T3/T4 Combo Treatment - Need Advice: I've been on... - Thyroid UK

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T3/T4 Combo Treatment - Need Advice


I've been on 100mcg T4 and 18.75 mcg of T3 for the past 2 months and have just had the following results back from the NHS:

TSH 1.04 MU/L

FT4 12pmol/L

TPO antibodies 629 IU/mL ( 349 KU/L when I was diagnosed)

Unfortunately the consultant did not supply me with ranges in the letter and because my TSH wasn't suppressed they haven't run a FT3 test- which is super helpful.......

Here are my private labs from back in August on the same doses:


FREE THYROXINE 16.700 pmol/L 12.00 - 22.00

FREE T3 5.55 pmol/L 3.10 - 6.80

So looks like not only has my T4 plummeted but my TSH has gone back up and my anti bodies have increased.

The most annoying symptom I'm getting at the moment is PVCs - which I used to get when I was under-medicated/before I was diagnosed.

So at this juncture do I need to increase T3 or T4 ? Or both ?

4 Replies


Yes will definitely get private bloods done - was just shocked that FT4 had dropped so much and that my antibodies had nearly doubled


So has Levothyroxine been reduced with addition of T3?

Do you take your T3 in split doses?

Some of us need split doses, especially initially

How are your vitamin D, folate, ferritin and B12 levels?

whatevs in reply to SlowDragon

Hi SlowDragon,

Yes I it take it split - 12.5mcg in the AM and 6.25 mcg at bedtime (with my 100mcg Levo).

Before I commenced T3 I was on 150mcg Levo solo. I moved down to 125mcg Levo initially with 12.5 mcg and then 18.75 mcg of T3 but the more T3 I added the more tired/hypo I felt. I'm certain this was due to reverse T3 as these symptoms improved greatly as I moved down to 100mcg T4 but kept T3 at 18.75 mcg daily.

The PVCs tell me I'm missing thyroid hormone - either T3 or T4 but without FT3 results from my latest bloods I only have the low FT4 to go off. But I'm reluctant to up my T4 back to 125mcg due to my previous problems.

I wasn't supplied with folate, ferritin, B12 results this time (although I'm sure they were done) but they did provide Vitamin D3 -629 IU/ml.

SlowDragonAdministrator in reply to whatevs

I have found, through experimentation, that I need dose of T3 every 8 hours. Twice a day was not frequent enough.

Roughly 7am, 3pm and 11pm

Perhaps something to try

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