Help with adding T3

[Jushkie]

Hi,

I've recently posted about needing some help with deciding on which blood test to go for, and then help with adding T3 to my usual levothyroxine.

I have been on 125mcg of levothyroxine for the past 12 months, I get a B12 injection every 3 months, take ferrous fumarate 48mg daily, folic acid 100ug daily, vitamin D 20ug plus vitamin K 50ug daily.

My results on 100mcg of levo (dosage unchanged for nearly 3 years prior to increase to 125mcg) were TSH over 2, T4 and T3 in lower quarters, felt terrible, was fobbed off with a chronic fatigue syndrome diagnose. Interesting thing is, roughly 3 months ago, after reading articles supporting their function in the never ending battle that is hypothyroidism, I started taking 500mg of L-tyrosine and 600mg of N-Acetyl-Cysteine. After roughly 6 weeks I've noticed an increase in energy, I sleep better, I can exercise most days without the awful debilitating pain and fatigue straight after. I still have days when I feel fairly drained, but it's now 2-3 out of 7, rather than the previous 6-7 out of 7.

Also there seems to be a big change in my test results, for the first time in nearly a decade.

I've now had my Medichecks results back, they are as follows:

TSH 0.357 (0.27-4.2)

FT4 21.6 (12-22)

FT3 4.8 (3.1-6.8)

Ferritin 51ug/L (13-150) - lower than usual

Folate 20ug/L (>3.89)

Active B12 175 pmol/L (37.5-188)

Vit D 76nmol/L (50-175)

As I've mentioned in my previous post, I've managed to get T3 through a relative in my home country, it comes in 25mcg tablets.

I would appreciate any input on my test results and any help with possibly introducing T3, the recommended dosage etc.

Many thanks in advance

[Judithdalston]

Before using the T3 i’d suggest you raise your ferritin levels as a priority, perhaps ferrous fumerate 210 mg tablets would be better than 48 one you currently take. Your vit D could be a bit higher, though summer sun might improve that naturally. We are all so different in our response to adding T3, but from your blood results you do look like you are poorly converting T4 to T3. I started adding1/8th of a pill for a few days, then went up to 1/4 pill; it took over 4 weeks to get up to whole 25 mcg pill. Unfortunately I removed too much levothyroxin ( 50 mcg down to 75 mcg) to make way for the T3, and ended up with even lower FT3. Go slowly. But you may find the tiny 5-10 mcg dose is enough for you. I found the initial tiny dose very powerful...it gave me palpitations until I got to the full pill dose ( tho went on to raise to 75mcg T3 as never got any further ‘overmedicated’ responses). You will find references to recording your daily basal temp. first thing, pulse and bp, and how you feel, to help with future juggling of doses up, or down....I am still doing this 15 months later after starting T3 combo, but I never got my temp.above 36.2C so not sure ‘diary’ of use except for giving one the felling of being proactive and taking control of one’s own health. Good luck.

[Jushkie in reply to Judithdalston]

Thank you for your reply, Judith

I did notice my hair falling out more again in the last few weeks, which might be because of my ferritin dropping (my usual result is between 60-70), I will pop to a pharmacy tomorrow to get the 210 dosage.

In regards to the T3, should I reduce my levothyroxine at all, or just add a quarter of the 25mcg pill to my existing 125mcg of levo?

[Judithdalston in reply to Jushkie]

That’s where you will find the differences...some need to drop levo. by an ‘equivalent’ to T3 being added by 4:1 or 3:1 say 100mcg T4 swop for 25 mcg T3, but even swopping 25 mcg T4 for 10 mcg T3 didn’t work for me...so it’s a bit of trial and error. Remember the levo.has a long half life, so a week after leaving part of your dose off half is still in the blood stream, 1/4 a week later... so they don’t ‘swop’ immediately anyway. If I was in a position of starting again adding T3 i’d add a 1/8th for a few days, then 1/4 of 25 mcg pill, before I considered lowering the levo.; once you start adding T3 remember ‘traditional’ thyroid blood results become meaningless : TSH and FT4 start going down, so only the FT3 result is ‘useful’. It’s how you feel , plus other stats. like bp, pulse, basal temp. that might guide you.

[Jushkie in reply to Judithdalston]

Great, thanks so much for your advice, I will start by adding a small amount of T3 to my usual T4 for a few weeks and see how I'll get on

[Jushkie]

Oh I forgot to add that my antibodies levels are fine.