T3 dose advice

[Simplyred57]

I’m 4 weeks in on T3 - I’ve gradually increased up to 25mcg on the advice of my Endo (split dose ) but I’m not feeling good , I reduced my thryroxine to 75 from 100 , not due to see him till 9th June , do I stick with this dose ? I’m sensitive to thyroxine changes and my instinct is to increase my T4 and reduce my T3, as I feel like I normally do when I’m under medicated. Groggy and tired and achy. I felt best when I was 2 weeks in , any advice please , TIA .

[greygoose]

Increasing to 25 mcg T3 in four weeks is not gradual. Normally, one starts on 6..25 mcg and increases by 3.25 mcg every two weeks until reaching 25, which would be six weeks. Then one holds for six weeks and retests.

So, you could try reducing your T3 by 6.25 mcg and holding that for a while, but I don't think you should increase your levo again. Why do you want to do that?

[Simplyred57 in reply to greygoose]

Thank you I will reduce my dose today , I just feel like I do when I’m due an increase in thyroxine, when I saw my Endo he originally was going to keep me on my original dose of 100 t4 but when I told him I was sensitive to changes he told me to reduce. I am also waiting for a short synacthen testy exclude under active adrenal gland as my random cortisol was 167, I new it was too quick , but it was his advice to do it this way , thank you for your invaluable advice as always .

[greygoose in reply to Simplyred57]

Whether or not you reduce your levo depends on your FT4 level. I don't see why he would say to reduce it because your sensitive to changes in dose. I would have thought that was a reason not to reduce it. But, that's just me.

You probably feel under-medicated because you've increased too quickly, and your body hasn't had time to catch up with the changes yet. This is why we should go slowly.

[Simplyred57 in reply to greygoose]

Thank you , I will definitely stay on the reduced dose until I see him.

[greygoose in reply to Simplyred57]

So, you'll be seeing him in around two weeks time? He will probably want to test your blood, but it might be too soon to do that. Ideally, one would wait six weeks on the full 25 mcg dose of T3 before testing. Can't help thinking he's rushing things a bit.

[Simplyred57 in reply to greygoose]

Yes I agree , I’m interested to see what my bloods are though , but as it’s NHS Hospital I won’t get them until a few weeks after seeing him, so not sure how he will advise me on my dose ? Hopefully will go on how I’m feeling for now finger crossed 🤞

[shaws Administrator in reply to Simplyred57]

I hope he takes your symptoms into account as well as your blood test, although I think symptoms are far better at judging the dose we should feel well upon.

[Simplyred57 in reply to shaws]

Thank you shaws - I have to say I feel really rubbish on the higher dose - slowly slowly for me from now on.

[SlowDragon Administrator in reply to Simplyred57]

My endo starts Patients off on just 2 x 5mcg per day or possibly 3 x 5mcg per day. Usually with small 25mcg reduction in Levothyroxine

Hold at this for 6-8 weeks before testing

Recommended on here that all thyroid blood tests should ideally be done as early as possible in morning and fasting. This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, best not mentioned to GP or phlebotomist)

Last Levothyroxine dose should be 24 hours prior to test, (taking delayed dose immediately after blood draw).

If/when also on T3, make sure to take last dose 8-12 hours prior to test, even if this means adjusting time or splitting of dose day before test

Would recommend getting full Thyroid and vitamin testing privately

thyroiduk.org.uk/tuk/testin...

Medichecks Thyroid plus ultra vitamin or Blue Horizon Thyroid plus eleven are the most popular choice. DIY finger prick test or option to pay extra for private blood draw. Both companies often have special offers, Medichecks usually have offers on Thursdays, Blue Horizon its more random

Medichecks currently have an offer on until end of May - 20% off

thyroiduk.org.uk/index.html

[Angel_of_the_North]

I spent the first month on 1/4 tablet. I think you increased far too fast.

[Simplyred57 in reply to Angel_of_the_North]

Yes I agree , I was following my Endo’s advice , but I knew it was too quick , will reduce back down and speak to him at my appointment,