I have sourced some Tiromel T3 & would be grateful for some guidance & reassurance please as I add it alongside my Levothyroxine. I got it as the brainfog days and word tripping continues, as does the pain & my anxiety. I am thankful that my energy levels have improved and fatigue gone and the pain does not stop me doing anything, it's just there. I was hoping getting my FT3 higher might be the answer, hence my post today.
I have posted several times over the past 3yrs and received a huge amount of guidance and advice, all of which I have followed. I have realised though that with all my previous test results, I had been leaving too long a gap between taking my Levo' & the blood test (36 hrs instead of 24, as I take it a bedtime) . That said, looking back there isn't really a lot of difference between my 36hr results and my 24hr ones. My FT4 is always towards the top of the range and my FT3 below midway (except the last result after 24hrs off Levo' shows FT3 slightly over midway). I have posted the last few results below for reference.
As a reminder, I am a 52 year old female, confirmed hashimotos / hypothyroid 2016, currently on 125mcg Levo. Been gluten free 2 years, take Thorne Basic B Complex & Cytoplan Magnesium L Threonate alternate days and leave off all supplements a week before testing. I'm sure I'm also going through the menopause too as periods are very irregular now.
These are my last 4 thyroid test results plus all the most up to date vits in the last one by the NHS.
APRIL 2018 - Medichecks (36hrs)
TSH 0.048 (0.27 - 4.2)
FT4 19.4 (12 - 22)
FT3 4.19 (3.1 - 6.8)
SEPTEMBER 2018 Medichecks (36hrs)
TSH 0.06 (0.27 - 4.2)
FT4 19.8 (12 - 22)
FT3 4.41 (3.1 - 6.8)
DECEMBER 2018 Medichecks (24hrs)
TSH 0.058 (0.27 - 4.2)
FT4 20.5 (12 - 22) 85% in range
FT3 5.11 (3.1 - 6.8) 54% in range
ACTIVE B12 165 (37.5 - 188)
JANUARY 2019 *NHS* (24hrs)
TSH 0.07 (0.35 - 5.5)
FT4 18.3 (10 - 19.8)
**NO FT3**
FOLATE 12.83 (>5.38)
FERRITIN 98.2 (10 - 291)
SERUM B12 757 (200 - 770)
VIT D 121.4 nmol/l
I have been taking my blood pressure / pulse & temperature (ear thermometer) twice a day, first thing in the morning and at rest in the evening . According to Blood pressure UK's chart, mine is in the ideal range, my pulse rate normal and my temperature has been everywhere between 35.4 - 36.1C.
I planned to introduce 6.25 mcg Tiromel (1/4 of a tablet) for 6 weeks alongside my 125mcg Levo (seeing as I'm not at the top of the range) to see if I felt any improvement, then retest, but would you advise reducing my Levo by 25mcg straight from the start?
I didn't want to rush so wanted to do this 6 weeks at a time, but please say if I shouldn't. Also, what side effects should I be looking out for in relation to pulse, blood pressure, etc? If they increase but are still in range is that ok or should I ideally be hoping for no increase at all?
If there's anything else, then please say.
As always, thank you.
Written by
janey1234
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You might want to consider reducing Levo a tiny bit. Perhaps to 112.5mcg daily (if you do then would suggest you cut the 25mcg in half, so that you do take 112mcg each day, rather than 100mcg and 125mcg alternate days)
See how you get on. Consider adding 2nd 1/4 tablet mid afternoon in 2-3 weeks. Then hold at that for 6-8 weeks before retesting
You can initially feel better, then personally I always then felt worse 4-6 weeks after any dose change. Not sure if that's common or not. But best to grit your teeth and wait for it to settle.
Maybe a daft question (snigger quietly to yourself if so 😁), but if you reduce the Levo when introducing T3 , doesn't that cancel out some of the T3 that is being converted from the T4 / Levo' in the body and therefore you end up taking more T3 to compensate ? Am I making sense? ☺
Also, as I currently take my Levo at night I was going to take my 1/4 T3 then. If I add another 1/4 in 2-3 weeks as suggested, would you still say take it in the afternoon and would I still need to not eat 2-3 hrs before and not eat 1hr afterwards?
Aaaaand (sorry)...any idea on my last question about side effects , if any, re pulse, blood pressure, etc
Ok...I'll do that, T4 at night (reduced to 112mcg), 1/4 T3 on waking, add another 1/4 T3 in 2-3 weeks in afternoon, retest 6-8 weeks after. See how I feel and report back.
Just another quick question SlowDragon, ... when I add the second 1/4 should I reduce my Levo again down to 100 or hold it at 112mcg until my bloodtest after the 8 weeks?
ok... I'm only 5 days in and I'm finding this all quite scary and lonely, self medicating. I'm continuing to monitor my blood pressure, pulse & temperature, which are up just a tiny bit (was at low end of 'ideal' so lots of room to manoeuvre) but I'm stressing so much over what I'm doing that that's probably the reason. I assume it'll take a while to tweak & adjust my T3 & T4 before I notice any difference.
Just another quick question SlowDragon , ... when I add the second 1/4 should I reduce my Levo again down to 100 or hold it at 112mcg until my bloodtest after the 8 weeks?
Adding T3 is not easy compared to using levo., I started nearly a year ago as bloods showed I was a poor converter and even when raised levo. to over the FT4 range my FT3 at 40% ish. I had read lots of advice on the forum about lowering levo. to introduce T3, so shifted it down from 125 mcg to 75 mcg to allow the 25 mcg Tiromel pill to be introduced. I started off with 1/8 th of a dose and felt an immediate, within a few hours, unstiffening off my hips. Over the following month added tiny bits more. Unlike you I had high blood pressure before I started, a hypo symptom I presume, which became normal on the 25 mcg dose; however my first bloods at 6 weeks showed that TSH, FT4 and even FT3 had gone down! We all seem to be very different whether we need levo., and higher FT4, and it is rather trial and error experimenting/ juggling between T4 and T3 replacement. Another thing you can try is the timing of dose eg splitting it up thru the day, or try at night. On the smaller dose I found I needed a ‘top up’ mid/late afternoon, but as much larger dose (33.5 mcg) just took in one dose in middle of the night. You might not feel the benefit of 1/4 or so pill if taken at bedtime etc. Some even take it 3 times a day, but I found with taking supplements, food/ drink, other medicines I found it so difficult to have two- hour food etc free gap around the T3 dosing to do for any length of time. Oddly now slowly worked up to ‘high’ 100:50 combo, but now just changing to 125/44... I do have fibromyalgia too, which might make a difference.
Thank you for your reply. Like you, @slowdragon has also just suggested the T3 in the day rather than at night, so I'm going to do that, starting with my 1/4 then adding another one in a few weeks in the afternoon. 🙂
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