Following on from my previous post, I saw a different endocrinologist last night with a view to asking for a T3 trial due to my high T4/low T3 result.
He was very pleasant and easy to talk to - unlike the previous one!
I explained I was experiencing fast heartbeat, sweating, difficulty sleeping etc and wondered if a reduction in T4 and an addition of T3 would help. He looked at my other medications and has told me to stop taking amitriptyline as it “ makes thyroxine behave differently” and has prescribed Nebivolol for the increased heart rate, muzzy head etc. He agrees that T3 can be good in some cases, but particularly if patient is taking a higher dose than me of T4, ie 150/200 -I am on 100 - but said that more importantly T3 can still cause increased heart rate and due to its short half life it would allow fluctuations in my TSH which would not be desirable because of the need for it to be suppressed due to my thyroid cancer.
He has also prescribed high D3 dose to address my low vit result.
Go back to see him in a month.
Is he just trying to fob me off??
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Tabitha6
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Sounds like he's fobbing you off, to me. Taking enough T3 will suppress the TSH, not make it fluctuate. I've never heard that before.
Besides, it's got nothing to do with how much levo you're taking, whether you need it or not. It's to do with your levels of FT4 and FT3. If your FT4 is at the top of the range, no matter how high your dose of levo, and your FT3 is at the bottom, then you can't convert T4 to T3 very well, and need the T3. That seems pretty basic, to me. I don't know where he gets the idea that you need to be taking 150 or 200 mcg levo before you're eligible. It's just like being knowledgeable is not a question of how much hot air you spout, but how much sense you make. And, for me, he's not making much sense.
Just another thought. This so-called 'short half-life' of T3 that they use as a permanent excuse for not prescribing it. Well, all things are relative, and compared to T4, yes, it does have a short half-life. It has a half-life of about 24 hours. T4 has 7 days. So, yes, it's shorter. But, if you're taking T3 once or twice every 24 hours, that shouldn't matter. (And, that is just in the blood. Once the T3 gets into the cells, it lasts about three days!)
It would appear that he imagines the TSH goes up and down according to the diurnal dip in T3. It doesn't. It doesn't move that fast. And, from what I've observed, it moves faster going down than going up. And, if your TSH is suppressed, it can take a long time to react and rise when blood hormone levels decrease. So, it's not going to be going up and down like a yoyo when you're taking daily T3 and the half-life of T3 in the blood is 24 hours, is it? (The pituitary only measures what's in the blood, not what is in the cells.) So, his explanation of the half-life of T3, really does seem like a fob-off, to me - unless he really is that ignorant.
What an interesting response greygoose. As always you explain clearly. The half life thing about T3 is interesting because when trying to titrate your dose, if you over-medicate on T3 you have to ride the waves for 24 hours. Overdosing on T4 can involve riding the waves for 7 days or more. I know which I would prefer! 🤸🏿♀️
No. Let another travesty about the attitude to T3. Many medics don’t like it irrespective of the price. I’ve read that they find it hard to titrate the dose and worry about the effects. I find that so ironic when you consider some of the devastating side-effects of some medicines regularly prescribed! I was nearly killed by a medicine I was given for dizziness when I was 18. Yet that is still freely prescribed despite the reaction I had being well known! Ridiculous double standards. 🤸🏿♀️
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Hope it helps. 
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