Back on t4/t3 combo

HI ,can I ask, is thyroxine 50mcg and t3 20 MCG less or more than 45 MCG of t3.I have transitioned back on to t3/4.I slowly increased thyroxine from 25 to 75 and dropped t3 from 45 to 20.I was on 75 thyroxine and 20 t3, but felt hyper,reduced thyroxine to 62.5 that was 5 days ago,started getting chest pain and headaches, so reduced thyroxine to 50 MCG and kept t3 at 20.Today however feel so tired sweaty and hot,could this be symptoms of too much medication from a week ago ?

14 Replies

Well, it all depends on how well you convert. T4 isn't equal to anything if you can't convert it. Did you have an FT4 and an FT3 reading before you started adding in T3?

Sorry geygoose maybe did not explain right,I was on t3 only an started adding thyroxine.Was on thyroxine for 16 years until all went wrong ,been really I'll for last 4 years.tried all combinations now on t4/ t3. My t3 levels have always been in upper end of normal.But last week my Tsh was 0.036,that's when I got headache and chest t3 was 4.8.

No, you explained perfectly well, and I understood. But, I was asking if, at a time when you weren't taking any T3, did you have your FT4 and FT3 tested at the same time, to see how well you convert.

Oh,yes,last time I was on thyroxine my t3 was 5 and ft4 19.I was on Teva for years until they withdrew and went downhill from there.I was on new make and suddenly after a few months went hyper ,thought I was dying.Never recovered since then but even on teva my tsh and symptoms and doses of thyroxine were all over the place.

Well, you don't give ranges, but on the face of it, it doesn't look like you have a conversion problem. So, the equivalence will be as shaws says below. :)

Thank you grey goose,once again.Could I have hyper symptoms from dose from 5 days ago,as reduced dose for 5 days now.

Yes 50 T4 + 20 T3 = approx 110 levo. (20mcg T3 = approx 60 levo). 45 mcg T3 = 160mcg levo. 75mcg of T4 + 20mcg T3 = 135 levo - all approx.

Thanks Shaw

So do you definitely have Hashimoto's? If so are you on gluten free diet or have you tried it

What about low vitamins. Have you got recent tests for vitamin D, folate, B12 and ferritin

Extremely common with Hashimoto's to have poor gut function and low vitamins

Hi slowdragon ,yes I have hashimotos.Not been gluten free.My antibodies were 600 16 years ago and Tsh 10 16 years when I was diagnosed,now antibodies 300.Yes vit d low at 30,on supplements Ferritin 69 which I think is okB12 good.Thanks for replying.

If your vitamin D is low then you will struggle to use thyroid hormones

With Hashimoto's we often need hefty dose to increase levels. If your in Uk that level needs to be at least 70nmol/L and nearer 100nmol/L is better.

How much vitamin D are you taking? Have you tried mouth spray vitamin D, might find it easier to absorb.

Many, many with Hashimoto's find gluten free diet helps significantly. Hashimoto's affects gut, causing leaky gut, or leaky gut triggers Hashimoto's. Healing gut, lowering antibodies and improving vitamins is key to making progress

Gluten is often the cause, of continuing gut issues, and high antibodies may be due to molecular mimicry.

Selenium, zinc, magnesium and vitamin C are all important too

Great clip about thyroid

Thanks slow dragon ,will get spay vit d I think

I use 3000iu dose.

When increasing level I use two sprays daily (6000iu) and then reduce to 3000iu daily for maintenance.

You need to test vitamin D at least twice a year until work out what level of supplement keeps you at good level

£28 postal kit


50mcg T4 + 20mcg T3 is equivalent to 110mcg T4 or 36.66mcg T3 so slightly under 45mcg T3.

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