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Thyroid UK
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Adding T3 to T4 medication

Hi, I'm wondering if anyone here has added T3 to their levo without getting tests done first? I've been back on levo for 4 weeks now and would like to try adding T3 to eliminate my hypo symptoms as i didn't get on well with NDT due to iron & adrenal issues which i'm dressing now. Ive heard adding T3 to T4 is much easier on the adrenals but i just can't afford to fork out another £99 for a full thyroid panel (people are suggesting i get RT3 checked) so wondered if anyone has had success at just adding it and going by symptoms alone? TIA

9 Replies


Experienced users can go by temps & pulse but I would never introduce a new hormone without testing deficiencies before.

RT3 is useful, particularly when you have had previous problems utilising T4 but not imperative. A Blue Horizon thyroid test to include TSH, T4 & T3 costs £73.35.



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thanks radd - that test is actually £49 at the moment so even better and that's the one i was going to order until people in another group said they wouldn't bother with TSH and just do RT3, T4 & T3 which'll cost £139 if i want RT3 included :(

so i'll just do the £49 one to get the basics really in your opinion? i guess if i have problems adding T3 then the full panel will be useful...god this is expensive work :'(



Yes it is very expensive but sometimes only comprehensive testing will find our answers. It depends why you were so intolerant of the NDT.

Testing RT3 is much more informative but will need other factors such as sex hormones to be considered when reading the results. This would disclose if your troubles with thyroid meds are due to an elevation//deficiency in something like oestrogen//progesterone, as these are made in the adrenal glands and can suffer when we have low adrenal health..

If you have adrenals issues and poor periods or are menopausal you could ask your GP to test sex hormones on the National Health.

Equally if your intolerance to NDT was low iron or just cortisol which you are addressing, you may find the addition of T3 to your Levo very beneficial. I did.

Either way I think it imperative to know your T3 levels before adding to your T4 medication .



Yes i am aware i have hormonal imbalances and have the clinical symptoms of PCOS so i paid for a private sex hormone test last summer and i showed i was pretty out of whack with oestrogen/progesterone and testosterone was above normal range which i knew anyway as i have excessive hair and had acne for 15+ years (which magically ceased february this year!)

i haven't been treating this specifically apart from being told to cut sugar out (go through phases, currently in a bad phase) otherwise i was offered metformin and OCP which i didnt want to take. I've now had the mirena coil for 7 months now and still have irregular periods.

Is there anything you'd suggest with this info before trying T3/NDT again then?

I will order the T3 & T4 test next payday and post my results to see where to go next with adding T3. I am feeling hypo everyday with fatigue, general lack of interest in anything, head and gland problems in throat, no libido, piling on weight....i just know i need to try something else as soon as i can.

thanks for your advice and guidance :)



Arrr.... did you have oestrogen dominance ? ? ...

A marina coil secretes progesterone that opposes oestrogen's effect on the womb lining and reduces the risk of cancer. I'm supplementing both (gel & pill) as was so deficient.

Oestrogen dominance causes the liver to produce high levels of Thyroid Binding Globulin (TBG) which binds the thyroid hormone and decreases the amount of "free" that can be assimilated and utilised by the cells , so giving you hypothyroid symptoms.

Can you ask your GP to retest sex hormones yet ? ? It has been suggested I retest six months after starting HRT..

If the marina coil hasn't done it's job yet of balancing progesterone//oestrogen, then adding T3 may not give the desired results until sex hormones are more balanced. However, medicating T3 asap after your thyroid tests might help everything rebalance (in its own small way).

Excessive (facial) hair, acne, and menstrual irregularity are classic PCOS symptoms ... poor you... Perhaps the marina coil has helped more than you know. I had elevated testosterone last year but thankfully must have caught it in time as haven't suffered any of the associated symptoms and don't have PCOS.

There is a high chance of insulin resistance with PCOS so eating well is really very important. It's all a bit of a nightmare isn't it ! ! ...


Oestrogen Dominance & TBG



hi rädd,

I wouldn't say i had/have oestrogen dominance going from the hormone test last year - wish i could post a picture of it but can't by the looks of it on here...?

anyway, the test was done during a 7 month gap of no OCP whatsoever and my progesterone was generally very low with a spike on day 14 (too early according to genova) and my oestrogen was barely above zero until day 16 when it spiked twice so was only within normal range on a few days. my naturopath said this was just a imbalance, not dominance of any kind but you're right, i think i've underestimated how much the mirena coil has helped me. i was advised against any contraception by my naturopath as it isn't natural but this is the only protection I've found that hasn't messed me right up! and my acne was the most depressing part of it all as it really affected my confidence for over a decade so I'm very thankful for that improvement. I know that it's not diet related as i've fallen off the healthy wagon many of times and never broken out again (touch wood! - still nervous it'll all change)

i could ask my GP for another test, can you recommend why though as i get A LOT of resistance in my GP's about everything i ask for? maybe i can show her that article you attached actually...? would oestrogen, progesterone & testosterone be enough? earliest app is 9th aug...standard eh but i would've got my results from the blue horizon thyroid test by then which'll be building a better picture.

really need to sort my diet out again now as i've really fallen off the AIP wagon with dairy, too much sugar, grains etc and now i have a flare up of my gallstone :( really don't want another operation this year so back to little or no fat and strict AIP. hard work indeed! do you follow a diet out of interest?

sorry to hear about your troubles with sex hormones too, us women do get the worst of it all eh! i'm so worried about starting a family in the next few years with all this going on - my negative brain is convincing myself i won't be able to have children. horrible :(



I read that an oestrogen dominance needs not involve high levels but just a decline in progesterone so causing an imbalance and too much TBG but you sound as if you are like me ...deficient in both.

I don't know enough about it to suggest anything further except have you investigated Wellsprings Transdermal creams ? ? ..

I am sorry to hear you have all this trouble pre having children. My real troubles started post children and I am now menopausal.

Adding HRT alleviated my depression & seems to have made thyroid hormones work better as my symptoms took a big leap forward for the better..

Maybe adding T3 and supporting adrenals big time will help to heal all these hormone imbalances.

If your GP is resistant to tests (& most are) leave it until a year. I think it would be reasonable to ask for a retest of sex hormones after 12 months given your problems.

If I ever come back to this world, it will be as a seahorse ! ! ..


Hi Radd

No i haven't heard of Wellsprings Transdermal creams, is that in the UK or available worldwide? i'll google anyway and maybe something to think about if my GP agrees to do a sex hormone test and they come back out of whack again. although before all they suggested was going on the pill which i point blank refused to so they didnt care beyond that. same story, different GP eh!

So sorry to hear about your slump after children and beginning menopause, it couldn't have been easy at all! sounds like you're over the worse and on the right track which met be a relief!

i'm still a bit confused as to how i should be supporting my adrenals to be honest...i realised my holy basil had seaweed in so maybe it was the iodine causing me problems?? back to the drawing board really on all that...maybe PS (very expensive) i already take zinc at night or maybe try a different holy basil?

do you know much about milk thistle? bought a tincture and was taking it before/after drinking alcohol for the first time in 3 months but read lots about it being a good adaptogen so maybe that would help the adrenals. must be less expensive ways like teas and lifestyle changes i can adopt as really cant afford to add any more supplements to my list :/

reincarnation of a seahorse - i'm fully on board with that!!



Holy basil is good and comes as a tea called Tulsi and I take milk thistle since chelating mercury last year.

Adrenals need a quiet life...lots of good food and sound sleep. Link below on supplements

I didn't have early menopause. I am middle-aged. I previously used the Wellsprings Progesterone Cream but it didn't do anything for me because after testing sex hormones it was realised I was rock bottom in both oestrogen & progesterone.

The 20-1 cream contains both.


Adrenal Hormones



Adrenals Supports



Wellsprings TransDermal Creams



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