Normal to feel bad when starting small dose of T3? Advice on testing cortisol and RT3.

[Emily78]

Hi,

I am thinking of getting my cortisol and RT3 levels tested. I have just started taking 5mcg T3 daily (prescription from endo) in addition to the 100mcg T4 that I have been taking for a couple of years. Should I wait till I've been on T3 for a little while before doing these tests?

The T3 has been making me feel pretty tired so far (only taken it for 3 days) and this morning my vision went blurry, which I've never had on T4. Anyone else have symptoms like this to start with? I felt shattered all day when I took T4 and T3 together in the morning, but better yesterday afternoon/evening when I took the T3 at 1pm. However I feel tired again this morning!

I am worried the T3 is causing my T4 to convert to RT3, and that I may have had RT3 problems to start with. I also think my cortisol/adrenals are messed up because I have a supressed TSH (0.01), but low-ish levels of T4 (16.2) and T3 (4.6). Also my T3 dropped from 4.6 to 3.1 when I trialled night-time T4 dosing despite the fact my T4 went up from 16.2 to 17.8. I can only think this is an RT3 problem, perhaps caused by an increase in cortisol my body is not used to?

I supplement the necessary vitamins and my levels are getting to where they should be. Just need to get folate and iron up a little more.

I don't have high antibodies so no Hashimoto's. I suffered with an eating disorder for about 15 years which really messed up my metabolism and I can't help wondering if my thyroid problems are actually secondary to that. I've been recovered for a few years but the damage might be lasting...

Advice would be much appreciated.

[jgelliss]

I made a mistake when first handed 5mcg T3 . T3 can unmask adrenal insufficiencies . I would highly suggest that your nutrients be first be well dosed and be mid to higher range . *SeasideSusie* has EXCELLENT and very informative information on and with the nutrients that are very important for us . Please check it out . Once that's in place please split your dose of 5mcg . Half Am and the other half mid afternoon or before you go to sleep . You will be the best judge what works best for you . It's trial and error . You might think that 5mcg is a small dose but when you start dosing you realize it's really not . Try to journal your symptoms it will help you a lot with what works for you and what does not . Learn to TRUST yourself .

Wishing you success moving forward .

[Emily78 in reply to jgelliss]

Thanks for this. That's really helpful. I'm aware my B12, folate, vitamin D and ferritin need to be mid to higher. My B12 and Vitamin D are good. I will check SeasideSusie's information to see if there's anything I am missing. And thanks for the suggestion of splitting the 5mcg dose. I've ordered a pill cutter online which will help me break a 20 mcg tablet into 8!! Much appreciated jgelliss.

Would you say it's OK to continue with the T3, even with adrenal insufficiencies, if my nutrients are optimal? Do things improve on the adrenal side with T3?

[Clutter]

Emily78,

Was your Levothyroxine dose reduced when 5mcg T3 was added?

[Emily78 in reply to Clutter]

No it wasn't reduced. I was not optimally-medicated in the first place, and either needed to raise my T4 to 125mcg or introduce some T3. My endo doesn't want my T4 to be too low as I am trying for a baby (T4 needs to be 15-20), and I imagine it will go down a little anyway with T3. I know T4/T3 combos aren't usually recommended for pregnancy but my endo thinks this dose will be OK. Thanks Clutter.

By the way, thanks also for the German pharmacy recommendation. Got the prescription in just over a week which is amazing turnaround.

[Clutter in reply to Emily78]

Emily78,

5mcg T3 is equivalent to 15mcg Levothyroxine so may not be sufficient if you were undermedicated. If it's making you feel tired try taking the T3 at bedtime. FT3 is naturally highest between 1am - 3am so it may suit you better.

If your FT4 was low it is very unlikely you have high rT3. If you did have high rT3 the only thing to do would be to reduce Levothyroxine dose which you've said you don't want to do. Adding 5mcg T3 won't raise rT3.

I think the objection of UK doctors to patients taking T3 in pregnancy is that there don't appear to be any safety studies. That doesn't mean it is unsafe, just that there is no research saying it is safe. Several members have taken T4+T3 and one T3 only and had healthy pregnancies and babies.

I'm glad Versandpo was easy to use.

[jgelliss]

Clutter,

Thank you for your SOUND ADVICE as always .