T4/t3: Hi everyone My new endo has decided to... - Thyroid UK

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T4/t3

Johnjoe123 profile image
21 Replies

Hi everyone

My new endo has decided to try t4 100mg and 20 mg of t3. She has decreased levo from 150 to 100 and added in t3.

I am due to start tomorrow any advice on how to add in this new combo would be appreciated. Slightly nervous as I feel so unwell on the levo. I had a total thyroidectomy in January!

Thanks

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Johnjoe123
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21 Replies
shond2015 profile image
shond2015

johnjoe123

My goodness - so sorry to hear of your total thyroidectomy..I would say this....don't feel nervous about your new prescription...you are probably going to start to feel sooo much better. If you haven't taken T3 before...you will (hopefully) experience immediate benefits! I really hope it works for you.

Just for your info - I was on Levo for just over 2 years after first diagnosis....felt continually unwell in all that time, inspite of continual increases in dosage. In July this year went private and started on NDT ...didnt' work for me, again, even with a high dose. Have now been self medicating, (with advice and guidance from private endo, on T3 only....feel infinitely better...some days I am completely normal. Still have some problems to sort out - as I have complications with cell receptors I think (not sure as still waiting for a series of blood tests to identify the issues...but my energy levels are virtually back to normal most days. Good luck

Johnjoe123 profile image
Johnjoe123 in reply to shond2015

Oh what good news have no energy. Am hopeful

Singoutloud profile image
Singoutloud

As T3 is at least 3 x stronger than Levo you may find 20mcg too much for your system to cope with at the beginning. You may find it better to start by cutting the tablet into quarters at first and building up slowly to a whole tablet over a period of a few weeks

Johnjoe123 profile image
Johnjoe123 in reply to Singoutloud

Thank you that's what I thought

shaws profile image
shawsAdministrator in reply to Johnjoe123

20mcg of T3 is equal to around 60mcg of T4, so Endo has done the right amount. T3 just because it is absorbed into our cells very quickly, it's effect lasts between one to three days.

I have tried all concoctions but am on T3 only and haven't looked back since.

Research has shown many benefit when on a combination dose T4/T3 but, as I said your Endo seems to know about t3.

EbonyEvans profile image
EbonyEvans

Try a quarter of a tablet (6.25mcg) with your T4. With a full glass of water. For two weeks. Add another quarter every fortnight until at 25mcg. Take your temperature every morning before you get out of bed. Drop back to the previous dose if you get heart palpitations. Have your bloods re treated six weeks after you’ve got to 25mcg. Get a pill cutter or Stanley knife (use tweezers with the latter).

Did your Endo not give you instructions? That’s bad if not maybe mention it next appointment. Good luck

Johnjoe123 profile image
Johnjoe123 in reply to EbonyEvans

Thank you for the advise

bandicoot66 profile image
bandicoot66

My endo did the same as I dont produce enough t3. Having adequaste t3 has made an enormous difference to my life. Its as if the world has come alive again. Hopefully you will feel the same.

SlowDragon profile image
SlowDragonAdministrator

Best to start with small dose and introduce slowly

You can cut 20mcg pill into 1/4s with small scalpel

Try only reducing Levo by 25mcg and adding 1/4 tablet of T3 morning and evening

Either wait full 6 weeks and retest before increasing, or if seems ok after 2 weeks increase T3 to 20mcg daily.

Personally I take in 3 doses. 10mcg on waking, 5mcg at noon and 5mcg about 6pm & Levo at bedtime

Dropping T4 by 50mcg may be too much. My endo only dropped T4 by 25mcg to add in 20mcg T3. Once I was used to it, found I needed to increase T4 back up as well

Have you had vitamin D, folate, ferritin and B12 tested? They need to be at good level

Post results and ranges if you have them

Johnjoe123 profile image
Johnjoe123

Thank you slow dragon, yes vits OK . I was wary of decrease by 50 and introducing t3 will do as you said. Can I take both together in morning?

SlowDragon profile image
SlowDragonAdministrator in reply to Johnjoe123

Yes. on empty stomach and nothing for hour after apart from water

shaws profile image
shawsAdministrator

Don't be nervous at all. It was a revelation when T3 was added to mine. I have always taken both T4/T3 together or any variations I've taken.

T3 for me was magical and I have a gland so I am sure you will feel much better. Your Endo also sounds good and efficient by prescribing a near exact dose in place of the reduced levo.

You will feel fine, I'm sure and wish you the best.

Take both with one glass of water when you get up. Wait an hour before eating. Food interferes with the uptake.

If your pulse is too fast or you feel too hot, just reduce dose of T3 slight next day.

Johnjoe123 profile image
Johnjoe123 in reply to shaws

Thank you do you agree with other threads to introduce slowly, or should I follow endo advise if reduce to 100 levo and take 10 t3 morning and evening?

shaws profile image
shawsAdministrator in reply to Johnjoe123

If you had never been on thyroid hormones, a gradual increase is usual. If we've been taking thyroid hormones a straight switchover, I think, is good and am not medically qualified but had a horrendous journey i.e. first remaining undiagnosed etc etc . Feeling far worse on levo than before being diagnosed and as soon as 10mcg of T3 was given to levo (some are too mean and concentrate only on the blood results rather than relief of symptoms) I felt an immediate difference - as though oxygen was being absorbed by my body. I shall also give you a couple of links and the doctor, who was also an Adviser to Thyroiduk.org.uk before his untimely death took 150mcg of T3 in the middle of the night, so nothing interfered with the uptake. He would never, ever prescribe levothyroxine only NDT or T3.

healthunlocked.com/thyroidu...

An excerpt from the folowing link

Rather than being a hormone, T4 is a prohormone. That means that enzymes have to convert T4 to T3 before T4 benefits us. T4 is no more a hormone than beans in an unopened can are a food. For all practical purposes, canned beans become food only when a can opener frees them so you can eat them. Hence, T4, like canned beans, only potentially benefits us, but actually does so only after being freed from its metabolically unusable form.

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

Johnjoe123 profile image
Johnjoe123 in reply to shaws

I know it all makes perfect sense I went 20 years without treatment, only since thyroidectomy are they taking me serious. I get so frustrated because I understand the science. Thank you for your help

shaws profile image
shawsAdministrator in reply to Johnjoe123

When someone has 'been there' 'done that' you don't want others to have bad experiences as the answers weren't forthcoming from doctors.

Clutter profile image
Clutter in reply to Johnjoe123

Johnjoe123,

I would add 10mcg T3 to Levothyroxine dose in the morning and take the 2nd 10mcg T3 at bedtime.

mrsm49 profile image
mrsm49

I was in the same position as you on 150 levo to start with. The endo dropped it down to 125 for a week before starting on 10 t3 in two lots of 5mcg (6am/12noon) After 6 weeks i had blood tests and was changed to 100 levo and 15t3 split to 10 & 5. That's where im at at mo and due more bloods in couple weeks when the t3 will prob go up to 20. I have had no bad side effects. Im monitoring my heart rate and temp and they havent changed but i do feel so much better for hours at a time while the t3 is working, like the old me again whoohoo, long may it last. Bit of a complication in that nhs have now told me they wont prescribe it any more so looks like im going to have to self source. Crazy really but it is what it is.

OzoneGirl profile image
OzoneGirl

Hi JohnJoe,

I am so glad for you that you have an endo' with enough sense to give you some T3!

I would definitely advise that you go slowly and split the T3 doses across the day as T3 has such a short half-life - i.e. it works fast & wears off relatively quickly.

I use a pill-cutter & find that even the tiny T3 tablets can be cut into quarters - I then take some at 9:00, 13:00 & 16:00-17:00, alongside some NDT.

Please let us know how you get on.

Johnjoe123 profile image
Johnjoe123 in reply to OzoneGirl

Thanks for advise believe or not just three days in and already feel it. I relate to you saying it wears off I feel that happening.

Why did I have to suffer for ten months post TT on just t4, its crazy

I will keep updated on progress.

OzoneGirl profile image
OzoneGirl in reply to Johnjoe123

But at least you have an endo' who has given you T3!

Smile & enjoy!

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