How long to decrease rt3?

[amala57]

Hi has any one got any idea how long it takes for rt3 to decrease once meds have been adjusted? Is it as individual as we are? Days or weeks? Thanks! 😊

[diogenes Remembering]

The halflife turnover of rT3 is the fastest of the group T4 (1 week) and T3 (1 day). rT3 turnover is about half that of T3 so it clears quickly once the stimulus to produce it has gone.

[amala57 in reply to diogenes]

Thank you. I am so ill. I have just posted again. Please can you help me? I'm scared. Should I stop My t3?

[diogenes Remembering in reply to amala57]

It's unwise just to STOP anything like this. Careful juggling of doses with time to evaluate the results of the juggle is I'm afraid the only way forward

[amala57 in reply to diogenes]

Yes but I can't move. If I do anything my pulse shoots up. I appreciate this site but I've had mixed advice and don't know how to proceed.

[diogenes Remembering in reply to amala57]

In which case, gently lower your T3 dose slightly and give time to see what happens. It won't happen quickly so you must have patience

[amala57 in reply to diogenes]

Ok thanks and t4? I'm taking 25mcg t4 and 2x 6.25mcg t3 since yesterday. I was on 125mcg t4

[diogenes Remembering in reply to amala57]

Keep T4 the same and lower the T3 since that is the active hormone.

[amala57 in reply to diogenes]

Thank you. Will I become hypo? I have no gland.

[diogenes Remembering in reply to amala57]

No: you might be slightly overdosed at present, and gently lowering dose may help.

[amala57 in reply to diogenes]

Thank you 😊

[Naomi8 in reply to amala57]

when I first added T3 to my T4,I had a bout of supraventricular tachicardia(heart rate greater than 120 BBP) that was still going after 5 hours.I had added 5 mcgs of T3,3 times a day for 3 days.Duty GP said to go straight to A&E.They kept me in overnight til my pulse returned to normal(after 9 hours)They assured me it was not dangerous & was not atrial fibrillation.

I had all the heart diagnostics done at outpatients later,then went back on T3 after a few weeks,reducing my T4 to zero as quickly as I could & upping my T3 gently.

I did very well on T3-only for 2 years,building up to 55mcgs in 2 daily doses.

I am now doing well on 75mcgs T4 & 3/4 of a 25mcg tab of T3.

I believe my severe reaction to such a small dose of T3 may have been reverse T3?I am so glad I didn't get put off T3.

[amala57 in reply to Naomi8]

Thank you Naomi that's so much like me! I'm sure it is a rt3 problem. Mine was 24 very top of normal. I live on my own and it's so frightening. I have reduced t4 to 25. And will take quarter of a 25mcg t3 2x day. I will see how I go. It's so tempting to stop the t3 but I realise it's exactly the wrong thing to do! Thank you so much. Very reassuring! 😊

[amala57 in reply to Naomi8]

Naomi8

Did you also get headaches when you started t3? I've had headaches but they are a bit better now.

[Naomi8 in reply to amala57]

No,I did not get headaches but on too much T3 I got hot sweats & temperature swings

[diogenes Remembering in reply to diogenes]

The website "Reverse triiodothyronine - Wikipedia" tells you something about the biochemistry of rT3.

[amala57 in reply to diogenes]

So the majority of rt3 comes from t4. So reducing t4 will help clear rt3. Have I understood that?

[diogenes Remembering in reply to amala57]

Correct.

[levelslass in reply to amala57]

Going from 125 mcg T4 down to 25 mcg T4 sounds mad to me. I can only quote what my endocrinology consultant Professor Hattersley wrote to my GP in 2012 "In summary monitoring patients who are on T3 is difficult. The TSH is a reasonable indicator but the measurement of the free hormones are not. I would generally try and keep the TSH less than 1 but higher than 0.2 and would achieve this by altering the T4 Thyroxine dose and not alter the T3. In general terms the BNF recommends that 10 micrograms of T3 Liothyronine is equivalent to 50 micrograms of T4 Thyroxine.Therefore her present dose is the equivalent of 150 micrograms of Thyroxine which is a fairly standard dose. (So I was then put on 75 mcg of T4 and 25 mcg T3 per day)

Me: So if you halve the dose of T4 and take 12.5 mcg of T3 morning and afternoon away from food wouldn't that be better? You may be getting palpitations because your dose of T3 is too low and it's your body's way of trying to get your heart to beat at a 'normal' rate. I get palpitations in the morning and struggle to breath properly until I take my morning 12.5 mcg dose of T3 (with 75 mcg of T4).

My advice would be go back to your GP and insist on going to see an endo consultant. It makes me very nervous that people are trying to self medicate when they don't know what they're doing.

[amala57 in reply to levelslass]

I saw my gp this morning. She emailed my endo . I haven't heard anything. I called my endos secretary on Friday. Still no word from endo! Thanks for your advice.

[JaninaWalker]

I was not on thyroid meds as I had no antibodies but did have mid range reverse T3, so I tried my own version of the Dr Wilson approach and in a total of so far 9 months of which half was taking T3 and half was not so as not to become adapted to it. I found the slower method was most helpful as it is TIME that allows the RT3 to fall out and I decided taking 5 doses per day was a waste as it did not work as well and was too complicated. Each dose was a half tablet of 25 mcg so 12.5 approx. per dose. I am now at the lower end of the ref range and was at mid range when I started beginning early Oct 2016....so expect it will take 6 months to a year depending on how much there is to see fall away.