T3 10mcg - will it make a difference?

[Niks76]

Good evening,

I had a hemi-thyroidectomy Nov 2014. NHS endo referral last year, first appointment was January this year. Previous to my referral I had been self medicating on T3 but doctors not willing to test my T3 levels, when I received my appointment I decided to go back to levo and start from scratch with the endos help/support.

In January after being back on 100 mcg levo for about 5 weeks and having gained a stone in weight my results were:

Thyroid Recep Abs 0.7 (<1)

FT4 12.2 (12-22)

TSH 4.17 (0.3-4.2)

Lab didn't test T3 despite being requested. Levo increased to 150 mid Jan

FT3 result 8th Feb 2.9 (3.1-6.8)

March results:

TSH 1.63 (0.2-4.2)

FT4 17.4 (12-22)

T3 not tested as previous test valid for 30 days (tested on day 29)! As Endo had been open to trial of T3 given that I was below range and said she would write to GP on receipt of my bloods, when the T3 wasn't tested, I had more bloods in April.

April results:

TSH 1.65 (0.2-4.2)

FT4 16.3 (12-22)

FT3 3 (3.1-6.8)

By this time she decided she would wait until my next appointment in May. As many previous symptoms had now returned, the weight gain and inability to lose any weight, tiredness, fatigue, aching joints etc and I felt like I'd wasted 4 months with nothing changing, I decided to add T3 myself again. Perhaps foolishly I didn't reduce my T4 but at the time I didn't believe my T4 results showed I was optimal. However mid May (after bloods taken) I stopped the levo and took T3 only.

May results:

TSH 0.01 (0.2-4.2)

FT4 15.1 (12-22)

FT3 7.1 (3.1-6.8)

She told me that supressed TSH increased my risk of atrial fibrillation and osteoporosis. Her letter informs that there is a lack of data on efficiency of T3 combination and current guidelines including The Royal College of Physicians and American Thyroid Associations do not recommend T3 treatment.

She agreed a trial of T3/T4 combination - levo 125 and T3 10. Given that my May results were only slightly over range for T3 and when not taking any T3 I had been under range, I don't believe 10mcg is going to make much improvement, especially taking once a day due to its short half life. Whilst self medicating again, I'd felt so much better, been more active etc, and as I had a holiday and a close friends wedding coming up, at which I was bridesmaid, I couldn't risk feeling worse again so I delayed making the switch.

I'm still reluctant to be honest but my next appointment is in a few weeks time so I'm thinking I should!

Any advice or thoughts on my results and whether I'm right in thinking 10mcg is too lower dose to make much difference? As she's stated that if there is no improvement she will stop the T3, I feel that she won't prescribe for long as its too low to make an improvement!

Any links to anything I can take to my next appointment please, about suppressed TSH and perhaps benefits of T3?

I'm beginning to wish I'd never been referred and struggled on self medicating as before so any advice welcome.

Thank you

[silverfox7]

I'm in a similar position. My Endo went back to Romania but before I was aware of that I saw a new chap who had no idea how reading results is different on any thing with T3 in it. I didn't say he was wrong but Dr I had told me........ so I then had to listen to his osteoporosis and AF talk which I said I didn't intend to take notice of. I also had a cancer op imminent so said this wasn't the time to change anything. But I complained about him to the Endo not realising he had left and they passed my lecture onto the chap I was complaining about! He did manage at some point he did know how to read results(!) but he is still trying to pressure me! This time he asked if during my op I was connected to an ECG machine. I was just about to sarcastically say I don't know I was asleep when he said of course they would have done so he asked if I'd had an AF and was genuinely surprised that I hadn't! That is a frightening admission butvi have to see the main man next time who the nurse says he's lovely and I'll want to cuddle him!!! Well may be if he drops this nonsense!

[Howard39]

Tsh is a pituitary gland test and was designed just for measuring t4.

To the best of my knowledge there is no recorded results that show a suppressed tsh does what she's claiming. I.e. Cause harm.

There was a great link a few days ago re the benefits of t3 - I will try and find it for you.

What doses were you on b4 your blood test in may?

The April results were poor so yes I would have added t3 in.

I think monthly testing is too soon and you need to be stable- swapping around is not the answer. But yes some t3 is better than nothing but I can't comment more until I know what you were taking. Most people I know who take t3 have a suppressed tsh but the free t3 was too high.

[Niks76]

Thanks for your reply, they wouldn't have been monthly had the T3 been done when requested. Each time it wasn't, that was requested again but the lab then tested TSH and FT4 again too (going against the 30 day rule they'd previously quoted for why they hadn't done T3).

I can't remember now if I was on 50 or 75mcg Tiromel at the time of testing. I had started on 25mcg and increased. In hindsight I should have reduced T4 when I started T3 but feeling so poorly, you forget don't you!?

I was under the impression T3 is usually dosed several times a day because of the short half life so not sure how successful 10mcg once a day will be and it'll be difficult to be accurate as the tablets are 20mcg and they're not easy to cut in half.

Has anyone had good results with taking T3 just once a day?

Thanks

[SeasideSusie Remembering in reply to Niks76]

Niks - I take a Levo/T3 combination and I take my T3 in one dose before I get up in the morning. I used to split the dose but found no difference when I changed to taking it all at once. Some people do find they need to split the dose.

[Niks76]

Thanks seasidesusie, how much of each are you on?

[LAHs]

From my very limited experience with supplemental T3 I would say that yes, 10mcg T3 will have a (positive) affect. I have had a total thyroidectomy and I am on NDT Armour. I very occasionally take half a tablet of T3 if I am very tired but have to be alert for something. It works very well but it sends my blood pressure (BP) up so I cannot do this with regularity. I love the way it makes me feel and wish I could take it everyday but the increased BP is scary. I bite off half a 25mcg tablet, so that would be about the 10 you are asking about. So, the answer to your question is, yes but measure your BP. My dose of 1.5 grains NDT is about the same as your existing 125mcg Levo. Oh, and T3 varies greatly during the day, so be sure you have left 24 hours since your last dose before you get tested - otherwise you might get a high T3 result and that will make the doc reduce or stop your T3 because a too high dose will definitely give you (temporary) atrial fibrillation eventually.

I once forgot and took my NDT and T3 before a blood test and my T3 came out as through the roof - and prompted an emergency call from my doc. I end up worn out by 4:00pm, so not much T3 left at that point.