I know I will get many people warning me NOT to self medicate with t3, but I feel I have nothing to lose. I see a psychiatrist and have tried various medications, but I still feel as though life is not worth living. I cannot bare to live as the person I have become since Hashimoto’s hypothyroidism stole the old me away over a year ago. I have read about t3 and the treatment of depression and want to reduce my t4(at the moment I take 150mcg) and add in t3. I was referred to an endocrinologist who said she never prescribes t3, even if someone’s bloods are low in t3. She also said depression and hypothyroidism isn’t linked. My gp thinks that my tsh is low and wants me to reduce my Levothyroxine, but I argued because I didn’t want to lower my t4 and t3. I have now sourced some Tiromel from abroad and need some advice about dosing. The tablets are 25mcg each one . I understand that I should start slowly but how and when? And how much should I reduce my t4 by? Thank you in advance.
Self medicating with Tiromel : I know I will get... - Thyroid UK
Self medicating with Tiromel
Hi
Following carefully, I've been plodding years and fed up now going around the houses it feels, I just want my life back too, the me I was happy with, just posted above you and to say don't give up, we can do, this xxx
Ps. I've just had my sex hormones results, I went the whole hog this time on medichecks. I don't know what age you are? As older I was thinking of asking for bio identical hormones (re Carol Vaudamann story)
(removed due to guidelines)
My results aren't too bad, I'm just trying to do the whole thing, I can't find the missing piece of jigsaw except chocolate. Xx
Actually, your conversion is quite good. You don't really need the T3, just an increase in levo, because you are under-medicated.
Depression is a symptom of thyroid, but doctors know nothing about symptoms - they don't 'do' them in med school. And, psychiatrists do sometimes treat with T3. But, if that works then one has to assume the depression was caused by low T3 - i.e. hypothyroidism. But, thyroid doctors are notoriously bad at joining up the dots!
Anyway, now you have the T3, you might as well take it. But, I wouldn't reduce your levo, if I were you, your FT4 is only just mid-range, and it will drop anyway, when you add the T3. It's people with FT4 at the top of the range that need to reduce the levo.
Start with a quarter tablet - 6.25 mcg - and take it with your levo, following the same rules as for taking levo - empty stomach, one hour wait for food, etc. You can increase by 6.25 mcg every two weeks until you reach 25 mcg. Then, hold for six weeks and retest.
Whether or not one splits the T3 is a very personal thing. Some people need to, some are better taking it all in one go. You have to find what is best for you by trial and error. But, always take the T3 as you would levo, for maximum absorption.
Your vit D is ok, but have you had your vit B12, folate and ferritin tested? They all need to be optimal, too. 
Oh! Dear! another doctor who doesn't know any clinical symptoms of hypothyroidism. I think she must only refer to TSH and T4 and you can tick of your clinical symptoms. Many seem to adjust dose to 'fit' the TSH into a slot, whereas :-
thyroiduk.org.uk/tuk/about_...
I wouldn't warn you not to self-medicate as its the only way I recovered my health. The problem at present is that it is difficult to source T3 oneself. Both your FT4 and FT3 could be higher.
I am not medically qualified. You can reduce your levo by 50mcg and add 1/4 tablet of T3 as the equivalence of 25mcg to levothyroxine is 100mcg.
Take notice of your pulse/temp when introducing increases and if either goes too high reduce dose by 1/4. You can also increase by 1/4 tablet every 2 weeks always keeping an eye on symptoms. Reduce by 1/4 if necessary.
Also your blood tests wont correlate if we take NDT or add T3, because blood tests were introduced for levothyroxine alone.
TSH is from the pituitary gland.
I don't think you will find many here who caution against self-medicating!
You don't need to reduce your T4 at all, your current FT4 level is just a smidgeon above midway in the range, and your FT3 is below midway, so simply add the quarter table of T3 to your T4, as it is. I will add that I've not started at less than a full 20 mcg tablet myself, and been perfectly fine even with cardio issues, so in general there's no need to be worried, but I suggest you go lower and slower as suggested by greygoose, to err on the side of caution.
Don’t know how to edit my first post, but I got new results today and almost a month after the bloods pictured, my t4 is 21.3 and my tsh is 0.33. T3 wasn’t tested which makes it difficult to see if I’m converting properly. I would still like to give t3 a go and would appreciate any additions or changes you might need to make to any of your responses. By the way, you really don’t know how much I appreciate your help x
Ah. That's a massive jump in FT4. Did you have an increase in dose after the last test? And, if anything, it will have worsened your conversion because it will now be converting to more rT3 than T3. So, yes, you would need to reduce your levo, according to that result. 25 mcg reduction in levo to 6.25 mcg addition of T3.
Oh, and to edit your post, click on the downward facing arrow, under your post, next to where it says 'More', and then click on edit in the dropdown menu.
Also, when you reply to someone's comments, you need to click on the blue 'Reply' button under the comments, so that they are notified that you have replied.
Thank you so much, you’re a star. There was no increase in levo between tests. The only difference was that I reduced one of my antidepressants (quetiapine) because it caused my cholesterol to rise to 8.9, after the reduction it’s gone down to 5.7. I’m so scared to start the t3, but I’m also desperate to try anything to live again.
Why are you scared?
I’m worried I will put pressure on my heart. Or am I being too dramatic?
No, you are not being too dramatic - and just thinking so is a symptom of how hypo you are.
As for your heart, it's better off having a good level of FT3 than a low one. You will only put pressure on it if you take too much, and I really don't think that 6.25 mcg is going to be too much. But, even if it does have a negative impact on your heart, it's not going to be instant. You will have time to reduce your dose again. If it reassures you, stay on 6.25 mcg for six weeks and then retest before increasing further. You can take it as slow as you like.
Thank you. I will check in with you again if you don’t mind?
Of course. Whenever you like.
Hi again, I have done the t3 at 6.25mcg and reduced the levo by 25mcg for a week now with no effects and my temperature is remaining below 36. Before i increase again, I just wanted to check that you suggest reducing my levo again by another 25mcg? You say retest in 6 weeks, do you mean just retest t3, as I was under the impression that the tsh and t4 wouldn’t be a very good indication of success?
Well, that was a bit too soon to increase. Normally, one increases every two weeks.
I don't think you need to reduce your levo again. See how it goes.
I said retest in six weeks if it reassures you that you're not going to be over-medicated on 6.25 mcg. As you've now increased your dose, I take it that you no-longer need reassuring.
Hold for six weeks when you get to 25 mcg T3. TSH is of little use when taking T3, but you do need to see if your FT4 is still too high - or not high enough. We always have to feel our way around all this, so we need as much information as we can get to guide us.
I only started the t3 a week ago, so do you think I should wait another week before increasing or just go for it. I still feel tired and my temp is 35.2. Sorry for all the questions.
Ask as many questions as you like, that's the only way to learn.
Sorry, I misread, I thought you said you already had increase your T3. But, no, I think after just one week, it's too soon to increase. Wait another week. Not surprising you still feel tired, it's only a small dose, but we have to go slowly.
Your last fluctuation, increase in FT4, could be a Hashi flare too. When I introduced Tiromel nearly a year ago I dropped my levo. down from 125 to 75mcg as I slowly introduced segments of the 25 mcg Tiromel pill- started with 1/8 th, to full pill about 4/5 weeks later. But my first bloods on 75:25 combo showed that all my TSH, FT3 and FT3 had gone down. I had palpitations, high bp (but basal temp. by mouth rarely shifting above 35.5C ) until I reached the full 25 mcg T3 and taking even the 1/8 th dose felt very powerful to me. I am now on 50 mcg T3 and 100 Mcg T4 but still rarely have a temp. over 36.2C, and bp normal for age. We are all so very different...i’d advise patience, record your stats. and how you feel daily.
I think the palpitations would scare me, but is that something I should expect? Is my temperature more important?
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