Reduce t4 to increase t3?

[Sybilla14]

Hi, I've been on 150mcg of Levo for c.13 weeks. My results on 5/1/18, fasting, at 7am with the last Levo taken 27 hours beforehand were:

TSH 0.25 (0.3-5.5)

FT4 20.7 (12-22)

FT3 4.5 (3.1-6.8)

I started 6.25mcg of T3 11 days ago. I am still feeling tired and although my thinking got maybe a touch clearer there's not really been a great deal of change.

Im wondering if I should now Increase t3 to 12.5mcg a day to see if that's better. Shall I do this by increasing the dose I take at night or is it better to add another 6.25mcg in the afternoon? Should I be reducing my t4 dose as well? Will taking t3 have any impact on my ft4 level - will there be less of it converting to t3 and more storing or converting to rt3?

[Clutter]

Sybilla14,

Symptoms can lag behind good biochemistry by several months.

You can add a second dose of 6.25mcg T3 in the morning with Levothyroxine if that's when you take Levothyroxine. Hold then at 12.5mcg T3 + 150mcg Levothyroxine and have a thyroid function test with FT3 before increasing further. Leave 8-12 hours between last T3 dose and blood draw.

Taking T3 direct can improve conversion of T4 to T3 so you may see a drop in FT4. Your TSH will almost certainly become suppressed <0.1 which your GP may consider to be overmedication.

[Sybilla14 in reply to Clutter]

Hi Clutter. Thank you.

I take my Levo around 3-4am and now also the liothyronine then. I'll just increase that dose and see if anything changes.

It is really interesting about the t4 conversion being potentially helped by the t3 supplementation!!

My gp told me I can have blood drawn for private tests at the surgery and they will not charge so I'll try that in a couple of months. I probably won't need an NHS test in a while as gp was already thinking I was testing too often when my blood results were so different on Actavis and MP.... I may have to tell him about the t3 when the next test happens but by then I will hopefully have a lot of improvements to back it up with🙂

[silverfox7]

The other way of doing this is to look at the things that aid conversion. Get your VIT D, B12, folate and ferritin tested. They help the Thyroid so much but we often find them to be low. They need to be optimal and many of us need to supplement to keep them there but they can correct conversion so your FT4 will fall as more of it will be turned into T3 so that will rise. It can take time depending how low your reading are. See SeasideSusie's posts re advice on that. Mine took 5 months but been pretty stable since.

[Sybilla14 in reply to silverfox7]

Thank you silverfox7. I take sublingual methylcobalamin every other day alternated with Thorne basic B. I also take cytoplan d+k2 4000 now 3 times a week. I started on solgar gentle iron again a few weeks ago and take about 10 of them a week. My ferritin may have indeed come down from when it was last tested but I think the vitamins should be okay. I've also been strictly gf for over 3 years and dairy free for a year too. I take about 10 supplements each morning then iron/magnesium in the evenings too. I'm almost maxed out I think😉

[silverfox7]

Yes I imagine many of us 'rattle if shaken'!