Hi. I was put in half a tab of t3 twice a day with my Levo reduced to 100 mcg with the one half in morning. How long before see an improvement in my fatigue and brain fog. That’s been 3 weeks and no improvement. Actually feel more tired and falling asleep when get home from work Thanks
T3: Hi. I was put in half a tab of t3 twice a... - Thyroid UK
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Lesleyrm63
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How big is your tablet? 25 mcg? So, your doctor started you on 25 mcg T3 a day? By how much did he reduce your levo? Seems to me he started you on too high a dose, and that could be why you're tired. Normally, one reduces the levo by 25 mcg and adds in 5 mcg T3.
So that would be correct. 5 mcg of t3 to 25 of Levo.
I am down to 100 Levo and 20 of t3.
Was on 250 so he has reduced the Levo down to what shd be woth t3
Yes, but the problem is, it's not really 'worth' that. Levo and T3 are not the same thing. Levo is T4, basically the storage hormone. T3 is the active hormone. T4 converts to T3, so when you take T4 only, it slowly and gently converts to T3 so that you get used to the T3 gradually, which is better for your body. If you've had low T3 for a while, suddenly bombarding it with 20 mcg T3 is going to be a huge shock to the system. Which is why we start with a 25 mcg reduction of levo, and add in 5 mcg T3.
Levo should only be increased/reduced by 25 mcg every six weeks. T3 by 5 mcg every two weeks. Your endo has reduced by levo by a massive 150 mcg and added a massive 20 mcg T3. It's all too much and your body must be in shock. You just can't play around with hormones like that. Low and slow is the way to go. 
So what should I do. It was the Endo consultant that did it not the doctor. My body isnt absorbing t4 as I have antibodies according to the last blood test.
When I say 'doctor', it's generic. You have Endos and GPs, they're both doctors.
Antibodies do not stop you absorbing T4 - did the endo tell you that? High antibodies are just an indication that you have Hashi's. They don't affect your thyroid hormone replacement. A lot of things can affect it, but not the antibodies.
If you can't absorb T4 then you won't be able to absorb T3, either. So, I think you have a conversion problem, rather than an absorption problem. For some reason, your body cannot convert T4 to T3 the way it should. There for you need the T3, that's understood. What was wrong was the way he prescribed it. Is he a diabetes specialist? They don't know much about thyroid.
As you're not benefiting from the dose he's prescribed you, would it be possible for you to increase your levo by 25 mcg and decrease your T3 by 5 mcg, and see if that helps?
Also, have you had your nutrients tested? Hypos often have nutritional deficiencies due to low stomach acid. So, we should get our vit D, vit B12, folate and ferritin tested, and supplement accordingly. If you've had them done, I suggest you post the results here, with ranges. If you haven't, I suggest you ask for them to be done.
Hi thanks. They had said at previous tests my bit d and b12 were ok waiting on results from hospital tests. I asked for consultant to call me today so hopefully calls this afternoon and I’m going to ask him about the reducing the Levo to such a low amount Thanks. Will keep u posted
Well, I understand why he did it, because he thought it was the equivalent of 20 mcg T3. But, there were so many other factors to take into consideration and he didn't think it through. Perhaps - probably - he doesn't know enough about thyroid to know that such drastic changes in both T4 and T3 are just not recommended, and he should have started you off on a much lower dose of T3. I doubt he understands the subtilities.
His secretary called back. Said my t4 was 8.75 but explained I’m not converting my test could be within range but it’s not converting to t3. Doubt she had a clue. Anyhow she said that I’ve to up my Levo to 150 keep taking 20 (2x10) t3. See how that goes. Keep you posted. If this doesn’t help I will be doing what you have said with doses.
Meant to add. They said all other bloods were fine ? It was 8.57 t4. Not 8.75.
Sorry me again. It was my tsh not t4 that was 8.57. Surely that means it is low. She said it was normal. I though anything above 5 was low tsh. Am I wrong.
A TSH of 8.57 is high, not low. It means you're very hypo. Is that your latest reading? Not surprising you don't feel any better, then. How long had you been on T3 when this test was taken? What about FT4 and FT3? A TSH on its own doesn't tell you very much. And, it certainly doesn't tell you how well you convert. What you need is a print-out of all your results - not just a TSH over the phone. Do you know if your surgery gives on-line access to your records?
No they don’t have online access to medical records. I will wait till see go and get them. Thanks for your help
Was taken 2 weeks ago been on t3 for 2 weeks.
OK, well, but too soon to be testing, actually. But a TSH that high when taking 25 mcg T3 is rather unusual. How do you take your T3? Do you take it on an empty stomach, and wait an hour before eating or drinking, just like levo?
Yes I take them about 6am. 10mcg of t3 Then have breakfast about quarter to 8 weekdays. Weekends always wait an hour. Take the other t3 around lunchtime. Wait an hour before eating Actually this is probably best day I’ve had since taking t3.
Perhaps the TSH just hasn't had enough time to adjust, then. Takes some people longer than others. But, it was too soon to test.
Still means nothing without a range. Didn't you ask for the range? What about an FT3 result? They can't know how well you're converting without testing the FT3.
BUT even if you aren't converting at all - which hardly, if ever, happens - the way he handled the addition of T3 to your levo was just plain wrong. And, increasing the levo at this point is hardly likely to help - could even make things worse. His secretary is hardly the right person to discuss this with if you want an in depth explanation. Sounds to me like he doesn't really know what he's doing and is just using his secretary to fob you off. Makes no sense.
Seemingly he is writing to my doctor so will get an appointment with them and get a full breakdown of the results. Want a proper print out to see how it’s fluctuated and will be better place to list on here once I have the information I. Front of me. He obv didn’t want to call me hence why secretary called me back. I didn’t think to ask she just said everything else was normal.
Yes, hopefully you'll get better answers then.
When you have the results, and have seen your GP, start a new post, because more people will see it and be able to comment.
And 20mcg T3 is not "equivalent" to 150mcg levo anyway only about 60-80mcg, so you've had a huge dose reduction
That's true. I began by assuming that 'the tablet' was 25 mcg. I really don't think this man knows what he's doing.
Exactly.
Started off with 2 weeks ago woth the t3. Cut Levo dose to 100. Put me on t3 at 20 mcg a day. Called yest said I’m gubbed by afternoon increases Levo to 150 still on 20 t3. So what should I be on if Levo 150 reduces from 250. I’m not sure how works. Been under active for over 25 yrs and weight. Even up and down like a yo-yo. Doctors never listened to anything I said then blamed my weight gain last year on menopause I go to gym abt theee times a week have to push myself as I feel I need to keep active.
That is a rediculous increase in levo. It shouldn't be more than 25 mcg every six weeks. But, it's a bit late to be worrying about what you should be on. You've been on the T3 for 2 weeks, now. By rights, you should be on 225 mcg levo and just increasing up to 10 mcg T3. But, you really should not be putting the levo up by that much, now. I don't know.
It's a mess, and I don't know what can be done to rescue it. Personally, my instinct would be to leave the levo as it is, now it's there, but reduce your T3 by 5 mcg, see if that makes you feel any better. Whatever your TSH says, I think your main problem at the moment is suffering from shock due to the massive decrease in your levo and the massive addition of T3. I think you should reduce T3 by 5 mcg and then hold at that for at least six weeks, while your body adjusts. But, if you go back to that endo, he's going to keep meddling with your dose and make things worse, because he doesn't know what he's doing.
But, just for your information, as I said somewhere above, levo should only be increased/decreased by not more than 25 mcg every six weeks, and T3 by 5 mcg every two weeks. But, I'm afraid it's up to you what you do next.
Well, it depdns what your free T4 and free T3 were before the T3, but, if you needed a reduction in levo: 225mcg levo and 5 mcg T3 for first 2 weeks, then increase to 2 x 5mcg T3 (if necessary) and retest after 4-6 weeks of starting T3
Thanks for your help both of you. I’ll keep on my 150 the now and just take 5 of t3 and going to see if I can find a specialist in Glasgow who deals with it.
My t3 is 20 micro grams. Take 10 in morn with the 100 Levo. Was on 250 Levo before taking t3. Take other half of the tab t3 in afternoon which is 10 micro grams.
SlowDragonAdministrator
Can you add your results from BEFORE T3 was added
Unless FT4 was very over range, that's a MASSIVE drop in Levothyroxine from 250mcg to 100mcg
Levothyroxine should only be adjusted in small steps
Standard protocol when adding T3 is (if FT4 is near top of range) to reduce Levothyroxine by 25mcg and add in 5mcg T3 in morning, and (if no adverse reaction) add another 5mcg T3 mid afternoon
Hold at this and retest bloods 6-8 weeks later
You have high antibodies so cause of hypothyroidism is due to autoimmune thyroid disease also called Hashimoto's
Low vitamin levels are EXTREMELY common.
Have you had vitamin D, folate, ferritin and B12 tested?
What vitamin supplements do you currently take?
Are you on strictly gluten free diet?
At this stage you better stick on current doses and get thyroid and vitamins tested after 6 weeks
For full Thyroid evaluation you need TSH, FT4 and FT3 plus both TPO and TG thyroid antibodies tested. Also extremely important to test vitamin D, folate, ferritin and B12
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
Day before blood tests suggest you split your mid afternoon dose of T3 and take 5mcg mid afternoon and 5mcg at about 9pm
Many of us find small 5mcg dose of T3 at bedtime gives very good sleep
Private tests are available. Thousands on here forced to do this as NHS often refuses to test FT3 or antibodies or all vitamins
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
Suspect you will see very significant drop in FT4. If so you may need to increase Levothyroxine back up in small 25mcg step
Come back with new post once you get results and ranges
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