Need advice how to self medicate with T3 which I sourced online recently. Currently on 200 mcg of T4.

I am new here. I am 7 years on T4, last two on 200 mcg of it. I don't feel well for years. Recently I decided to try self medicating with T3 I bought online without prescription. I need advice how much to lower my T4 and how much T3 to add at the beginning? I don't have any recent test done except TSH (my GP hasn't tested me for T4 and T3 for 2 years). My TSH is 4.2. She says it's fine. But I don't feel fine. Please help.

[SlowDragon Administrator]

BEFORE starting any T3 you will need full Thyroid and vitamin testing

200mcg is a good amount of Levothyroxine, yet TSH is far too high

How do you take your Levothyroxine?

Gut issues or nutrients malabsorption both extremely common when hypothyroid, especially if you have high thyroid antibodies

For full Thyroid evaluation you need TSH, FT4, FT3 plus TPO and TG thyroid antibodies and also very important to test vitamin D, folate, ferritin and B12

if vitamins are low these MUST BE IMPROVED FIRST before starting T3

Private tests are available. Thousands on here forced to do this as NHS often refuses to test FT3 or antibodies

thyroiduk.org.uk/tuk/testin...

Medichecks Thyroid plus ultra vitamin or Blue Horizon Thyroid plus eleven are the most popular choice. DIY finger prick test or option to pay extra for private blood draw. Both companies often have money off offers.

All thyroid tests should ideally be done as early as possible in morning and fasting. When on Levothyroxine, take last dose 24 hours prior to test, and take next dose straight after test. This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, GP will be unaware)

If/when you eventually also start on T3, make sure to take last dose exactly 12 hours prior to test

You will need full testing 6-8 weeks after each dose change in Levothyroxine or T3

If antibodies are high this is Hashimoto's, (also known by medics here in UK more commonly as autoimmune thyroid disease).

About 90% of all hypothyroidism in Uk is due to Hashimoto's. Low vitamins are especially common with Hashimoto's. Food intolerances are very common too, especially gluten. So it's important to get TPO and TG thyroid antibodies tested at least once .

Link about thyroid blood tests

thyroiduk.org/tuk/testing/t...

Link about antibodies and Hashimoto's

thyroiduk.org.uk/tuk/about_...

thyroiduk.org.uk/tuk/about_...

List of hypothyroid symptoms

thyroiduk.org.uk/tuk/about_...

Come back with new post once you have results and ranges and members can advise

[Hidden in reply to SlowDragon]

Thank you. I will order some tests tomorrow, although I don't have money for all of them so I will have to shorten the list. I take Eve multivitamin by Now Foods every day and I try to eat healthy so I don't think that I have any issues with vitamins or minerals. Maybe my body doesn't convert T4 to T3 very well? I was reading about it. I mentioned that to my GP but she thinks that she is so above me, she usually repeats the word 'nonsense' whenever I try to suggest something, I am always so offended by her behavior

[SlowDragon Administrator in reply to Hidden]

Sorry but you need vitamins tested

Hypothyroidism trashes gut function and lowers vitamin levels

It has nothing to do with how good your diet is.....more to do with how little nutrients your gut can absorb

Multivitamins are not usually recommended on here. Too little of what we actually need and most have iodine in, which needs avoiding especially if you have high thyroid antibodies

drknews.com/iodine-and-hash...

Getting vitamin levels optimal is usually the first step

We can not tolerate taking T3 unless they are

Antibodies need testing too obviously. If high this is autoimmune thyroid disease also called Hashimoto's

Gluten intolerance is extremely common with Hashimoto's

[Judithdalston]

Yes as Slow Dragon says worth getting your FT3, with FT4, TSH, Total thyroxin and both autoimuune antibodies (TPO and TgAb) tested, along with folate, ferritin, b12 and Vit D before adding T3. Adding T3 is not an easy option, and if your Vit/ min levels are compromised from poor gut absorption resulting from Hashimoto's you need to get these at optimum levels- your not feeling well for years might be low nutrient levels ( see SeasideSusie's replies on brands, dosage etc on supplementing). I started to add T3 to levothyroxin back in the spring: I mistakingly reduced my T4 dose down from 125 to 75 mcg as I slowly added 25 mcg T3, but ended up with lower FT3, so added T4 back, then raised T3 dose to 37.5 mcg...still not feeling quite right, so need blood test to fine tune! I got palpitations from adding T3, but these went by the time I got to 25 mcg added, and Bp went down. Some say use basal body temperature as a guide to getting T3 dose right...mine perhaps went up 0.2 C, and the other day had gone back down again to 35.8C, so what seemed a huge 'extra' dose of T3 has not made much of a difference to my metabolism. We are all very different, so it is best to get your Vit/min levels optimal and supplemented, before trying T3 too, and be patient DIYing.

[Hidden in reply to Judithdalston]

Thank you. My temperature is fine, I check it sometimes and it's always normal. As I already said, I don't think I have problems with vitamins as I take good multivitamin tablets daily and I try to eat healthy. All test on vitamins are quite expensive. I am not in very good financial situation at the moment since I have 2 kids on university and one still in school and my husband was made redundant last May and I work only part time helping my friend in her small pastry shop... For the time I think I will order FT4 and FT3, my GP haven't done them for whole 2 years!

[Judithdalston in reply to Hidden]

Unfortunately Fatima multivitamins are not good to help improve your nutrient levels: they are relatively cheap because they contain compounds that are less easily absorbed by our bodies, plus by being mixed they can contain minerals notably that 'wrap around' other ingredients in our gut (even nutrients in our food and drink); iron and calcium for eg are often added but they mean the other vits/ mins are unable to be absorbed. You will see from this forum with the obvious exception of the B Complex vitamins ( including B12 and folate, plus biotin etc), that most vits/ mins are recommended as single compounds, and for certain ones like iron, to be taken well away ( 2-4 hours away) from everything else( that includes your levothyroxin, other drugs, food...). Just checking you do know to take your levothyroxin/T3 by itself, only with water, say first thing in morning or bedtime, then no food /drink for at least 1 hour, or if you eat beforehand wait 2 hours before T4/T3 taken. Can be a problem if you want to split up your T3 into 2 or even as some do 3+ doses daily.

[Hidden in reply to Judithdalston]

Thank you. Yes, I understand that now. It seems I wasted lots of money on multivitamins for years. I take all of my T4 when I wake up, well before any food or drinks. But I heard people take T3 in divided doses?

[SlowDragon Administrator in reply to Hidden]

Sorry just testing FT4 and FT3 is likely waste of money

Better to spend £29 on vitamin D test

vitamindtest.org.uk

Or £79 on the whole lot if you order when on special offer

[Hidden in reply to SlowDragon]

Which vitamins I can test for £79?

[SlowDragon Administrator]

The fact you are on 200mcg Levothyroxine which is fairly high dose yet you have very high TSH strongly suggests poor gut function

Eve multivitamins contain iodine

So definitely not recommended

greygoose can elaborate about why multivitamins are waste of money and may be causing harm if you have Hashimoto's

80-90% of hypothyroidism is due to autoimmune thyroid disease also called Hashimoto's

[greygoose]

Hi fatima49, I'm sorry but this is an expensive disease - to begin with, in any case. You cannot know what you need to get well unless you do the right tests - and the NHS won't do them because they don't like spending the money, and know too little about thyroid to understand that that is a false economy.

You could very well have a conversion problem, but you won't know unless you do the tests. And, a conversion problem can be caused by an absorption problem leading to low nutrients. But, you should only take the nutrients you need - more is not better and can be dangerous - and the only way to know what you need is to test.

It sounds as if you have a particularly awful GP - no chance of seeing a different one? She should not be telling you your ideas are nonsense, but if she doesn't agree she should be explaining why.

I understand about money being short, but taking a multi-vit is also a false economy - you might just as well throw your money directly down the drain. Normally, with supplements, you get what you pay for, but there's no such thing as a 'good multi-vit' - no matter how much you pay for it - for all sorts of reasons:

* If your multi contains iron, it will block the absorption of all the vitamins - you won't absorb a single one! Iron should be taken at least two hours away from any other supplement except vit C, which is necessary to aid absorption of iron, and protect the stomach.

* If your multi also contains calcium, the iron and calcium will bind together and you won't be able to absorb either of them.

* Multi's often contain things you shouldn't take or don't need : calcium, iodine, copper. These things should be tested before supplementing or they could cause problems.

Calcium: it's rare to be deficient in calcium in Europe, even if you don't eat dairy, and taking calcium supplements of any kind can lead to problem like heart attacks and kidney stones, because they aren't easily absorbed.

Iodine: It's also quite rare to be iodine deficient, but even if you are, correcting that deficiency is not as simple as just taking a supplement. And, if you are hypo, taking iodine could lead to further complications - especially if you have Hashi's.

Copper: Hypos often have high copper and low zinc. The two need to be balanced. So, the last thing you need is a copper supplement. Over-dosing on copper is not pleasant.

* Multi's often contain the cheapest, least absorbable form of the supplement : magnesium oxide, instead of magnesium citrate or one of the other good forms; cyanocobalamin instead of methylcobalamin; folic acid instead of methylfolate; etc. etc. etc.

* Multi's do not contain enough of anything to help a true deficiency, even if you could absorb them.

So, not only are multi-vits a waste of money, they could actually do you harm.

[Hidden in reply to greygoose]

Thank you so much for explaining all this to me, I didn't really know how this whole multivitamin thing works, I thought that I am doing the right thing by taking it. I wasn't aware that there is so much more to it. But If I really do have a problem with absorption in my gut what can I do about it? Is there a cure? I know I must sound stupid but I don't know anything about this problem.

[greygoose in reply to Hidden]

No, you don't sound stupid at all. None of us are born knowing all this stuff. And that's how the supplement business manages to make so much money because, in general, people do think they're doing the right thing by buying multi-vits, because they don't know anything about it. It's a totally dishonest business.

People usually start trying to heal their gut by going gluten-free. If you eat meat, you could try making and consuming bone broth (this is not my thing, so can't tell you how to go about it; if you're interested, post a new question asking for recipes )

There's also the question of stomach acid, which is probably low. So, have a look at this article, and try the home test at the end:

scdlifestyle.com/2012/03/3-...

[Hidden in reply to greygoose]

Thank you so much. I have plenty of baking soda so I'll do a baking soda stomach acid test tomorrow morning. This one seems easiest and doesn't require much. I eat meat but no that much of it. I never made a bone broth in my life though, so it seems that I will have to post a question for the recipe although this is not a cooking forum and my question will probably sound a bit strange to some people I don't completely avoid gluten but I hardy ever eat any sort of bread, cakes, biscuits or pastry (this must sound funny since I work part time helping my friend in her pastry shop but I never eat any of the goodies there). From the limited knowledge I have about gluten the only source of it I am eating sometimes is pasta, hardly anything else.