How to reduce levothyroxine when introducing T3

[CornishChick]

I’m currently taking 100 levothyroxine per day. I’m excited to try out T3 and have just started on 6.25 in a morning, which I understand can be increased if all is well, to 12.5 after two weeks, taken twice daily. If this is correct, please can someone confirm how I should reduce my levothyroxine, and how I cut it, as my GP dispenses 100 tablets. Thank you.

[Marz]

You may not need to reduce your T4 unless your levels were high in your last test ...

[SeasideSusie Remembering]

CornishChick

I agree with Marz, you need to know your current FT4 and FT3 so you can work out whether or not you need to reduce your Levo.

[Marz]

Reading your other posts I see you have struggled with iron levels - have they improved ? Am asking as they need to be good - along with B12 - Folate - and VitD for thyroid hormones to work well.

[CornishChick]

Thank you both. My last bloods were

TSH 0.13 (0.27-4.2)

FT4 19.2 (12-22)

FT3 4.76 (3.1-6.8)

I was told that my FT3 is a little low, hence why I’m giving it a try.

I haven’t been able to pay for any further bloods since, but was thinking of asking my GP if he’d re-do them.

My vitamin D was 22, but was last tested and was about 120 from memory. I’m taking 3,000/day of better you spray.

I’m taking B12, currently 1,000, and the usual other supplements including Thorne B complex.

I was told to eat loads of pate, which I’m doing 2-3 times per week. I also eat red meat around 3-4 times per week.

So I don’t know my actual revised levels now. Do GPs offer a re test? I’m a stay at home Mum, so don’t have copious amounts of spare cash, especially after buying all the supplements!

Thank you for all your advice, I’m very grateful as I enter the next stage, and am on a learning curve.

[Marz in reply to CornishChick]

I will tag SeasideSusie so she sees your reply as technically you replied to yourself 😊 I know easily done - have done it myself !

[CornishChick in reply to Marz]

Oops sorry!

[SeasideSusie Remembering in reply to CornishChick]

CornishChick

It's very difficult to say as those results are about 4 months old and your conversion rate wasn't bad at 4.03 : 1 (ideal 3:1 - 4:1). It was suggested at the time what optimal levels of vitamins and minerals are for good conversion to take place.

Your ferritin was 41 (10-204), folate was 9.9 (3.1-20), and you were awaiting Vit D results.

SlowDragon suggested that you adopt a gluten free diet before starting T3.

So really, you need to see how all your levels are. Things might have changed.

[CornishChick in reply to SeasideSusie]

Thank you. I’ve been gluten free for several months now, I don’t feel any different (still tired with chronic insomnia), although my gut is more settled.

Should have my thyroid and vitamins retested now then? I understood from previous posting that my T3 was just a little under, that’s why I thought I needed to add a little.

Sorry I’m so confused, I’ve only known levo for 20+ years, and only recently learnt about supplements, gluten free, T3 etc.

Ps my latest Vitamin D was about 120 a few months ago, I don’t have the exact reading and date to hand.

[SeasideSusie Remembering]

CornishChick

I understood from previous posting that my T3 was just a little under, that’s why I thought I needed to add a little.

Yes, your FT4 and FT3 weren't in balance but if your nutrient levels are better now it's just possible that your conversion has improved. If it was me I would retest at this point, see where all my levels lie and then make the decision as to whether to add T3 and whether Levo needs reducing. I wouldn't go by 4 month old results. If you can do the Medichecks Thyroid UltraVit test that will tell you everything you need to know then you can go from there.

[CornishChick in reply to SeasideSusie]

Ok many thanks.

Does this go on offer on a Thursday do you know?

Does anyone know if a GP will re do these tests, or will he think I’m cheeky asking?

[SeasideSusie Remembering in reply to CornishChick]

CornishChick

There are offers on every Thursday, but it's a bit of a lottery which ones. You could wait and see, or do a google search for a discount code.

You could ask your GP but you're not likely to get everything done, especially FT3 and maybe not all the vits and mins.

[CornishChick in reply to SeasideSusie]

Thank you. How long would you stop the T3 for before doing another blood test please? How long does it take for T3 levels to return to ‘normal’ please?

[SeasideSusie Remembering in reply to CornishChick]

CornishChick

Can you just clarify what you want from your test.

1) Do you want to know your levels whilst taking your current combination of Levo plus T3?

2) Do you want to go back to Levo only and see what your levels are then?

[CornishChick in reply to SeasideSusie]

As you recommend, stop T3 and test levels. It would also be useful to know if I do need to take T3, how to test.

[SeasideSusie Remembering in reply to CornishChick]

CornishChick

The biological half life (the time required for the body to eliminate half) of T3 is 2.5 days, so every 2.5 days you would have half of the previous dose. So if you took 5mcg T3, there would be 2.5mcg left after 2.5 days, then there would be 1.25mcg left after another 2.5 days, etc.

So it depends on when you started taking 6.25mcg daily and how long you've taken it for.

[CornishChick in reply to SeasideSusie]

Ahh that’s interesting thank you. I’ve only been taking 6.25 since last Thursday. If I stopped now, would it be about 17 days to clear, or have I worked that out wrong? Sorry can’t think straight!

[SeasideSusie Remembering in reply to CornishChick]

CornishChick

Maths not my strong point here so I'm not quite sure how you work it out.

Day 1 - 6.25

Day 2 - 6.25 + 6.25 = 12.5

Day 3 - 6.25 + 12.5 = 18.75 - 3.15 (half of Day 1 has now gone) = 21.85

etc

I honestly don't know how you do it, that doesn't look right to me.

With Levo, it's said 6-8 weeks is needed for the full effects of a dose change to be felt and to show in results. Levo has a half life of 7 days.

So with T3 having a half life of 2.5 days then that's, say, 1/3rd less time than Levo so maybe 2-3 weeks is about right for the full effect of a dose change. Is that enough time for the T3 to leave the body completely after stopping it? I honestly don't know.

Maybe it's just easier to do the Medichecks Ultravit test taking the T3 you're currently taking. You will get your current vitamin levels and can see if they need much improvement and if so you could work on that. I added T3 before mine were optimal, and worked on improving them as well as tweaking doses of Levo and T3, but my conversion wasn't borderline like yours, it was 5.5 : 1

[CornishChick in reply to SeasideSusie]

Ok thanks for that. If I do as you suggest then and test whilst still taking the T3, which I’ve been taking for 6 days, how long should I leave it to have an effect on my bloods? Would it be a couple of months on 6.25 and then test?

Sorry if this sounds thick, I’m in new territory.

Thank you.

[SeasideSusie Remembering in reply to CornishChick]

CornishChick

For me, I leave 8 weeks after a dose change, even T3, because it seems to take that long for me to get the full effect of the change and it to show in my test results. Some people find they need 6 weeks.

Not thick at all, it's all new and we learn as we go along

[ABLCKDIAMD]

My situation is a little different. My doctor told me to "Cut" it in half and my mil is 25 mcg.

I use a pill cutter. Remember ask your doctor before doing anything.