Need to slightly adjust meds, advice on whether I do T4 or T3 please.

[Lovecake]

Hello all,

I’ve been reading a lot on this forum and picked up some excellent advice already.

I have Hashimoto’s, it’s in our family (joy!).

I take Thyroxine and recently have added T3 (Thybon Henning) as I see a private endo. This has made a huge difference. When I was on Thyroxine only, I was plodding along (with so called ok blood results). But the biggest issue was the fact that my energy level would disappear over night if I had a busy day. (We’re talking National Trust house and gardens plus a bit of housework, not getting drunk and going clubbing).

Anyway, the first 3 weeks of taking T3 i felt amazing. I could have taken up tennis!

Then it started dipping a bit. I get migraines if anything in me is out of kilter, eg, tiredness, hungry, cold, hot, etc. I had to take my Imigran as before which was disappointing as I’d had 3 weeks migraine symptom free.

So, I’m getting to the point: I think I need to slightly up either my Thyroxine or the T3 to get bad to feeling very good again.

I reduced from 100mg Thyroxine to 75 in order to take 5mcg of T3 3x a day. I don’t take the full T3 as it originally gave me a bad head. So am taking 2x 5mcg of T3 (1/4 tablet twice a day).

When I had my bloods done I was feeling ok, but i had noticed that I was not as great.

I also take vitD every day. Have changed to My Care spray in the last 2 weeks due to suggestions on other posts. I take B12 too (low dose) as my B12 is usually around 400 (range 211-911).

Bloods taken 11th July (no meds or vitamins taken within 24 hours except T3 19hours).

BUT due to the time, I had my breakfast 2 and half hours before.

TSH 0.07 (.55-4.78)

T4 12.8 (10 - 18.7)

T3 5.3 (3.5 - 6.5)

VitD 65 (50-374)

Thyroid peroxidase Ab >1300 (0 - 60) taking selenium and no gluten to try and reduce this number.

Sorry for the long post. I hope someone can help.

I was thinking of adding a 1/4 of T3 a day, but am also thinking that one of you said that T4 level should be at least half way through the range. So wondering if I up the Thyroxine a little, say to 87.5 on 4 days a week?

My endo was happy with my last results as I was feeling so much better than before, but I have not felt so good in the last 2 weeks. Could it just be the hot weather? Not sure, as I coped when I first started on the T3, nothing fazed me.

Thank you for reading my post. Any advice will be greatly received.

[Lovecake]

Forgot to add:

I’m dairy free and soy free, (about 4 years) since before my thyroid diagnosis. (Just over 2 years).

My ferritin and folate levels are ok. I eat calves liver periodically to boost that as get a bad head from taking folic acid etc. 🙂

[Lovecake in reply to Lovecake]

And I use sprays from Better You, not My Care (no brain today obviously 🙄)

[greygoose in reply to Lovecake]

I don't think calves liver is going to boost your folate. You need lots of leafy greens for that.

FT4 should be at least half way through the range when on T4 only. When you start taking T3, FT4 levels drop. Whether or not raising - trying to raise - the FT4 level will help you, no-one can say. You'd have to try it and see. But there's no obligatory level to aim for.

[Lovecake in reply to greygoose]

Thank you greygoose

I eat plenty of fresh vegetables and fruit and meat, so hopefully they will all help my health. (Use a good local butcher for the meat/poultry which is from reputable local sources). Also grow some fruit and veg which will help a bit too.

Thanks for the advice. I felt so amazing on the first 3 weeks of taking the T3. Unfortunately , no bloods taken, (can’t do them that often). So I’m thinking that my T3 level was a bit higher because of the Thyroxine being lowered but not all out of my system.

I might try the extra 1/4 of T3 first as the results will be quicker. If I don’t feel quite right, I’ll up the Thyroxine a little instead.

You do an amazing job here. I’ll keep reading and learning 🙂

[greygoose in reply to Lovecake]

You're welcome.

[Macquelius]

Hello, i am new here and just noticed your post and we are very similar, my blood results mirror yours except for the TSH, mine was 0.5 last time I was tested. I am also on T4/T3 combination and I have a good endo who fine tunes my dose and monitors me every 6 months. I take 100mcg thyroxine for 2 days and 75mcg every 3rd day, making a total of 650mcg per week. It's fiddly and I have to take care but it gives me the exact dose that is best for me. In addition I take 5mcg (quarter tablet) of Liothyronine (T3) twice a day as I am one of the 15% sub group of patients who do not convert properly.

Anyway my endo is happy for me to self adjust if I feel I need to but he always instructs me to adjust the thyroxine and leave the T3 as it is which I have always done.

I also have low Vit D and use the Better You spray and my last bloods showed a level of 65 also.

[Lovecake in reply to Macquelius]

Hope you find this forum interesting. Have learnt a lot. (Forget a lot too LOL).

My Endo is pretty good. I can go back when I feel I need to or just have a phone conversation too.

I have decided to up my levo a little. Been taking an extra 12.5 on 4 days. I thought with my migraines that it would be better for me to have a more regular dose than have 2 days at 100. I might be wrong, but it seems ok so far. And yes, a bit fiddly too. I have a 7 day pill box and do the week so I know where I stand with the meds.

I am feeling more energetic this week, hopefully it’s because of the T4 increase. Maybe my vitamin D level has gone up since being on the better you spray? I won’t know until I do a blood test in about 4 more weeks.

Thank you so much for your comments. It’s good to know I’m not being awkward with needing such precise medication. I have a feeling it will always be a balancing act. 🤗

[Macquelius in reply to Lovecake]

Yes, my endo is of the opinion that most people need fine tuning, one size definitely does not fit all, but GPs just don't get it unfortunately.

[Lovecake in reply to Macquelius]

Very true. I have the same endo as my cousin. My sister has just been diagnosed and we all have daughters, so keeping an eye on them and making sure their vitamin levels etc are good. It’s in our family with most females and even my uncle having thyroid issues.

I ignore the GP mostly, they really haven’t a clue.