Can liothyronine push up tsh? Thanks

[zebady]

I was added 10 mg of liothyronine and my tsh went up to 12.8 mul from 0.2 ( needed for cancer supression) is the liothyronine at fault here please, at the time my levothyroxine went down from 300 to 275? ....... also on the blood results my t3 has allways been optimum (6.5 pmol/l ) so would a change of adding some more liothyronine not help how rubbish I feel? Thanks for your help xxx

[shaws Administrator]

I think the lowering of your levothyroxine might be the fault (bearing in mind I'm not medically qualified). 10mcg of T3 is around 50mcg of levo, in it's effect. The increase in your TSH is down to insufficient thyroid hormones.

Research has found that when combining T3/T4:-

tpauk.com/images/docs/reduc...

Extracts from above:

Inadequate Diagnostics

Post-thyroid or tissue deficiencies are not

only not assayed but dismissed, and they a assays often proscribed. But the post-thyroid

physiology should be assayed because it separates the thyroid diagnostics from the production of symptoms by several functions. For example, if only TSH is assayed, then there are four functions between the pituitary gland and the production of symptoms: the thyroid gland, peripheral conversion of T4 to T3,.............................Since these functions can be deficient (or ex

cessive clearance) they can diminish the T3 up-regulation of the respiratory cycle, reduce the body’s energy production, and increase the production of symptoms.

Obviously with the dismissal of post-

thyroid assays, clinicians attempting to care for patients with the continuing symptoms of hypothyroidism do not have sufficient information. This lack of information makes the existence of counterexamples reasonable..........

and

(from page 80)

Dose Selection in T3/T4 Study RCTs

The second logical basis for a conclusion is the actions taken, i.e., the doses given to the subjects. Most subjects received T3 below its adult starting dose of 25 mcg/day. The subjects in RCTs received T3 in some ratio to the withdrawn T4. The various RCTs used T4:T3 ratios of 14:1, 10:1, and 5:1. Subsequent research by the US National Institutes of Health (NIH) found the therapeutic equivalence was 3:1.

Thus, most of the subjects were under

treated with the T3/T4 combination. In light of the NIH finding, the conclusion that T3 therapy is never needed is invalid.

[LtAngua52 in reply to shaws]

Thanks for this link shawa,

It annoys me that so much evidence that supports many of the things that are said on here are confirmed in this research, but has been suppressed for use!

[shaws Administrator in reply to LtAngua52]

I think they don't read research articles and stick to their old forumulae despite their patients complaining. They don't even listen to doctors who get the brunt end of patients who aren't recovering and one in particular invited all Endocrinologists to a conference to discuss the parlous situation of diagnosing/treatment of patients and who were given far too low doses of levo to make them well and relieve symptoms. Previous to the guidelines we got between 200 and 400mcg of NDT.

As this doctor was a Virologist and his name became public because he made people well. For that he appeared about 7 times before the GMC and it certainly wasn't his thousands of patients who attended these!

By the way, one by one the Endocrinologists refused his invite and the last one the day before the Conference. Do they live in a 'cloud' apart from patients and not develop their knowledge. It would appear so.

Doctors who treated their patients were struck off even though it was learned in medical school but they didn't follow the modern guidelines!.

I believe it is pharmaceutical companies who foot the bill for their Conferences - I believe the American one was so it is a payment 'in kind'.

[SilverAvocado]

Mikepassword, in general, this is a very strange result. It's so strange it makes me wonder if there was an error with the test. Errors do happen, as the sample could have been contaminated or switched with another, or some everyday medications disrupt the tests.

Theoretically TSH should fall as freeT3 increases, and stay the same when it stays the same. And an increase in TSH like that should be accompanied by you feeling much more ill. But that is quite a large dose of 'theoretical'.

[shaws Administrator in reply to SilverAvocado]

I believe those who've had thyroid cancer have to have large doses to keep the TSH suppressed. Whatever is causing Mikepassword's TSH needs to be investigated I believe.

[Angel_of_the_North]

10 T3 is about equivalent to 30 T4 so shouldn't have made any real difference. Generally TSH falls when T3 is added as long as the total meds are high enough, so needs investigating. If you are a good converter (and with that level of T3 you are), there's not a lot of point in adding T3. Any change in time of dose or how you are taking it? Thinking absorption problem.

[Michy1]

I had thyroid cancer and I am on 125 mcg levothyroxine, both hospital and doctor won't help me and I'm in a lot of muscle pain and feel very depressed. What would be the best tablet to switch to and at what dosage?

[SilverAvocado in reply to Michy1]

Michy1, best practice is to have blood tests taken every six months and the dose adjusted. It is likely you are on too little, or maybe even too much if you aren't being monitored.

There is an option to add T3, as the OP has. I had my thyroid removed for cancer 3 years ago, and am now paying for all my own blood tests, and buying a third type of replacement hormone, NDT. This is dessicated thyroid taken from pigs (or sometimes beef), which is not available on the NHS.

[Michy1 in reply to SilverAvocado]

Thank you, I am in the process of trying to find a good Private Dr to do this.

[SilverAvocado in reply to Michy1]

Oops, just seen that I made an error above, I said testing every 6 months, but I meant every 6 weeks.