T3 addition - advice needed

[betty2480]

I added Tiromel to my 50mcg Levo about a month ago I think. Started on 1/4 of a 25mcg tablet, after two weeks increased to 1/2 a tablet.Haven’t felt any difference really, still shattered nearly every day. When I first started the T3 I felt a bit ‘wired’ but eased off. Felt no ‘wired’ sensation on 1/2 a tablet.

Should I increase my dose? Still experiencing other hypo symptoms - brain fog, mixing words up, tiredness despite full night’s sleep.

(Went gluten free about five weeks ago. No real difference yet, only felt a lot less bloated)

Thank you in advance x

[Judithdalston]

You have two choices really....keep on this dose of T3, which you don't think is doing anything for you, for 6-8 weeks and then test thyroid bloods, or increase your dose by 1/4 pill daily, for say two weeks, see how you feel.... test after 6-8 weeks, or add another 1/4 pill... etc. I decided on adding Tiromel to T4 to gradually get up to 25 mcg, then wait 7 weeks on a set dose ( 25 mcg T3 plus 75 mcg T4), before checking bloods this week, though I thought I felt I would need more. For me the T3 did give a 'kick', I had it in split doses at 6 am with levothyroxin, and 6 pm, for the first month, now I don't notice it, got some permanent improvements related to disability that had almost stopped me walking at all, but still got hair falling out, low basal temperature, inability to loose weight, and need nap during day.

[SlowDragon Administrator]

Personally I think you need to stick on the current dose 6 weeks and retest

You have made two big changes very close together

Gone gluten free and added T3 almost simultaneously

What are your vitamin D, folate, ferritin and B12 levels like

[betty2480 in reply to SlowDragon]

Hi SlowDragon, here are my most recent results.

I also just started taking probiotic tablet, magnesium citrate too.

healthunlocked.com/thyroidu...

[SlowDragon Administrator in reply to betty2480]

The standard treatment is to increase levothyroxine slowly in 25mcg steps over many months. Retesting 6-8 weeks after each increase

This repeats until TSH is around one and FT4 is near top of range. (Usually somewhere between 100mcg and 200mcg )

If FT3 remains low after increased Levo, getting optimal vitamins and trying dietary changes.

Then adding a small dose of T3 is next step

You may find it difficult to asses what is happening as have changed lots of things at once

[betty2480 in reply to SlowDragon]

Thank you 😊

[SlowDragon Administrator in reply to betty2480]

Looking at last Medichecks tests from month ago GP should just of increased Levo by 25mcg

healthunlocked.com/thyroidu...

[betty2480 in reply to SlowDragon]

Thank you. I will speak to my doctor about an increase and stop the T3 for now. Thanks SlowDragon x

[silverfox7]

It would have been better to sort out vitamins etc first as those can have an impact of your thyroid response but I would stay as you are and retest after 6 weeks and see what your reading are. In future stick to one change at a time so you know whether that's been positive or not.

[shaws Administrator]

50mcg of levothyroxine is only a starting dose. Why hasn't your doctor added 25mcg every six weeks to relieve your clinical symptoms.

If you've reached an optimum dose it should relieve all of your clinical symptoms but, if not, then you can think about adding T3 at 1/4 tablet every two weeks. Taking pulse/temp before starting, as a guide, because we can feel quite hot and just assume we're taking too much but on checking neither has changed much.

[endomad in reply to shaws]

Very good point Shaw. I often feel boiling hot but when I check my temp still only 35.4 on average, rarely goes over 36. Also I sometimes felt my heart was beating out my chest but resting pulse still between 60-70 bpm. I had become so use to low pulse and in beginning temp of 34 degrees that any improvement felt dramatic. I taught me to check everything.