I am writing to find out, if any had issues with t4/t3 combo. It seems getting off cytomel has done something to my thyroid, it has not been a good thing. I am only on t4 right now, even though I am emotional better. I still feel bad, off the cytomel, it is almost my t4 to t3 conversion could be comprised. Before I had normal conversion, by adding the cytomel my thyroid is not the same! I can’t understand why my body is out of wack!
Did someone have problems with t4/t3 combo? - Thyroid UK
Did someone have problems with t4/t3 combo?
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shawsAdministrator
I cannot really answer your question, all I can say is that on T4 only which it is an inactive hormone and has to convert to the Active T3. It is T3 that is needed in all of our T3 receptor cells so that our body can function normally. Do you convert T4 into sufficient T3?
A number of Research Teams have shown that many benefit from a T4/T3 combination in a 4:1 or 3:1 basis.
It could be that T4 isn't converting to T3 sufficiently or that your dose is too low to enable sufficient T3 to be produced.
Have you had a Free T4 and Free T3 blood test which woud show the levels and I know these are rarely tested both should be in nearer the upper part of the ranges.
I remain unwell on levo alone.
• in reply toshaws
Shaws I need to follow up with my endo again, he said taking the cytomel, could inhibit natural t4 to t3 conversion. Yes, I see must people say taking both t4 and t3 that they notice improvement.
I am not medically qualified in any way. Is he sure - or does he have the answer that you cannot convert T4 into into T3? Has he tested both Free T4 and Free T3?
The fact is that some of us cannot feel well at all on T4 only (I'm one) and experts have also stated through several different research companies that many need a T4/T3 combination to feel well.
I don't care what my T3 number is because I feel well and have no symptoms and do not need a high dose. Those who have thyroid hormone resistance can only recover on T3 alone and need higher doses. One of our advisers took 150mcg of T3 in the middle of the night so that nothing interfered with the uptake. Maybe if we add in diogenes he might have an explanation with regard to your Endocrinologist's view.
p.s. one of my doctors phoned to tell me that my TSH was too low, my T4 was too low and T3 too high. My answer:- Doctor my TSH will be low as I take T3 only, so my T3 will be higher and I don't take T4.
Doctor stated but T3 converts to T4 so your T4 should be higher. I replied, I'm sorry doctor but it is ther other way around, i.e. T4 converts to T3.
• in reply toshaws
Hopefully I didn’t mess up the conversion process, I feel pretty good on cytomel only. One thing, I hope to do is see, where I can do with cytomel. I took cytomel 5mcg, as thyroid therapy, about a year ago. I felt good, but bad at the same time. I suppose my free t3 needed a boost, my t3 uptake was 27 and the range was 24-49.
5mcg is a very low dose equal - in its affect - to about 20mcg levothyroxine. I doubt anyone can feel better on that dose and still expected to have normal energy. Sometimes a very low dose can have the opposite effect for us, the patient. The following contains good advice ' Safely Getting Well on Thyroid Hormones'.
naturalthyroidsolutions.com...
• in reply toshaws
I have felt better on t4 50 mcg, however, my body is resisting it. I’m taking 5mcg of cytomel, with the t4 hoping to notice a difference. Generally, I feel crappy on both, I don’t see my endocrinologist, until the next week for a consultation. I had a friend recommend t3, it has been a bad thing, by adding it to my t4. I might just do 5mcg of t3 twice a day to get the equivalent of 50mcg of t4.
When first starting taking levothyroxine, we might feel an improvement initially but the dose is supposed to be increased by 25mcg every six weeks until we're symptom-free and that is usually when TSH is 1 and FT4 and FT3 in the upper part of the ranges..
50mcgof levo is a starting dose and usually it is raised by 25mcg every 6 weeks until we ae symptom-free. However, some of us cannot improve and a trial of T3 on a 3:1 or 4:1 T4/T3 basis has been found to be beneficial. Too low a dose wont help us nor too high. The aim is a TSH of 1 or lower with no symptoms and a FT4 and FT3 in the upper part of the ranges. The best judge is how our symptoms are being relieved not the numbers on a blood test.
I spent 14 years on T4-only,with mental health issues(anxiety,mood swings),as well as arrthymias.I spent 2 years on T3-only but switched to NDT because of mental/mood issues,despite improved physical symptoms including cardiac ones.
Now I am feeling better on 3:1 by adding a very small amount of T3 to my NDT.I also believe T3-only has affected my thyroid function.I now think I should have reduced my dose of 55mcgs of T3.
I think 14 years on T4-only affected my thyroid function,too.
I have tried upping my NDT,but am feeling better by lowering it & adding T3.Possibly because of previous mono-therapy.
I have gone back to circadian dosing in the early hours & have gone gluten-free again.
• in reply toNaomi8
What your saying is t4 and t3 is more effective, the difference is better over t4 only. I think it wouldn’t hurt to try t3 again, by lower my t4 it could help.
Naomi8• in reply to
I am saying I think I need T4 & T3.I think I need more T3 than some people.Some people need more T4 &less T3.
• in reply toNaomi8
Thank you, the explanation helps a bunch! Just kind of in limbo right now, understandably thyroid issues are based on individual suitability.
Naomi8• in reply to
I think adding some T3 to the T4 you are now taking,could improve things for you.I would research thoroughly on here,how much to introduce,how & when to increase dose etc.
When I first added T3 to T4 I had a big cardiac reaction.I went back to T4-only for a few months,then went back to T4/T3 but moved on to T3-only as quick as was recommended.
I don't seem to be able to tolerate thyroxine now.I use 2 grains of NDT for my T4 plus 1/4 tablet T3.
This gives me 76mcgs T4/25.25mcgs T3
• in reply toNaomi8
When you said don’t tolerate thyroxine, it means the loss of effectiveness or adverse reactions. I had a similar issues with regular levothyroxine, switching to tirosint helped me, as the cytomel different story. I don’t feel coherent anymore, prolonged poor thyroid function, could be to blame. Inasmuch, cytomel makes me loss assertiveness and personality, as well as my motivation.
Naomi8• in reply to
That's an interesting reaction to T3.I wonder if other people have had a similar reaction.I was on thyroxine for a long time(14 years)I am now 69.I think ageing with Hashimoto's presents its own issues.I do not convert very well.Thyroxine gave me ectopic beats & tachycardia episodes.
So far NDT is serving me better than thyroxine:thyroxine with liothyronine:T3 on its own.I am experimenting with adding a very small amount of T3 to give a ratio of 4:1(T4:T3)
• in reply toNaomi8
This explains a lot, you have hasimotos thyroiditis. I don’t have this type of thyroid condition, mine is sub clinical hypothyroidism.
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