I have been diagnosed with Hashimotos disease and am currently taking a combination of Levothyroxine (150mg) and Liothyronine (25mg). I have been feeling good on this combination.
However my TSH has been suppressed ever since I started Liothyronine 2 years a go. I understand this increases my risk of Osteoporosis.
A recent DEXA scan showed Osteopenia and now I am considering cutting out Liothyronine to prevent Osteoporosis. I cut down my dose of Liothyronine to 12.5mg for a few days but my symptoms are returning - tiredness, knee pain, brain fog etc.
Is there anyone who has been taking Liothyronine for a long time who can reassure me that it is safe to take it in the long term?
My recent blood test results were;
TSH - 0.01 mu/L (normal range 0.27-4.2)
Serum Free T4 - 22.7 (normal range 12-22)
Serum Free T3 - 5.9 pmol/L (normal range 3.2-6.8)
Thank you for your help
Written by
M4ndi
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I am T3 only and have been for several years. A bone scan revealed almost perfect results - I was around 70 at the time !
Your TSH is as it is as you are taking T3 - so messages going to the Pituitary, signal adequate levels in the blood so no need to pump out TSH.
There is much more to bones than thyroid levels. How is your B12 - VitD ? Lots to read on this Forum too if you use the Search Facility. Good website below - where you can read the other nutrients required for bones.
I can’t comment on safety, but do suggest you ensure your intake of bone mineral cofactors are good. Everyone knows about calcium, less so that we also need vitamin D3, magnesium & boron, as well as some weight bearing exercise for our joints in order to produce new bone mass.
I am only on T4, but I have a suppressed TSH and a Dexa scan showed osteopenia- (right on the edge of osteoporosis for my hip.)
I talked to my endo about this - he is a thyroid specialist - and he agreed that my bones haven’t suddenly crumbled because my TSH has been suppressed for a few months. I have had a low BMI most of my life and although I exercised, my main sports were swimming and cycling which aren’t load-bearing so didn’t help my bones. I also did a lot of walking - though less so once I got hypo as I was too unwell - but since I had a low BMI that wasn’t great for bone building either! I just didn’t stomp my feet enough!
I am not going to reduce my meds - they help me to feel well so I can exercise and stay fit and try to improve my bone mass. To be honest, it’s a risk I’m prepared to take to feel well and my specialist agreed with me.
I am making sure I have more calcium in my diet (hence the glass of milk I added to my sign off!), I took Vit D3 anyway. I’m also upping the walking again. (My GP suggested skipping - but I laughed and said I’m so clumsy I’ll probably trip over and break my hip!)
No way am I going to try my raise my TSH by cutting my T4 and going back to feeling like a walking shadow again. In fact, I’m still increasing it. I’m not ‘hyper’ or over medicated on my current dose. Both T4 and T3 are well in range and I have no symptoms of over medication - so I don’t see how it can affect my bones anyway.
Just my experience - but I thought I would share it with you. 🤸🏿♀️🥛
I have also had a low BMI all my life and a pretty sedentary lifestyle for the last 8 years and that’s probably why I have osteopenia! I completely agree with you, good to know that your endocrinologist thinks the same
I have started weight bearing exercises and supplements now though, so hopefully things will improve
For patients taking liothyronine there was no increased risk of death (0.78; 95% confidence interval: 0.54–1.11), fractures (HR 0.79; 0.49–1.27), atrial fibrillation (HR 0.91; 0.47–1.75) or cardiovascular disease (HR 0.90; 0.42–1.92).
No increased risk of fractures or atrial fibrillation in patients taking liothyronine compared to L-thyroxine was demonstrated.
If reducing your dose means you are less able to exercise that would be bad for your bones
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LIOTHYRONINE PRESCRIBED AT LAST
Advice need re T3 before hospital appointment 
This is a good example of what present accepted assumptions are regarding T4 treatment, combination therapy re control by TSH levels
Thyroid levels are about the same with or without Levothyroxine
Still feeling exhausted after taking Levothyroxine 3 months
