T4 and T3 Combo

I'm new on here and looking for advice. My endo added 10mcg of T3 to my 100mcg of Levo as i wasn't doing well on Levo only but after a number of weeks I was feeling very hyper on this dose, on advice from my GP I reduced the levo to 75mcg and the T3 to 5mcg. I am now feeling under medicated with very little energy. Can anyone please advise if I should raise the T3 back to 10mcg?

[greygoose]

Yes, I would. It really isn't a good idea to reduce both at the same time.

[Hidden in reply to greygoose]

Thanks for replying I'll raise the T3 then. I'm not very clued up on this combo yet so i really appreciate the advice

[greygoose in reply to Hidden]

You're welcome.

[SeasideSusie Remembering]

Hidden You should have reduced only one at a time.

Ideally you should have been started on 5mcg T3 and increase by 5mcg after a while. T3 is 3 times as potent as Levo, and any increases should be gradual for all hormones, as should decreases.

Without seeing your results it's difficult to say, but as you added 10mcg of T3 to 100mcg Levo then felt hyper, I would have reduced the T3 to 5mcg and left the Levo at 100mcg and see how that felt. By reducing both you reduced from the equivalent of 130mcg Levo to 90mcg Levo and that's quite a reduction in dose.

Personally, I would be increasing Levo back to 100mcg and keeping T3 at 5mcg for now, then re-test in 6-8 weeks.

Have you got your test results from before you added T3, plus after you added it? Let's see what's been happening and perhaps we can understand what's going on. If you don't have them, as your surgery for a print out, it's our legal right in the UK to have copies of tests (Data Protection Act 1998).

[jezebel69]

When I was prescribed T3 to add to T4 I reduced the T4 for a while before adding any T3 - then I added the T3 at 5mcg and gradually increased. Its a delicate process lol

[Hidden in reply to jezebel69]

Looks like i shouldn't have reduced them both at the same time, this is so complicated lol

[Hidden]

Thanks SeasideSusie When i was on Levo only my results were within range (can't remember exactly what they were now) but i felt terrible hence why they added the T3. I felt good on this to start with but my TSH went down to 0.05 and was hyper.

[SeasideSusie Remembering in reply to Hidden]

No, you weren't hyper, you can't be when you're hypo, but you can be overmedicated. It's finding the right balance of Levo and T3 so just changing one at a time is the way to go. Like Jezebel 69 says, it's a delicate process so looking at the test results and seeing which needs tweaking can guide you. So if you've got your results post them and we can see where extra hormone may be needed - the T4 or T3.

[Hidden in reply to SeasideSusie]

I'm due to be retested in a few weeks so i'll post them here when i get them. Now that i've made the change do you think i should keep the levo as is and up the T3 to the 10mcg?

[SeasideSusie Remembering in reply to Hidden]

I am on a combo of Levo and T3 (self sourced T3, GP not involved) and I have been tweaking doses for 18 months, testing regularly a few weeks after dose changes. I've never felt overmedicated or had any hyper type symptoms during this time, and my T3 is up to 31.25mcg with one brand, 25mcg with a different brand, along with 100mcg Levo.

During dose changes to try and find where I feel best, when I reduced Levo from 100mcg to 75mcg, keeping T3 at the same dose, my FT4 plummeted from 75% through range to 8% through range - from 19.5 to 12.8 (12-22). My FT3 reduced as well (my conversion seems to have improved since optimising nutrients) but not so dramatically. I was very unwell. I raised Levo back to 100mcg and 5 months later my FT4 still hadn't got back to where it was.

However, a change of T3 brand and the new one is stronger, so I now have to try and sort that out.

I was due to retest this week but have had to delay it as I have a virus so not a good idea to test at the moment.

We're all different, so my reaction to reducing by 25mcg Levo may be a lot different from someone else's, but based on my experience and the fact that you felt hyper after adding 10mcg T3 but now feel undermedicated after reducing both Levo and T3, then I would raise Levo first, keeping T3 at 5mcg. You don't appear to have tried 100 Levo/5 T3, you went straight to 100 Levo/10mcg T3 and felt hyper. My take on this is put the Levo back up to 100 and stay on 5mcg T3. But you've had different suggestions so you need to decide which way you want to go.

[Hidden]

Thanks so much SeasideSusie you make a lot of sense, I'll try putting my Levo back up and see how i go on that. I feel better just getting advice lol

[SlowDragon Administrator in reply to Hidden]

Do you have Hashimotos and if so are you on strictly gluten free diet

Have you had vitamin D, folate, ferritin and B12 tested and supplementing if necessary

Selenium supplements can also help

[Hidden in reply to SlowDragon]

I have Graves Disease and was given radium to make my thyroid under active. I have Celiac Disease so i'm totally gluten free, i'm also Lactose Intolerant. I supplement with all you mentioned plus Magnesium and Calcium due to the celiac and lactose issue. I haven't had these tested yet but will be asking to when i see my GP next.