by 4 =9x4=36+ 38= 74 therefore 1.75 grains would equal 129.5

Please comment if I'm wrong as have been confused by this before.

I have also queried in my mind the balance of T4/T3 in both as I suddenly didn't feel well on my Armour before Christmas and since New Year have reverted to my T4 / T3 Liothyronine NHS prescription.

[Hidden in reply to Hidden]

I just get confused too!

I think NDT feels stronger than synthetic hormones?

[Hidden]

It's a bit difficult to comment on that as the type of medication and dosage that works for one person doesn't always do so for another......It is all so individual.

I decided to return to T4/T3 so that I am totally under the care of my GP and Endo.

I hope you are soon settled on what suits you best.

[Clutter]

Joesmum, 1.75 grains contains 66.5mcg T4 and 15.75mcg T3. You're taking considerably more T4.

[Hidden in reply to Clutter]

What I find confusing on a combination of T4 and T3 is just how high the FT4 level should be?

My endo is trying to raise my FT4 level to at least half way. My FT3 at last bloods was about half way. So he's kept me on 15mcgs of T3 and is raising the T4.

What would your thoughts be?

Ideally he trying to get me to a stage where I can lower my T3 dosage. He put me on T3 because of the terrible time I was having increasing the levo.

Am I now on too much T4?

[Angel_of_the_North in reply to Hidden]

Why? You don't need as much T4 if you are getting T3 directly. If you can't convert T4 to T3 well, there's no point giving you more T4. Is it because T3 costs too much?

[Clutter in reply to Hidden]

Joesmum, I don't think there is a 'should be' level for FT4. If FT3 is good it doesn't matter that FT4 is low.

On 75/100mcg T4 plus 30mcg T3 my FT4 is 14.1 (9-19).

[Hidden in reply to Clutter]

Thanks Clutter.

The reason my endo added the T3 was because I had so many problems raising the Levo (psychosis...) he wanted to get something in me quickly that I could tolerate. ( I could raise T3 quicker for some reason).

I do convert but painfully slowly.

My last bloods showed a FT of 11.5 (7.5 - 21) and an FT3 of 4.6 (3.8-6.8).

His advice was to raise T4 by 25 mcgs from 100 mcgs and keep the T3 at 15 mcgs. This latest increase has taken nearly 8 weeks, 6.25 mcgs at a time.......again!

I think eventually he will switch me completely over to T4 but is doing it very slowly at a pace that I can tolerate.

Being Central hypo he is looking to get my FT4 top third of range and FT3 top third of range.

He has said that I may always need a small amount of T3 but cannot gauge just how much at this stage.

I feel in very safe hands but really welcome your thoughts.

[Clutter in reply to Hidden]

Joesmum, Increasing T4 dose will improve FT4 which should then convert to better T3. If not, increasing T3 dose will improve FT3. I don't understand why there is an end game of reducing or dropping T3 dose. As far as I understand a poor converter will always need some T3 to deliver decent FT3.

[Hidden in reply to Clutter]

Totally agree. I think at the moment though he doesn't quite know just how poor or slow a converter I am.

He handles a lot of tricky cases and seems to be very liberal with his approach which in one sense is good because he doesn't appear to allow himself to be governed by Text books. From what I can see he seems to work with many wonky pituitary people!!😊

I shall you keep you posted. I'll be interested to see what my final dosages are of T4 and T3 particularly as TSH is completely ignored in my case. Not there yet but hopefully this year sometime!

[Clutter in reply to Hidden]

Joesmum, he's helped you so far so I'd continue to trust him and his treatment plan.

[Clutter in reply to Hidden]

Joesmum, apologies, I've been calling you Josiesmum on this thread. I've edited it now.

[Hidden in reply to Clutter]

Not to worry, I answer to most things!😊