I need guidance on what to do: So an update on... - Thyroid UK

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I need guidance on what to do

Cheekycharlie1981 profile image

So an update on previous post, I’ve been taking my t3 at 2.5mcg daily with breakfast infact due to the strange reaction and me being nervous I’ve sucked on the tiny tablet as scared of over reacting.

Now I don’t feel myself my levothyroxine is 150mcg it was 175mcg and definitely not optimum levels then.

At the moment I feel spaced out my head feels crushed and some what heavy, horrible out of it feeling.

I had awful nights sleep woke in a panic which is not like me at all.

I really feel awful and thinking of stopping t3 and going back to 175mcg of levo. But I feel I’m giving up.

Why do I feel so heavy headed like I’m falling, my nerves are a state I’m feeling very on edge. Advice please.

I’ve wimped out of taking my t3 this morning.

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Cheekycharlie1981
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10 Replies
SeasideSusie profile image
SeasideSusieRemembering

I can't explain why you feel as you do I'm afraid but thyroid meds should be taken on an empty stomach, one hour before or two hours after food, and they are designed to be swallowed whole with a glass of water. Some people say that T3 doesn't need the same time gap as Levo, but personally I'd want to make sure nothing affects absorption of my thyroid meds so I treat Levo and T3 the same.

greygoose profile image
greygoose

The amount of T3 you're taking - plus the way you take it - is hardly going to have any effect on you at all. I doubt if any of it is getting into your system. However, you have reduced your levo, so you're probably under-medicated, now.

I’ve just not felt like this before. I’m taking my levo as normal away from food. The only change I’ve made is for over a week I’ve been on 150mcg and I started the t3 on Friday.

I’m a bag of nerves due to this warm reaction I’ve had but not had it with the way I’ve taken it.

My heads very heavy with a few headaches and I’m feeling very out of it and not aware.

So it could be under medicated rather than the t3? Should I stop it with my symptoms? I woke in a state last night and took me ages to get off.

When on the 175 mcg levo I slept pretty well but always feel tired but not like this.

My husband could not find my pulse last night it was that faint yet I felt my heart had just been pounding.

I need to relax but my bodies on edge.

Are headaches normal or any any of my symptoms related to starting t3? I’m starting to worry I’m

Under medicated.

SeasideSusie profile image
SeasideSusieRemembering in reply to Cheekycharlie1981

Are headaches normal or any any of my symptoms related to starting t3?

Have you checked the patient information leaflet to see what side effects are listed?

I know headaches is listed as a side effect of Levo.

SilverAvocado profile image
SilverAvocado

Hi Cheekycharlie1981, it's not uncommon to have a big struggle introducing T3. This is said to be caused by adrenal glands and other parts of your body that have to work harder when the hormone increases your metabolism.

On the forum I've observed this tends to happen with people who are very undermedicated and obviously do need the tablets. I looked back at your old posts and couldn't find any results with ranges so am not sure if that applies to you.

You can take steps to resolve this issue, and there are a few different strands that all need work at the same time. As you make progress in each area it will make the next area easier.

1. Address vitamin deficiencies and get your results optimal. Start with ferritin, folate, vit D and vit B12. You may be able to get your doctor to test these. If not get finger prick mailorder tests, see the ThyroidUK website for how.

2. Address and treat your adrenals. There is a lot that can be done. Start with lifestyle factors, reduce stress, rest more, learn to meditate, sleep well, eat healthily and don't skip meals, etc.

Think about ordering a 24hr adrenal saliva test. After you know how you do on the test you can think about introducing adaptogen herbs or adrenal extracts.

Unfortunately your doctor probably won't help, unless you turn out to have Cushings or Addison's disease.

3. You can start taking the T3 but introduce it super slow. Grind the tablet or cut into tiny pieces with a razorblade. Get the tiniest crumb of tablet you can reliably make up. Instead of starting on 2.5mcg start on this tiny crumb. Take that dose with your Levo for a few weeks, and if symptoms don't return increase the daily dose by another crumb. If you still get symptoms, cut an even tinier piece (or wait until you've had improvement in 1 and 2 and try again) or if you get them later in the process drop back to the previous dose and stay with that a few more weeks.

I wouldn't suggest reducing your Levothyroxine dose at all until you're able to take more than 2.5mcg of T3. As others have mentioned, taking that decrease means you're now dealing with symptoms of undermedication from that at the same time as trying to introduce T3. If you get to the point where you can jump up to 5mcg daily of T3 reduce your Levo dose by 20mcg.

Cheekycharlie1981 profile image
Cheekycharlie1981 in reply to SilverAvocado

Thank you for your response.

Yes I definitely feel under medicated never had so many symptoms. I at least need 175mcg of levo to feel normal and now that’s 150mcg and I’m only now tolerating the 2.5mcg t3. I feel a bit weird but I’m taking it.

Should I increase my levo back up? My endo wants me to take 5mcg t3 and 150mcg levo but that’s not adding up to the 175mcg levo I had I’d been on, it would be 10 mcg t3? According to the dosage guidelines. Shall I take 175mcg/150mcg alternative days? Least I’m not in such a low place then I’ll ask to increase to 10mcg t3 when I see my endo in 2 months time?

I defiantly need more than I’m getting and my endo is not very informed on dosage. I get my full bloods and vitamins done in 2 months time. I’m supplementing and my diet is good.

Again thank you all.

SilverAvocado profile image
SilverAvocado in reply to Cheekycharlie1981

T3 is about 3-5x more potent than T4. In my own dosing I always assume 4x. So the 2.5mcg of T3 you're taking now is the equivalent of about 10mcg of T4, and if you can get onto the 5mcg of T3 that would be equivalent to 20mcg of T4.

Doctors tend to assume T3 is more on the potent side. I've seen them use up to 10x stronger. Your doctor may be assuming 5mcg of T3 is the equivalent of about the 25mcg of T4 you've been reduced by. As long as there is the option to have a dose increase a bit later with that I think it's okay to use that assumption.

If you're now successfully along the 2.5mcg of T3 you could reduce your Levo by 10mcg (from your original dose of 175mcg). With Levo it is very slow acting, and its okay to average your dose out over the whole week to add up to a 10mcg per day reduction.

Also if you're tolerating the 2.5mcg of T3 okay you could try to go up to 5mcg in a few weeks or once its settled down. It's completely fine to wait 6 weeks if you want to without really losing time. You could do it in two steps if you'd like to.

Cheekycharlie1981 profile image
Cheekycharlie1981 in reply to SilverAvocado

My levo was reduced a week before I started the t3 as told by my endo. It’s taken me 2 weeks to actually take the 2.5mcg normally.

I’m now very tired and under treated.

I’ve read your post so ideally I need to be on 10mcg due to my 25mcg reduction of levo.

I’d hope once I see him he’d increase it.

So should I not increase the levo alternative days and hold out under medicated to see if I can get an increase in t3?

Cheekycharlie1981 profile image
Cheekycharlie1981 in reply to Cheekycharlie1981

Also I find what your saying about adaptogen herbs interesting. I don’t have a gallbladder any more so herbs like Turmeric can over stimulate gall production. Any that are safe to use long term? I try to avoid to much liquorice as I have enough of that in herbal teas.

My t3 conversion has slowly been getting worse, those results were posted awhile ago but my most recent.

I’m feeling very tired today, my legs are heavy not like me at all.

Should I increase the t3 to 10mcg instead of upping the levo? I’m

Not sure what’s best. The consultant is away on a long holiday so I’m suffering in silence.

SilverAvocado profile image
SilverAvocado in reply to Cheekycharlie1981

10mcg of T3 is the equivalent of about 40-50 of T4, the T3 is about 4x as potent.

Managing to get onto 2.5mcg in two weeks is good progress. Just hang in there and hopefully you'll soon start to feel an improvement. If I were you I'd stick with 2.5mcg for two to six weeks, whatever makes you feel comfortable, and then try to increase by another 2.5mcg.

Generally I think it's not a good idea to hang around undermedicated when you don't have to be. All your other issues like vitamins, cortisol and any other conditions will be put under extra pressure and getting worse. Ideally only reduce by the amount of Levo that's the equivalent of the T3 you plan to add. Its okay to reduce the Levo a week or so early if you like. Levo is slow acting and slow to leave the body while T3 is very quick acting, so doing this gives the Levo time to leave your body. If you introduce the T3 slowly over two weeks its probably not necessary to reduce Levo early.

Most people prefer to increase T3 rather than T4 when they get a choice, because they will have felt an improvement when they first started it. I would wait until you've completed this current increase and held on the same dose for at least 6 weeks and had a new blood test before deciding what to do next. That way you'll have all the extra information from what you're trying this time.

Its hard to advise about adaptogens, particular before you've had a saliva test. Partly because there are so many to try and the field is so fuzzy so you really need to do your own research, and partly because some tend to increase and some tend to decrease cortisol so you need to know where your own results fall to make a choice.

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