So I have actually been given a 3 month trial of T3 by my endo on the NHS!! Because of my mental symptoms i.e depression anxiety memory loss... im quite lucky that i don't really suffer physically like some people on here apart from chest pain every now and again and the odd days I get tired and achy.. I do get a pressure feeling in my temple which is weird and also tinnitus ..
I'm very sensitive to any change in Levo I suffer really really bad whether I increase or decrease it's horrendous, and I know I need to start very slow on T3 added to Levo.. my endo has said to decrease Levo to 75mcg and add 10mg of T3 twice a day that's 5mg in a morning and another 5mg evening..
My worry is that if I decrease Levo so suddenly to 75 and only start tiny bits of T3 I will suffer really bad mentally even worse than I am now, what should i do??
I'm currently on 100mcg of Levo for 6 days and 125mcg for 1 day a week..
My latest results are..
FT4 - 25.1 (11-23)
FT3 4.77 (3.1- 6.8)
TSH - 2.5 (0.27- 4.5)
Thank you in advance.
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ThyroidObsessed
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I take T3, but have most of the reverse hypo symptoms to you ie pain and weakness, rather than anxiety, though I do have memory loss. Everyone is different in the way they ‘react’ to T3 initially; remember the T4 from levo doesn’t leave your system immediately it has a long half life, so at the end of week 1 the removed 25 mcg will in fact still be in your system at about 12.5 mcg, end of week 2 at 6.25 mcg.... on top of the 75mcg of levo. your dr. prescribes, plus the T3. I felt the benefit of an 1/8 of a 25 mcg T3 pill immediately, and within 2 days upped to 1/4 pill, then added another 1/4 pill later in the day. I noticed palpitations and high pulse, until I got to the full 25 mcg pill a month later ie hypo symptoms as I too reduced my levo. dose( from 125 down to 75 mcg) and it sent my FT3 down. Then I had to up my levo.to 100 mcg for another 6 weeks. Some find they have no side effects from the T3, if you feel overmedicated the FT3 will start to leave your system in 3-4 hours, so you could juggle / miss your second dose of the day. When I had palpitations, rather than worry about them( I knew I was on a tiny dose then) I took the T3 in one go, with levo. in the middle of the night and slept thru them. Some T3 specialists recommend taking the T3 in one dose to flood the receptors, so you could try this; I found splitting the T3 dose into 2 , even 3, spread throughout the day gave me the feeling it was ‘running out’, and needed topping up, which was rather unpleasant. Hopefully someone with symptoms closer to your own will give some advice. Good luck.
Thank you for your response it makes sense and has helped me think this through, I'm hoping it's my saviour, my mental symptoms are really severe I feel like I'm going crazy most days!
I would leave adding the T3 alone for the moment. Your results show your are not converting well as FT4 over range and FT3 just over half way. Have you ever had VitD, B12, folate and ferritin tested? These 4 also help your thyroid to work better, improve conversion issues and can lesson some symptoms plus you can only check on conversion when on Levo. Once you add in T3 results are read differently and FT3 result is the only accurate on and should be high in its range but FT4 can fall in its range. CAN being the important word here and so you cannot used the FT4 and FT3 reading to see if it's correct. Plus some people find that they have difficulty raising the level of T3 unless vits etc are optimal. So I know it can take longer but I would prefer to do conversion issues first before adding in T3. I reversed mine completely before I changed over to NDT and had no problems changing over or since. Plus getting the Fab Four optimal has been a bonus as well and I now have managed to find maintenance doses for two of them.
Thank you for your reply .. I have spent the last w years getti g my vitamins optimal also changed my diet drastically and take high dose vitamins on a daily basis, I also take selenium daily and zinc, I eat liver once a week also.. my ferritin went from 27 to 87 in a year, I don't know what it is now and my folate went top of range also my b12 is at 1000 at the moment, my vitamin D when last checked was at 80 but that was before I even supplemented anything I now take 10,000 daily of the betteryou spray with k and magnesium...
I don't believe my vitamins are causing me issues I just think I cannot convert very well no matter what I do...
I know what you mean but the vitamin deficiencys seem to go hand in hand with the thyroid problem , I definitely feel better using the b12 spray in my mouth , I obviously couldn’t process it via my stomach
Well pleased that you are looking at vitamins but surprised they have t already reversed your problem. I think I would go back to square 1 and make sure everything you do is done correctly. This group is run by Thyroid Uk if you aren't aware of that. Have a look at their site. They have loads of info re do's and don'ts and it could be worth looking at that to check if anything you may have overlooked.
That Endo probably hasn’t been hypothyroid or taken the hormones! Those changes could be quite perturbing if not downright uncomfortable if not done very gradually and ten micrograms T3 would blow my sox off, I know people take more but we are all different and the balance with t4 and the way our thyroid metabolism functions is profound and may be delicate and take a while of gentle experimentation for us to suss out and adapt our treatments to be in balance. If it were me (and it soon will be since I am going back onto combination after a trial of t4 only) I would split both the levothyroxine and the liothyronine to a max of 5mcg t3 in total over 24 hrs and see how you go. The natural thyroid production rates are more evenly distributed over 24hrs and t3 production between 5 & 10 mcg, going to 10 straight away could be double what your healthy normal was!
I just want to clarify something with you. You wrote "my endo has said to decrease Levo to 75mcg and add 10mg of T3 twice a day that's 5mg in a morning and another 5mg evening." However, if a Dr prescribes "10 mcg twice a day", (mcg not mg btw) that means you take 10 mcg two times during the day - so in my case, I am prescribed 20 mcg twice a day, and therefore have a total of 40 mcg each day.
The endocrinologist has asked you to reduce your levo from 100mcg to 75mcg? i.e. by 25mcg.
He has then advised you replace 25mcg T4 with 20mcg of T3. "20mcg of T3" has the effect of around 60mcg of levo? So I think I'd add 10mcg of T3 (and bear in mind that I'm not medically qualified) wait a couple of weeks and then add 1/4 tablet. Always take note of your relieved symptoms. If you still have some add the other 1/4 of T3. -If at any time (and if you're like me you get nervous when increasing as we don't know the effect it will have) if you have constant palps reduce to previous dose.
I've always taken one daily dose of whatever I've taken, be it levo, NDT, T3/T4 or T3 alone and everything was relieved by T3 alone. You can take the combined dose once daily.
I'm guessing you mean 10mcg of Levo in total over the day? Although this means you are taking quarter tablets, as far as I'm aware on the NHS there are only 20mcg tablets?
Whichever it is, 10mcg or 20mcg of T3, this is going to be an increase in your dose. The 25mcg of T4 you are dropping is the equivalent of about 6.25- 8mcg of T3, and the dose you've been given is quite a bit more than that. So you don't need to fear being undermedicated, but I agree you should add this slowly.
T4 is much slower acting than T3, so when you stop taking your Levo ( containing only T4) it will take several days if not a week or more to see the difference. On the other hand T3 is very fast acting, and will start working within hours, tho you may not feel the difference for a few days.
A reasonable strategy is to reduce the Levo as instructed, and then start taking your first 5mcg of T3 either that day or a day or two later (to give the T4 a chance to flush out of your system a little), and hold on that for a couple of weeks. Then you could think about adding the second 5mcg.
In general, most people do not have trouble introducing T3, so don't go into it fearful. Some people do find it more difficult, but the solution to that is just to reduce back to where you were comfortable, and start again with a smaller dose.
Hi Thyroid obsessed, I've just skimmed back over some of your old posts. I wrote some long replies to this one describing how to start on T3 if you have problems. Theses apply just as much now. It's always worth going back to read my old posts, I find, as sometimes there are very good comments that continue to be useful.
As it’s a three month trial you need to know if T3 helps quite quickly. A 5mcg dose is very small - you may not notice it, but I’d try to keep the endo on my side. Perhaps start by following the instructions endo gave you about T3. It is supposed to be a partnership.
10mcg T3 is about equivalent to 50mcg Levo. So on paper it seems a sensible reduction in Levo. As you have had chest pains endo will be cautious introducing T3.
Have you been given 5mcg tablets? If you’re cutting up 20mcg just make sure you use a ‘good quarter’ tablet once your body has tried T3 and you’re happy about it.
Good luck, it is scary at first, but I didn’t notice anything for weeks after starting T3 at a much higher dose than you.
Thanks fir your reply, i gave been given the 5mcg tablets I'm gonna start first keeping my Levo at 100mcg and adding 2.5mcg of t3 in a morning see how u feel then add another 2.5 t3 later in the evening... How long should I stick at that dose before increasing the t3 and lowering the Levo do u think?.
If the T4 goes too high you won’t be able bring it down very quickly but if the T3 is too high you will get immediate relief by leaving a dose out. If your body isn’t converting T4 to T3 you don’t know what effect adding T3 will have on your conversion rate, that’s probably why endo has said reduce (in the context of heart symptoms). Good luck
I’ve just recently been trialling T3 added to my levo too. Although I don’t get the problems with mood that you describe, I do suffer very badly from head pressure, palpitations, dizziness and tinnitus, along side the usual tiredness and ill feeling if my T4 drops at all.
When I started (dr recommended dropping levo by 25mcg and taking 2x 5mcg T3) initially I felt fab three days in. Then I got the most awful ice pick headaches and stopped the T3, I couldn’t stand it. Dr wasn’t very helpful suggesting dropping levo ny another 25mcg but I knew this was a bad idea!
So after having a couple of really bad days which only served to prove I needed the T3, I restarted taking a quarter tablet twice a day. It was a tiny amount and I didn’t feel anything at all but I did this for three days before increasing by a quarter tablet, and so on until I reached the full dose. No headaches and I feel great now.
I think you need to prepare yourself that you will feel bad for a few days, but only a few days. I had actually reduced my levo by 75mcg in a four week period (my dose was too high, so was advised to drop prior to meeting and then dropped again to accommodate T3 - it was never going to go well!) so no wonder I felt bad. But it was only a few days.... not even the length of time it took to build up the T3.
I don’t know if there is a way around it, maybe you won’t be so bad as you will have more residual levo in your system then I had. I was already four weeks into a 25mcg drop and added another 50mcg drop, only adding in a little T3.
So I’d say be prepared but only for a couple of bad days 😊
Hi thanks for your reply, I am on 100mcg of Levo and have took a quarter of a 5mcg t3 tablet today like u did, I haven't dropped the Levo yet and I'm not gonna until I at least get up to 5mcg of t3 because I know the bad effects I get when dropping so suddenly.. would u agree this is a good thing to do?
Hi, I’m not medically qualified in any way but as I understand it, the T4 remains in your system for longer. So, if you don’t drop it, and you intro the T3, you will be over medicating.
Whether it’s a problem when you’re introducing such a tiny amount, I don’t know.
I think I suffered because I had dropped 25mcg three weeks before I then dropped another 50mcg. Even the the Endo I saw the other day agreed that was going to cause issues!
If I was you, I’d maybe drop my levo gradually too - so take a quarter T3 for a couple of days while taking slightly less levo? Hope that makes sense!
Again, I’m not qualified but I followed my gut on how I thought my body would react and it wasn’t so bad
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