T3 low medication?

[Readdy]

My T3 is low doc wants me to go on liothyronine 25mcg I’m already on levothyroxine 100mcg my T4 is bit high so he wants to reduce this to 75mcg. Is this low dose of Liothronine? Is this any good? Wants me to take 3 doses every 4/6 hours?

Did mention NDT but he said dosage was difficult to achieve?

Appreciate any advice? Thanks

[NWA6]

Are you in the UK? What was your most recent bloods? He is correct to lower your dose of T4 when introducing T3. And most people start with doses spaced out, usually every 8hrs and not with food ect ect. You might have to introduce slowly, 25mcg might be too much initially. Depends on how low your FT3 results are and how sensitive you are to drugs.

[MaisieGray]

Whether you need to reduce your T4 when adding T3 depends on your existing levels of thyroid hormones. If your FT4 and FT3 were both low in range, it wouldn't make sense/there is no need to reduce your T4. However, if your FT4 is currently over range on your existing dose of T4 and your FT3 low in range, then yes, it likely indicates you need to reduce your FT4. However, the devil is in the detail, so any dose-changing and/or treatment decisions should be made in the light of actual results against their reference ranges, not general descriptors such as "a bit high" - is that a bit high within the reference range, or above the reference range? Can you post your actual TSH/FT3/FT4 results together with their respective ranges so that folks can comment more accurately. Regarding T3, how you dose ie whether you take a single dose or two or more doses in a day, is a very individual thing, and you need to do what suits you best - for instance since I started taking it 11 yrs ago, I've only ever taken it in a single dose; but others will have their own experience. It is trial and error to find out your optimum way of dosing. In terms of the starting dose, I have twice started at 20 mcg with no reduction in T4, and been perfectly fine; whilst others have needed or preferred to start low and increase gradually. There is no evidence that T3 needs to be taken away from food in the way that Levothyroxine does, and some evidence to show that in fact, it doesn't; so if you were taking a single dose of T3 you could take it with your T4 and you would in any case, be taking it away from food if you are taking your T4 'properly', but if you are taking a single dose of T4 and decide to trial 2 or 3 split doses of T3 you would need to decide for yourself if you want to take those doses away from food. If you also take other meds and/or supplements, taking several doses of thyroid meds throughout the day, starts to get more challenging to avoid both them and food. On a practical note, I see from your previous post that you were planning on seeing a private Endocrinologist; so has this been prescribed by a private consultant and will you be paying for your prescription to be dispensed? I ask because that will be a costly option if you source it in the UK. However many here who have a private prescription for T3 send it to Germany in order to be dispensed the brand Thybon Henning at only 30 Euros for 100 tablets; but those tablets are manufactured in 20 mcg and not 25 mcg, and if you are paying for your meds, your prescription would need to be written accordingly if you wanted to source that way.

[Angel_of_the_North]

Wow! That doctor is a keeper! Sounds absolutely right but you'd probably be better starting on just 1/4 of a T3 tablet a day for the first few days then 2 x 1/4 tablets and so on, as 25mcg T3 will have an effect more like 75mcg of levothyroxine.

[Readdy]

Thanks everybody my TSH is 0.015 Free Thyroxine 27.7 Free T3 4.43 had test before which showed T3 at 1.4 which I was told is low.

My TSH is high I believe as I have infections!

Am going to take the T3 slowly as suggested thanks

[NWA6 in reply to Readdy]

TSH is low. T4 is high and T3 looks low to okayish but rubbish compared to T4. Although I’m only guessing as you haven’t put ranges with your results 😬

[Readdy]

Sorry new at this TSH range 0.27-0.42

Free Thyroxine range 12-22

T3 range 3.1-6.2🙄thanks

[NWA6 in reply to Readdy]

Thanks Readdy. So the best way to share your results is like this

TSH - 0.0015 (0.27-0.42)

FT4 - 27.7 (12-22)

FT3 - 4.43 ( 3.1 - 6.2)

I think the general consensus is that this layout is easiest on the eye 🤗

And you can also edit your post with the little dots on the right hand side, just so more people can easily see changes in the original post, otherwise it might get lost in the responses.

[Singoutloud]

It's great that your doc is open to T3 but I would be wary of going straight to 25mcg per day. Either he doesn't understand the strength of t3 compared to levo or he is setting you up to fail by giving you too much too soon. It is at least 3 - 4 times stronger than levo so you do have to be careful or it can make you feel much worse. I take only T3 now but started with a quarter of a tablet each day increasing by a quarter every a couple of weeks but only if I felt I needed to.

[Readdy in reply to Singoutloud]

Spoke to pharmacy yesterday he’s prescribing me 5mcg x 3 times a day I got it wrong. My Levo is going down to 75mcg what dose of T3 should I start at pls??

As the lady said just try 1/4 tablet first then wait? I see Endocrinologist again in 4/5 weeks thanks 😀

[Singoutloud in reply to Readdy]

I would probably start with 1 x 5mcg tablet once a day for a couple of weeks and then increase to 2 x 5 mcg per day and so on. Others may advise to increase more quickly but I found the low and slow method worked fine for me so didn't get any symptoms of being over medicated at all. I did split my doses at first but just take it all in one go now.

[NWA6 in reply to Readdy]

I went straight on with it. 150 x 2, 125 x5 Levo per week and 5mcg x 3 times a day. No reaction except extreme happiness 🤗 after 2wks I started with 10mcg in the morning and 5 at lights out. Still all good a couple of weeks later. I was nervous because there have been some horror stories but nope, all good for me 😀

[SeasideSusie Remembering in reply to Readdy]

Readdy

what dose of T3 should I start at pls??

As the lady said just try 1/4 tablet first then wait?

I agree with "the lady" and Singoutloud - start low and gradually build up. T3 is 3-4 times as potent as Levo and can be a shock to the system, so if you start at 15mcg daily that's the equivalent of 45-60mcg Levo.

I would start with 5mcg daily, give it 2 weeks to see if you have any adverse reaction, if not then add another 5mcg - 5mcg morning, 5mcg later in the day. Then I'd give that at least another 2 weeks, give it time to work and for hormone levels to stabilise.

If you are reducing dose of Levo that's going to take 6-8 weeks to be fully effective anyway. Rush into adding so much T3 and you wont know what is making you feel any different - the reduction in Levo or the addition the T3. Many people only need a small amount of T3 so to avoid missing the dose which is right for you just take is slow.

I don't think many doctors understand this, and the cynical side of me thinks a lot of doctors want a T3 trial to fail so that the NHS doesn't have to pay such a huge amount of money for it.

You could keep your follow up appointment with the endo and explain that you'd rather take it slow and make the changes gradually, or you can delay your appointment until you are on the dose he recommended.

[Readdy]

Thanks a lot yeh was slightly nervous as I know some people at reactions with too higher a dose and ive got enough other medical probs at mom will take it slow

Endocrinologist is good cos he’s private