GP stopping levo, starting T3 at same time... help please!

[TaraJR]

I had Graves in 1987, RAI in 1990, since then hypothyroid and on levo. For years I’ve been on 175, and have felt pretty good. Then something changed, I don’t know what, and for nearly 18 mths I’ve been utterly exhausted, plus other hypo-type symptoms, plus a few new things, but myT4 was high, T3 low, and TSH very low.

Vit D was also below range (now very good)

March 2016-  TSH 0.04 (0.35-3.5)     Free T4 21 (8.0-21.0)     Free T3 4.5 (3-8-6.0)

Last year my T3 went down to 3.7

I’ve researched loads (felt too ill to go out much), got my test results from the past 15 months. Seen 2 endos, both said I'm on too much levo, neither thought it’s a T3 problem when I asked, tho the 2nd one has written to my GP suggesting a trial of T3, on a ‘self funded’ prescription. My lovely GP has given me a month free to see what happens 

GP said stop taking my 175 levo; and take 10mcg T3 twice a day instead.

I’m very worried I’ll still have effects of levo to start with and don’t want to end up going hyper. GP will ring me again in 10 days to see how I am.

Any ideas on best way I can swap over? And also what time of day is best for T3? Many thanks in advance!

[Clutter]

TaraJR,

You'll become hypo not hyper on 20mcg T3. 20mcg is equivalent to 60mcg T4.  Your GP should have prescribed 3 x 20mcg T3 daily as an equivalent dose to 175mcg T4.  You could reduce Levothyroxine by 50mcg and add the 20mcg T3 in 2 x 10mcg doses which will raise FT3.

[TaraJR in reply to Clutter]

Oh Clutter thanks a lot for this. I was excited yesterday when I got it, but today felt unsure about dosage etc. But doesn't the effect of T4 stay in your body for at least a few days, so I'd feel the effect of 175 for a while? Which is why I thought I might go hyper! 

Do you know if there are optimum times of day to take T3? 

[Clutter in reply to TaraJR]

TaraJR,

When I was switched from 200mcg T4 to 60mcg T3 next day I didn't experience hyper symptoms.

Take T3 when it suits you.  I take the larger dose with Levothyroxine in the morning, and a second smaller dose at bedtime.

[TaraJR in reply to Clutter]

So do you take levo as well as T3?

[Clutter in reply to TaraJR]

TaraJR,

 Yes, I take 75/100mcg Levothyroxine alternate days and 30mcg T3 split into 20/10mcg doses every day.

[bantam12]

If you haven't had your calcium checked it would be worth doing, if high then PTH test. Hypo type symptoms + low vitd + previous RAI can be signs of hyperparathyroidism.