Adding T3 to T4 Only Regime

Hi Everyone...

I was previously on 2.5 grains Nature Throid (18mcg T3 / 76 mcg T4) NDT with Dr. P. for about two years and felt great even though I have Hashimotos. All my energy came back, hair stopped falling out and pretty much all my symptoms resolved themselves bar some muscluar cramps.

However due to cost and a change in personal circumstances I had to stop NDT and Dr. P. and go onto Levo T4 working upto (125mg) with the NHS and feel urgh. I've been on this for 7 months and I have depression, anxiety, put a stone of weight on, memory fog is awful but hair loss is stable although very dry and fine. I've been off work for 3 months due to this.

I've now managed to pursade my new amazing NHS doctor, who actually knows something about thyroid treatments, feedback loops etc. to allow me to restart T3. Due to the Concordia scandal I've had to buy my T3 from Mexico (Cynomel 25mcg) and he is ok with this, will monitor me and even force the NHS labs to do T3 tests - regardless of me having an 6 monthly full Blue Horizon Thyroid panel done.

My last tests from Blue Horizon (Levo T4 100mcg) include:

TSH 0.49 (0.27 - 4.20)

T4 Total 97.0 (66-181)

Free T4 19.50 (12.0 - 22.0)

Free T3 3.5 (3.1 - 6.8)

Anti-Thyroidperoxidase Abs <9 (<34)

Anti-Thyroidglobulin Abs <465 (<115)

So, my question to all of you is how would you start integrating T3 into this regime?

I would like to see my Free T3 levels increased to try and improve my symptoms to that of my NDT days. My doctor is happy to let me self medicate my regime as long as he can test me.

Any help would be appreciated!

Thank you x

[DotLeeds]

I was on an NHS trial for T3. They reduced my Levothyroxine to 100 from 125 and started me on 20mcg T3 split into 2 doses. Rather a powerful change and I would recommend you take it a bit slower. After a month I felt a bit over-medicated so reduced Levothyroxine to 75 on alternate days. NHS refused funding despite significant improvements in my symptoms. Now have private prescription.

[Judithdalston in reply to DotLeeds]

Curious - was that just an individual trial for T3... so did your bloods not show any improvement tho you felt better?

[DotLeeds in reply to Judithdalston]

Individual trial. Bloods showed improvement but decision was taken to increase my Levothyroxine to 150 to see if my body could convert sufficient T4 to T3. After 6 weeks my T3 levels were only slightly reduced but my symptom had returned.

[DotLeeds]

I regularly checked my pulse and blood pressure at the doctors while on T3 trial.

[Judithdalston]

If you search this forum thoroughly you will come across a huge variation on how people introduce T3 to their existing levothyroxin..my main tip is patience and experimentation.I have been hypothyroid/ Hashimoto's for over 12 years. I added 25 mcg earlier this year, and as often advised here took my T4 down from 133.5 mcg ( which pushed my FT4 above its upper range, and not raised FT3 to halfway in range) to 75 mcg. Rule of thumb people going by was decrease T4 by 25 mcg for every 10 mcg added- in my case this would have been a 62.5 mcg reduction, though mine was a little less. I added the T3 slowly, starting with 1/8 th of a pill with levothyroxin at 5-6 am, then couple of days later added another dose 5-6 pm.... Then put one dose up to 1/4 pill for a week, and week or so later changed other dose to 1/4 too. So about a month to get up to 25 mcg T3, then kept on this dose with 75 mcg levo for 6 weeks, but during this time experimented with timings..bedtime dosing, moving afternoon dose around. Some find T3 helps sleep( I go back to sleep after 5 am dose), others find it keeps then awake, in the afternoon you can feel the need for the second T3 dose( some like the whole in one am dose). I got raised pulse, Bp and palpitations as added the T3 but just as got to the full 25 mcg dose these problems literally disappeared overnight.

Sounds ok, but on doing private blood test found as expected TSH had reduced ( almost - x10), FT4 went down 10 points, and oddly FT3 went down too! I was advised by administrators to raise my levothyroxin again( 25 mcg a time), so now back on 125 mcg T4 with 25 mcg T3, and feeling rather like I did 15 weeks ago re tiredness/aching/ napping. My basal temperature did not rise in first month, sadly broke my old fashioned Mercury glass thermometer subsequently, am warmer now but that might be the weather! I will take new bloods in 4 weeks having been on new dose for 6 weeks by then. My very first 1/8 th T3 pill made the most difference- released stiff/ painful hips, so I could walk ( had spent 24/7 on sofa over winter with fibromyalgia), and now manage 10,000 steps daily ( so ironically even more in need of higher FT3), so I am a great believer it can help hypothyroidism ...but one size doesn't fit all! One of biggest draw backs of two T3 doses is finding time to take other drugs, supplements, food/ drink with the minimal 'hour before..two hour after' gaps in dosage. Good luck.

[Hidden in reply to Judithdalston]

Thank you for your reply. Yes, I went through most of the search results for adding T3, just wanted to get one final opinion from the group! x

[Judithdalston in reply to Hidden]

Good luck, hope you get right option first time!