T4 and T3 dose conversion.

[Monnty]

Hi again.

I now have t3, Tiromel, 25mcg tablets.

I was prescribed 175mcg of thyroxine daily and my endo suggested I reduce thyroxine down to 100mcg and taking 40mcg t3.

Well I've been on 100 mcg thyroxine and 25 up to 50mcg of Tiromel after 4 days. {50 as I can't do 40 and I hoped 50 would be better than 37.5}

Now been on it for just over 2 weeks. I haven't noticed any of the side effects or any benefits either. If anything I feel under medicated again. Bloating and weight gain with pains and cramp at my ankles first thing in the morning.

I've been taking the t4 and half the t3 when I wake up and then the other half of the t3 in the afternoon.

I'm considering upping it to 62.5mcg but not wanting to do any harm by overdosing

Any advice or experience would be helpful in case I'm under or over medicating.

Thank you. 😉

[shaws Administrator]

25mcg of T3 is equal, in its effect, to approx 100mcg of levothyroxine, so at times you've been taking doses of up to 300mcg thyroid hormones?

I think you should start at the beginning again. Taking 100mcg levo plus 25mcg T3 and stay on that dose for two weeks. Taking your pulse and temp several times a day and also clinical symptoms you have.

If you feel good and have relief of symptoms that may be sufficient. Symptoms are the main clues of how we are doing.

Next - if you still have some symptoms I'd increase T3 by 1/4 tablet at a time every week or so until you are symptom free.

Stomach always has to be empty when taking thyroid hormones (with one full glas of water) as food interferes with the uptake.

I will state I am not medically qualified. I have hypo and take 50mcg of T3 daily and am well.

[Monnty in reply to shaws]

Thanks, interesting point on the temperature. I have monitored my pulse and there had been no noticeable changes . My weight has increased but I've not looked at temperature.

T4 was beneficial to me but not sufficiently to clear my symptoms. It appeared that I was not converting to t3 hence the agreement that I should go on the combination.

I can't say I am the most strict with empty stomach. Morning tends to be 20 minutes or so before I eat but the later ones can vary.

[shaws Administrator in reply to Monnty]

It is more convenient for us to take one daily dose. Due to the fact that we have a 'space' in our daily life to enable the best possible outlook for our hormones.

If it is easier for us - and it does make a difference an empty stomach as you are then sure that 'all' your hormones are being assimilated.

Some find bedtime dosing best (as long as you've last eaten about 3 hours previously, particularly if you have had protein (takes longer to digest). The following link may be helpful, especially the one dated January 30, 2002.

web.archive.org/web/2010103...

[shaws Administrator in reply to Monnty]

Levothyroxine is T4. T4 is inactive and has to convert to T3 (liothyronine)- the only Active hormone required in our billions of receptor cells. If conversion is hindered and we think we're taking sufficient but may wonder why we are still symptomatic.

[shaws Administrator]

p.s. I will say that a few people have thyroid hormone resistance and they cannot convert levo into T3 so have to take T3 only. That's just a thought for you to consider in the future.

[Clutter]

Monnty,

You can quarter a Tiromel tablet easily with a pillcutter. 3/4 of a tablet (37.5mcg) is the closest you will get to 40mcg your endo prescribed.

T3 is not an instant fix. It takes time for T3 levels to build up and metabolise. If you increase beyond the 50mcg you are currently taking you will become overmedicated. My advice is to take 37.5mcg T3 and check FT3 in 6 weeks before increasing further.

[dolphin5]

My experience tells me that how much you drop your T4 when starting T3 depends on the level of your T4 at the outset. I was advised by the endo to drop from 125mcg T4 to 100, and to add 20mcg T3. This did not work for me. The T4 very quickly became too little (i.e. within a week or so), and the T3 became too much after about 3 months.

I now take 125 T4 as before, and only 12.5 T3 per day (unless doing a long cycle ride, and then I take 16.75mcg). More of the T4 gets converted, so my FT4 results are lower (and well within range instead of above the range). My FT3 results are now in the lower half of the range, instead of at the bottom or below.

All of this has made me feel better than before (doing it my way).

So it all depends on your starting point, and I would advise small changes until you get both the results and how you feel to a better position.