how much t3 and when?: Hi all I've spent so much... - Thyroid UK

Thyroid UK

137,153 members160,835 posts

how much t3 and when?

Efoula1980 profile image
7 Replies

Hi all

I've spent so much money on nutritionists tests and supplements over the past year that i am loathed to spend more money i don't have to see a Private Endo but i am wondering whether I should. I was on 100 levo for 11 years and was ok; now suddenly after a very stressful period in my life i have chronic fatigue, really bad brain fog and short term memory loss and gut issues. So i decided to try T3.

Last test results (BEFORE STARTING T3):

T4 16.7 (9-24)

T3 3.8 (3.5-6.5)

TSH 0.82 90.35-5.0)

Trying T3:

1) So first I tried 100 levo and 6.25 t3 taken together in the morning - after about 5 days got bad headaches, stopped and tried option 2.

2) Then I tried 75 levo and 6.25 t3 taken together in the morning - again after about 5 days really bad headaches worse than with above; stopped and tried option 3.

3) For around 5 days I tried 100 levo alternating with 75 levo and 6.25 t3 - after about 4 days of this i almost flipped out - tightness in chest, really angry, really emotional, really anxious. So i've gone back to 75 levo and 6.25 t3 which has evened me out again.

The t3 is amazing! it straight away has helped with the brain fog and fatigue so i want to continue taking it but am worried about these horrible headaches.

My main question is: are these headaches going to pass or do you think my body is telling me that it's not the right amount?

Thanks i really appreciate any help anyone can give me.

Written by
Efoula1980 profile image
Efoula1980
To view profiles and participate in discussions please or .
Read more about...
7 Replies
SeasideSusie profile image
SeasideSusieRemembering

Efoula

You didn't need to lower your dose of Levo, your FT4 was only half way through range anyway and taking T3 generally lowers FT4.

Maybe T3 doesn't suit you, maybe one of the excipients is causing the headaches.

Are all your nutrient levels optimal?

SlowDragon profile image
SlowDragonAdministrator

Ask your GP to test vitamin D, folate, ferritin and B12

Efoula1980 profile image
Efoula1980 in reply to SlowDragon

HI Seaside Susie

Thanks for replying.

That's goes against the other posts i've seen on here. i'm confused. So what are you suggesting?

All levels good except iron which i am supplementing for.

Slow Dragon thanks - done that - as above - iron needs to be higher.

Thanks guys

SlowDragon profile image
SlowDragonAdministrator in reply to Efoula1980

So vitamin D is around 100nmol

B12 and folate at top of range

Ferritin needs to be half way in range. Eating liver once a week should help if it needs improving

SeasideSusie profile image
SeasideSusieRemembering in reply to Efoula1980

Efoula

I didn't get notification of your reply as you replied to SlowDragon's post but didn't tag me.

What goes against other posts you've seen on here? Me saying you didn't need to lower your Levo? If so, what have you read on here?

Normally when adding T3 to Levo it's because conversion is poor, often FT4 is very high in range or over range and FT3 low in range. That is when it's suggested Levo is lowered when adding T3.

With your results on Levo only

T4 16.7 (9-24) - 51% through range

T3 3.8 (3.5-6.5) - 0.1% through range

So your conversion is obviously very poor and T3 is needed, but because your FT4 is only half way through range there was no need to reduce it.

As I said, taking T3 tends to lower FT4 anyway. On a combination of Levo and T3, some people are fine with a low FT4, some are not. After 2 years of tweaking my Levo and T3 I now know that I need both about 75% through range. If my FT4 is below half way I am not at all well.

SeasideSusie profile image
SeasideSusieRemembering in reply to Efoula1980

Efoula

You have asked me

I have ready other posts where they say t3 is 3 times stronger than t4 so that means you should cut down t4 while you take t3 so that the total amount is still equal to what you previously were taking. I think that was the jist but i may be wrong.

I didn't know T$ is lowered when you take T3.

It doesn't matter what you were previously taking as Levo, or taking the same total amount, what is important is the dose you need when taking a combination of Levo + T3, that is very individual and we have to find out what suits us personally.

For example, immediately before I added T3 I was taking 175mcg Levo, I had been on 200mcg and also150mcg and everything possible in between. All gave me an over range FT4 and low in range FT3 so I wasn't converting T4 to T3 very well and I was very unwell.

I am currently taking 112.5mcg Levo + 25mcg T3 which, using the "T3 is 3 x stronger than Levo", would equate to 187.5mcg T4. I am feeling reasonably well thyroid-wise on those doses with FT4 and FT3 around 75% through range. On a different brand of T3 I needed a lower dose so my total T4 would be less.

So it's not about taking the same total amount of T4, it's about what balance of T4 and T3 suits you.

As far as cutting down Levo when taking T3, it all depends. If your FT4 had been at the very top of the range, or over range, like mine was, then reducing Levo would be the correct thing to do. So if your result had been

T4 26 (9-24) rather than T4 16.7 (9-24)

then it would have been correct to reduce the dose of Levo because it's obvious that the dose is too high. However, as already mentioned, as your FT4 is only 51% through the range, you are not overdosed on Levo and reducing your dose would lower your FT4 and may make you feel worse. And as I said, taking T3 tends to reduce FT4 anyway. The first step with your level is to add T3 gradually and see how you feel.

When adding T3 to Levo, it takes a lot of gradual tweaking of doses to see where you feel best. It's very individual. You may feel fine with a low FT4 when you have FT3 where it needs to be. I need my FT4 and FT3 about 75% through range to feel reasonably well, if my FT4 is low in range I am very unwell.

How did you work out the percentages below? With your results on Levo only T4 16.7 (9-24) - 51% through range T3 3.8 (3.5-6.5) - 0.1% through range

To get a very rough figure - your range is 9-24. Add them together and you get 33. Your level is 16.7 and half of 33 is 16.5 - you are very slightly higher. There is an equation to work it out exactly when it's not so obvious:

z-x divided by y-x multiplied by 100

where z = result

x = lowest number of range

y = highest number of range

I'm glad you agree i need t3 but what do you think my plan should be regarding dosage from now on? I would really appreciate your advice.

First thing I would do is retest and get your new levels after you have been on 75mcg Levo + 6.25mcg T3 for 6 weeks. You have been changing your doses too quickly and now need your hormone levels to settle down. Once you have those new results we can see what dose changes are appropriate to start with.

Btw I have been having the headaches for about 4 years now and they get much much worse on around the 5th day onwards while taking the t3. When you started taking t3 did you have side effects that went away?

I had no side effects whatsoever from T3. I have had daily headaches for more years than I can remember. I have been on Levo for 43 years. Now I know that Levo has a side effect of headaches (it's listed in the Patient Information Leaflet) I believe mine are linked to the Levo, whatever brand I've had over the years. Why yours would be worse after the 5th day of taking T3 I have no idea. I would be surprised if it was the T3 as T3 is absorbed quickly so I think the headaches would start within possibly 2 days if they were due to the T3. But I am not an expert, nor am I medically trained, so don't take my word for it.

Do you think i should just go see a private endo?

That's very debatable. Some people have done so and been very disappointed and thought it a waste of money, others have been more successful. You would need to choose very wisely, making sure the endo is a thyroid specialist (not a diabetes specialist) and be aware that if the endo also works within the NHS then there is a likelihood of them toeing the NHS line regarding T3. Some are open to T3 and may provide a private prescription.

If you want to go down that route then send for the list of thyroid friendly endos from ThyroidUK. Email Dionne

tukadmin@thyroiduk.org

then ask on the forum for feedback on any that interest you, replies will have to be by Private Message as we can't discuss individual doctors on the open forum.

Efoula1980 profile image
Efoula1980 in reply to SeasideSusie

Thanks SeasideSusie for a very thorough reply.

You may also like...

How much T3 to increase by?

another 5mcg back at the time. Anyway, on 125mcg Levo taken at night and 10mcgs T3 split in two, my...

How much T3 should I add?

room for T3? After another 8 weeks at a reduced levo amount of 125/100/100/125/100/100/125 my...

Adding T3 to T4 - how much

it worked ok. But after this last year of struggling (feeling really, really bad but labs showed...

If you split your t3 dose, how much do you take and when?

tired and one time this made me feel hyper for about two hours, so I guess I can't doubt the...

How to reduce levothyroxine when introducing T3

currently taking 100 levothyroxine per day. I’m excited to try out T3 and have just started on 6.25...