More or less?

[Murphysmum]

First off, apologies. This must be like my 5th post in about two weeks!

However, something just occurred to me. A few months back I started T3/T4. Initially 10mcg/125mcg per day. Felt great, no symptoms, 100% better.

However, a couple of weeks back I started getting hard and neck pressure and some muscle weakness. I increased my T3 by 5mcg to 15mcg per day. Head and neck pressure seems to have gone but this week the muscle weakness is back with a vengeance, really bad.

I had thought maybe I needed to keep increasing T3 to around 20mcg per day as this seems to be quite a common dose - whether to change levo dose I wasn’t sure.

But tonight I wonder.... did I hit a sweet spot on 10mcg T3 and a slightly decreased dose of levo? Ie, the levo in my blood would be somewhere between my 175 and 125mcg doses when I felt fab.

Is it common to need to keep increasing T3? Do you always have to reduce T4 if bloods suggest it’s in the right area? (Last results were T4 18.7 (12-22pmol), T3 4.99(3.1-6.8pmol) and TSH 0.036.

Should I actually stick with T3 at 10mcg and increase levo again?

Heeellllppp, I’m thoroughly confused! And yes, my vits n mins are good, working on ferritin!

[Hidden]

What is your pulse and temp? I use pulse to guide T3 doses.

[Murphysmum in reply to Hidden]

Pulse is quite normal at around 60bpm resting. Was low prior to starting T3.

Temp - no idea. Might start checking that...

[Hidden in reply to Murphysmum]

You pulse would suggest that an increase of T3 would be both safe and probably needed. 60 is really quite low unless you are an athlete. A normal pulse for a fit healthy person is said to be around 75 but a normal pulse has a wide range from I suppose about 60 to 100. My pulse is about 95. I take it most days, if I was slimmer, fitter, younger I would expect it too be lower. I expect you will find that your temperature is low too. I really dont know enough about T4 and T3 combinations to advise much further. It is common for people to feel better for a couple of weeks after dose increase then relapse a bit until another increase and this continues until you are at the right dose. How long have you been taking iron? good levels of this might make a huge difference as your body will be unable to utilise the thyroid hormones properly if still low. I have left over 6 weeks between increases of T3 and am not sure of the ideal time frame for an increase. I hope others will advise more clearly on this and the combo.

[Murphysmum in reply to Hidden]

😬 eek, if my pulse was 95 I’d feel like I was going to explode! In fact, I did have a incident one night where my heart started racing - it started around 75 and went up to 105 and I felt horrible. So maybe below 70 is more normal for me? I’m no athlete though - I’m not very overweight but I couldn’t run to save myself!

I’m be been taking iron on and off for about 8 months now. I took two months religiously, then was bad and took one every few days and more recently, started taking them every day again as I was surprised my ferritin was still so low. I should say when I wasn’t taking iron I was eating pate or black pudding at least twice a week or more. That doesn’t seem to have had any effect at all.

Thank you for your advice, I will persevere with different T3 doses 😉

[JAmanda in reply to Murphysmum]

Racing pulse is a definite sign of overmedication. 60s normal pulse I think. Mines that now.

[Missydoo82 in reply to Murphysmum]

i would say 60 is an ideal pulse. I mean the heart doesnt need to work hard thats all it means. My pulse was 60-65 when I felt eally healthy and prior to thyroid medicine and now its 75 which i still feel its high and definatelly dont want it higher than that. It was 95 -120 when I was on too much t3 and I felt like I was going to explode. Now I am on a stable t3 dose (10mcg) and added extra t4 ( currently on 113 mcg) , so I will see what happens. The increase with t4 definatelly hasn't affected my pulse unlike t3 increase.

[Murphysmum in reply to Missydoo82]

I agree.

75 would be too high for me. I’ve had the odd occasion when I’ve felt like my heart is racing and it’s in the 70’s! 😳

My problem is I get quite a lot of skipped beats or palpitations and it’s usually because my thyroid levels are low, not high.

And yes, definitely more heart “things” going on now with T3.... pity I can’t feel it working on the brain “things” in the same way!!

[McPammy]

Have you got the ranges for the TSH blood results please. That figure seems quite low. Had you taken T3 before the blood tests? Or had you left a gap. I’m thinking you may be heading into being over medicated on T3. My experience is that my symptoms end up nearly the same if I’m under or over medicated interns of weakness. Also what dose where you on when these tests were completed.

Can I ask if you have trouble in converting T4 to T3. Have you had blood tests proving this. I’m only on5mcg twice a day, that’s all I need. I do have a conversion issue.

I think everyone is very different and there’s not a normal amount to take each day. Maybe age, weight, gender and diagnosis has something to do with a correct dose for each person. I also take Levothyroxine only 75mcg daily.

Do you split your T3 dose throughout the day. It has a short life 6-7 hours. I take mine twice a day as directed by my Endocrinologist. I use to take NDT then my previous endo didn’t tell me to split my dose. Splitting made a huge difference. From being great in the morning to very weak late afternoon with one morning dose. To great all day splitting it.

[Murphysmum in reply to McPammy]

Well, this is what I wonder!

I too have found that the muscle weakness particularly returns once I’m over medicated. This was proven with increasing doses of levo under the guidance of Dt Toft.

The TSH level is very low, range 0.2-4.2, (but higher than it has been) and this would seem normal for me. It’s always been suppressed.

Yes, I have trouble converting - I do convert, just not very well and it took my T4 levels to be at about 30 for my T3 to reach top of range on levo! (Sorry, o forget the ranges then but suffice to say that was seriously over!)

I think I may be like you, but it’s impossible to know isn’t it if the therapeutic effects have stopped because you need more, or because you’ve overdone it! 🙈

[helvella]

Stop apologising!

There are plenty who have posted five times or more in a day!

[Murphysmum in reply to helvella]

😂😂 ok!

Honestly, different ideas pop into my head several times a day, then when I feel well I don’t look on here for days at a time.

Thank goodness this forum is here though - we certainly couldn’t ‘pop’ to our gp with the same number of questions!

(Or expect sensible answers - before anyone else says it!!)

[RockyPath]

A resting heat rate is the 60s may be perfect for you. Everyone is different

My brother offered a brilliant idea several months ago when I was puzzled about dosing, and I’ve followed it successfully twice. If in doubt, stop everything and pay attention to how you feel. Measure pulse, temp, everything you use for indicators; Pay close attention to muscle weakness as the hours tick by. If you experience a point where you feel better, then falling levels are your proof that you were overdoing it.

With T3 of course you’re going to know within 24 hours. With T4 you’ll need more days. Have you ever tested your T4 limits by measuring rT3? Many people think it’s a meaningless measure, but, when it goes through the roof, this makes a pretty compelling indication that T4 needs to be cut back dramatically.

[JAmanda]

Head and neck pressure? I’ve been taking that as a sign of over medication not under. Could be wrong!!! I’ll see when I get a retest but am now taking far less than I was told to. 25 levo/5 lio instead of 75 levo/ 10 lio.

Not sure I’m helping - I have no idea! But I also got earache with the head squeeze feeling and I couldn’t stand it.

Feel ok.