Stopping T4 Levo and taking T3 only with Hashim... - Thyroid UK

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Stopping T4 Levo and taking T3 only with Hashimoto's

Since my wife's last private blood test, TSH 4.24, T4 Total 74.3, Free T4 11.87, Free T3 2.91, copied to Endo, he advised upping Levo from 50mcg to 75mcg for 4 weeks then 100mcg daily, with no recommended increase of prescribed T3 from the current 10mcg per day. Some improvement in general on 75 Levo but still often very shaky and depressed AM, and no significant change for the better on 100mcg, despite my having the type of Levo changed due poor results. Still days of feeling miserable, sometimes all day, together with unsettled gastric system, and often constipation. In desperation I stopped Levo altogether and put my wife on 20mcg T3 in split doses of 10 each per day. This regime only started 5 days ago, but there has been a clear improvement in her wellbeing overall, together with improved gastric symptoms.

Any comments on this, and on the likelihood of the improvement continuing, will be welcome.

8 Replies

20mcg of T3 is quite a low dose - 25mcg is around 100mcg of levo.

I was very unwell on levothyroxine alone, improved a bit on adding 10mcg of T3. I am now well on T3 only and take one daily dose of just under 50mcg. That's not to say everyone does. Some members have found T3 doesn't suit but the fact that your wife's T3 was very low on 100 levo plus 10mcg would seem to me - I am not medically qualified - wasn't converting levo to T3.

I take my dose once daily. I do know some people split doses but I'll give you a link from a doctor, deceased, who himself took one daily dose of 150mcg of T3 for around 40+ years. The whole link is informative but go to the date January 30, 2002 - the last sentence reads:-

As a result, a single dose of T3 will be long gone from the patient's system before he or she experiences most of the benefits of that dose�a molecular and metabolic yield that may smoothly spread out over one to three days.

This site is now archived as Dr Lowe died through an accident but he would never prescribe levothyroxine at all. Dr Lowe advised increasing by 1/4 around every week but cannot find the link. Pulse/temp should both be taken befor beginning T3 so that if pulse goes too fast (mine never did on T3 but shot off on levo at times 144) or temp too high. If either, reduce to previous dose.

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Thanks Shaws, just a slight correction, the last test was done while she was on only 50 Levo and 10 T3. Seeing Endo next month, and will get another private test done first, as they only ever do TSH, however, I hope that if her condition remains or improves further, I will be able to lobby for further T3. Will read the archived links, which I may have done previously.


The blood tests aren't as important as how your wife 'feels' on particular doses. There is also natural dessicated thyroid hormones which contain all of the hormones a healthy gland would produce and was the only product available from 1892 up until the late 50's when the push for blood tests and Levo was gradually the only option for us.

I think that's why so many are on this forum that doctors have never learned/lost the knack of diagnosing by patient's clinical symptoms alone and don't presribe until on optimum but stop when the TSH reaches a point and will not prescribe an option if patient is clearly still unwell but are willing to 'add' anti-depressants - pain relief etc.


When I found the right dose of T3, I found the effect did build over time. Given that you wife was on 50mcg levo plus 10mcg of T3 - I would view 20mcg as probably about right.

I would suggest that you try also supplementing Selenium, if your wife is deficient in that it may explain why T4 did not work.

best of luck.


Because her tsh was raised and the T4 and T3 low with 50 T4 and 10 T3, I would suggest maybe 30mcg T3 would be nearer the mark but it's hard to say without blood tests and prob best to wait for them :-)


She is already on selenium taken with her first dose of T3, previously it was taken with Levo at night. She also takes other supplements.


I would caution against completely dropping the T4, while your wife may feel well dropping it and adding T3 at the start, this may change when the T4 levels that are already in the blood drop down. You might want to consider a small T4 dose as well as T3, e.g. 75 t4, 20 t3.


This is what she was on, and still not good.


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