Weight gain when lowering dose

[Emits]

Latest results on 125mcg levo and 18.75mcg t3 tests taken 24h after last dose t4 and t3. Am still feeling horrible.

Tsh 0. 03

Ft4 16.7 (10-19.8)

Ft3 6.7 (3.5-6.5)

Endo said he wanted me to get tsh back in range. My tsh had been under range since starting so I'm not sure this will help me.

To reduce t3 to 6.25 and keep levo the same. I've done this and feel so much better but my weight has started to creep up again. Did loose some when on 18.75mcg t3 but this dose was obviously to high for me. I tried to take 9.875mcg t3 for 2 days but got a pounding heart beat so I lowered the dose again to 6.25.

What are your thoughts you knowledgeable people on here?

Thanks!

[shaws]

My viewis he should have reduced your T4 rather than T3. It is T3 which is the Active hormone and T4 inactive - it's job is to convert to T3 but you may need the Active more beneficial than T4. It's obvious with your reduced dose your metabolism has also slowed. Although your blood test showed T3 very slightly above the range, it would be because as you take a combined dose it cannot equate with taking levothyroxine alone i.e. T3 was added. When you take a combo of T4/T3 it also lowers TSH.

[SilverAvocado]

My first thought was the same as Shaws - better to reduce Levo than T3. There's a tactical reason for this as well as medical; you may struggle to ever get T3 increased, and your Endo may be trying to ease you off it so they can cut out T3 prescribing.

Where to go from here is a hard question. You say you had a pounding heart when you tried to raise the T3 again, but was that an issue when on 18.75? The obvious soltution before you mentioned the heart was to go for a dose in between the two. In a lot of ways I think it comes down to a judgement call - is the weight gain and any other symptoms you might have alongside better or worse than the palpitations?

The only other thing I can contribute is that settling on a dose continues for months. You may find that in 3 or 6 months time you feel a bit better on this dose, or you can try going up to 9.875 again and see if it feels any better. It's hard to find good advice about how to do fine grained dosing Or I suppose you could fiddle even further and try dropping the Levo a little when you increase the T3. You might have to reduce the Levo a week or two before you try adding the T3, as Levo goes through the system much more slowly.

[Emits in reply to SilverAvocado]

Thank you for your advice it is difficult to find the optimal dose indeed.

[marsaday]

The important point to go over again is how you feel. You say you feel much better on this dose, but you are gaining weight.

Can you give some more info on how you felt on the higher T3 dose and how you feel now. Plus how long have you been on the 6.25T3 dose?

Ideally i would carry out some dosage experiments to see how i felt with some different ratios:

1) I would want to see what life was like on 150 T4 and 6.25 T3. Your Ft4 is mid teens so there is plenty of room for it to come up. It maybe an Ft4 of 20 is where you feel even better.

2) Stay on 125 T4 and see what 12.5 T3 is like.

3) Look into using the T3 in the middle of the night (4am) as this will tap into the cortisol circadian rhythm and so hopefully improve thyroid uptake.

Many people do well on T4 and a little T3. It just doesn't seem to be talked about on the forums that much, as say using NTH.

[Emits in reply to marsaday]

Thank you for your advice!

On higher dose 18.75 I felt irritated and could hear a pounding heart beat in my ear when going up the stairs or standing up. I was also very tired. Now all of that is so much better but I'm gaining weight. I've been on this dose for 3 weeks.

[marsaday in reply to Emits]

Ok sounds like your body is not able at this moment to use bigger t3 doses. I would see how more t4 goes as mentioned. Plus you need to work on improving adrenal function. A smaller t3 dose should be very beneficial as well so keep going with the smaller doses.

It sounds positive that some things work so feel good about this and build on the small successes.

[SlowDragon Ambassador]

Do you have Hashimoto's (high antibodies)

Are you on strictly gluten free diet

Would suspect your vitamin levels are to low. Do you have recent test results.

What supplements do you take?

[Emits in reply to SlowDragon]

Test results for TPO-ab was 50 (<60)

No, not gluten free. My test results from 6 months ago was all vits optimal according to this site. Will have new ferritin and vit d taken next week.

Am taking multivit, selenium, Magnesium and B12 25mcg.

[SlowDragon Ambassador in reply to Emits]

Multivitamin likely to have iodine in....definitely not a good idea when hypo.

Vitamin B complex is usually recommended when taking B12

But remember to stop that (or any supplement with biotin in) 3-5 days before any blood tests as biotin can falsely affect results

You are not taking vitamin D at all at moment?

[Emits in reply to SlowDragon]

Not more than what's in the multivitamin (it doesn't contain any iodine). So do I need a B complex too? It's not enough what's in the multi? Forgot to say I'm taking ferrous fumarate 310 once a day too.

[SlowDragon Ambassador in reply to Emits]

greygoose can offer opinion on multivitamins