My resting heart rate has been steadily going up for last six months. February last year I saw a private doctor who said my T3 was too low because I wasn’t converting properly. She switched me from Levothyroxine 125mg to Novothyrol (100 mg thyroxine and 25mg T3). I felt better in myself but my heart rate has gone from 68 bpm to 82bpm and in last few weeks really making me feel unwell as it’s making me feel really jittery and anxious. Any advice? Should I go back to just the Levo and drop T3 for a while? My absorption might have improved following taking selenium and vitamin B’s for a while though stopped those now. I would also really appreciate any advice on who might be a good functional doctor to see who can assess my whole body’s needs.
Here are my Feb 18 bloods:
T3 4.9 (3.10-6.8)
TSH <0.01
T4 15.5 (12-22)
And my Feb 17 bloods:
T3 3.8 (3.10-6.8)
TSH 0.03
Free thyroxine 22(12-22)
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janeroar
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It's always better to go by 'how we feel' when taking thyroid hormones and the fact that you feel you are on too much, I'd reduce your T3 by half (I am not medically qualified). I take T3 only.
Your doctor has reduced levothyroxine by 25mcg and added 25mcg of T3 (which could be, in its effect, nearer 100mcg of levothyroxine).
I would miss dose of T3 (do you take one daily dose of T4/T3?) for a couple of days and then begin with 1/4 tablet of T3 to T4 always taking pulse and temp. After two weeks you can add another quarter. At any time your pulse/temp is high drop to previous dose and that should be your optimum.
We should have no clinical symptoms if we're on the right dose.
You should get a thermometer from pharmacist. It is usually marked on it where the 'normal' temp is (people's normal can be different). Before you get out of bed take your temp and it is usually around the normal. If it went several digits above and I think you wouldn't feel too well then it could be that your temp is raised. Read the following and then click on the bottom line:
Sometimes when I've felt hot and took temp, I was surprised it was still normal. So I think a thermometer is a good idea and at least we don't have to guess. Usually hypo people complain of coldness and temp can be low. I doubt few doctors are aware of this.
You have posted on a thread which is 4 years old, so I would suggest putting up a new post so that you will get more responses.
First of all, to source T3 only you'd have to buy your own as doctors cannot prescribe it in the UK. That can be a problem. We also cannot put information on the forum.
I'd advise you to request a referral to an Endocrinologist who might be able to do T3. Also a T4/T3 combination works for many people.
It is preferable if you can get T3 added to your T4 as many do well on a combination. You don't really want to pay as we have to take thyroid hormone replacements for our whole life.
Also, if we are able to source T3 from somewhere else, at times it might run out and that causes stress for us.
If you are in the UK, the cost of T3 is prohibitive and that's the main reason they don't want to prescribe it.
There is another way to improve conversion. Go back to Levo and get your Vit D, B12, folate and ferritin tested and you will find you probably have to supplement. Once you need to supplement its usually for life though you may fine a lower maintenance dose that keeps you up there. I found I wasn't converting well and I did manage to correct it though it took me 5months. I've been pretty good since. The supplements may well get rid of some of your symptoms as well. The other plus of doing it this way is that your results show you that you are on the right tract as your previously high FT4 and your low FT3 will change slowly. The aim is to get both FT3 and FT4 in the top thirdxor even the top quarter of their respective ranges. So when they are in that position you may still have to increase your meds-just somethingvto look out for. When you take any form of T3 then the results are read differently so TSH will be suppressed, FT4 can fall in the range and FT3 should be high in its range and is the only accurate result. Because of that you can't compare FT4 to FT3 to check on conversion as FT4 could be anywhere!
You may not get it spot on so may then have to add in a small amount of T3. I'd looked into my problem as Levo was starting to hate me! So I wanted to return to NDT but that doesn't always work without getting conversion sorted first so I was later able to go over to NDT without experiencing a problem there.
Thank you Silverfox I think you’re right about supplements helping me to convert. My vitamin levels improved a lot but I stopped taking them once I got to high middle range. Should I continue? Don’t like taking vitamins if I can get what I need in food. I do try and eat really well and pretty much gluten free.
Thanks for the fabulous links SlowDragon. Would you advise dropping my dose? Problem is novithyrol has the T3 mixed in so can’t separate it out. Maybe I should get some separate so I can reduce it?
personally I am extremely sensitive to dose pre portions so take Levo and separate T3 (always make sure its same brand too. Each brand reacts differently for different people.)
I mean I take Levo 125mcg (at bedtime) always Mercury Pharma brand
And 5mcg dose T3 waking, 3pm and bedtime. So 15mcg total per day. Always Morningside Healthcare brand. (Was on Mercury Pharma T3 - but found that weaker so took 20mcg daily on that brand)
All doses on empty stomach and then nothing apart from water for hour after
I can't do thinks foodwise as I have so many intolerances but I would use tablets to get levels up so you know how it feels to be right then see if diet will help but I would only address one at a time otherwise you won't have a clue what is making a difference. In the U.K. If we are low in Vit D then we always shall be. We just don't get enough of the sun long enough as too far north do stick with the dose for those. B12 needs to be 500 plus and neurological problems can be a problem so the rangesare pretty low so I would stick with supplements there as well. I think folate improves with green veggies but you need to check about that and ferritin.
And yes you need to continue. I know Vit D drops like a stone if you stop and I imagine the others so as well. It's because we have a thyroid that's not working right that the levels drop again but you may find that as you improve you can try to find a maintenance dose to keep things working well. You may find tgatcVitamin D you can lower a little in the summer if you spend time outdoors and get some from the sun so it's very much try it and see.
Just an update I missed my dose as suggested by Shaws and my heart rate has dropped to 68 from 82 this morning. V pleased. Thank you to everyone for all your good advice. What a brilliant informative and caring bunch you are. So appreciative.
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