Increased T4 (levo)

[Coachgeorge]

My doc increased my levo from 50 mcg to 75 mcg. I don’t understand half life or how long it takes certain medications to make a change. About how long will it take to see any changes? Thanks so much!

[SlowDragon Administrator]

Usually 5-10 days to notice some effect. On going improvements for several weeks

Bloods should be retested 6-8 weeks after any dose change

You can start noticing returning symptoms after about 6 weeks, if you are still on too low a dose

[Coachgeorge in reply to SlowDragon]

Thank you. Trying to figure out dosages for T4 and t3. I started 10 mcg of t3 (had been 7.5) Monday and the anxiety was awful. I know it’s a low dose but I’m very sensitive to meds. Had a draw yesterday for t3 and vitamins as doctor didn’t order those last week with the T4, tsh and folate. Told me not to take any t3 today and increased levo to 75mcg. I have to call her late today to see if there was a change without the t3. I think it’s too much t3 and not enough T4. I think 5-7.5 t3 is where I need to be. Should have bloods back later today. This is a balancing act and my patience is thin.

[msmono in reply to Coachgeorge]

My sympathy - the balancing is difficult I'm finding but there's lots of support and info on here which I've found helpful. Let us know how you get on

[Coachgeorge in reply to msmono]

Agreed! I’m learning but the process is slow, serious brain fog. Best for you!!

[greygoose]

If you only started 10 mcg T3 on Monday, yesterday was far too soon to test. You should be on a dose for six weeks to get meaningful results.

I don't really understand what's going on, she told you to stop T3 and increase levo to 75? Have you stopped T3 for good?

[Coachgeorge in reply to greygoose]

No just for today while we wait on bloods. I don’t think I could’ve taken another day on 10mcg. My anxiety was unbearable. We tried 10 mcg once before and I reacted the same way. Shakes and nausea were awful. Things aren’t great today but I’m not as bad. My T4 was low last draw, 1.19 (.8-1.8). It dropped from 1.32. Probably should’ve waited to increase t3 from 7.5 to 10 until after draw. I’m hoping my t3 is where it needs to be and I just need more T4.

[greygoose in reply to Coachgeorge]

T4 was probably low because you'd added in T3. That makes FT4 drop.

To be honest, you won't know where your FT3 is because you were on 10 for three days, which will have messed up the results.

[Coachgeorge in reply to greygoose]

Figures, I just can’t get this right. Actually, my doctor told me , “we are chasing our tails with these med changes” Told me I basically need to suck it up and stay with a process. I won’t get better until I do.

[Greekchick in reply to Coachgeorge]

I think your MD is right - you need to stay the course you are on for 6 weeks or so - since you have brain fog I will repeat the advice of many - you need to be patient and give things a chance to work. Wishing you all the best.

[Coachgeorge in reply to Greekchick]

You are so right. I just couldn’t take the anxiety. Since we tried the increase once before and it didn’t work, I just felt like 10 was more than I could handle. I’ll be interested in how she wants to proceed with the t3 after today. I am hopeful 75 mcg of levo with a lower dose of t3 will help me. T3 makes me feel like I’m “speeding” if I take more than 5, 7.5 is even a push. I’ll do better with my patience. Thanks for hanging in there with me.

[Coachgeorge in reply to greygoose]

Okay so if T4 dropped because I’d added 7.5 mcg of t3, then I probably should’ve increased T4 and not t3, right?

[Angel_of_the_North in reply to Coachgeorge]

No, not necessarily, You don't need free T4 as high if you are taking T3 as pretty much all T4 is for is converting to T3,. If you don't do that well, raising T4 doesn't do anything useful - just converts to rT3 instead of T3 and then to T2 after a few hours. Generally, it's best to start with 5-6.25mcg T3 once a day for at least a few days, then 5-6.25mcg twice a day for a week or so, then, if necessary 5-6.25mcg three times a day or increase first dose to 10-12.5 mcg and so on. If you've been hypo for a long time, "speeding" might just be how normal people feel.

[Coachgeorge in reply to Angel_of_the_North]

Thank you. I’m not sure I understand all the information. I know whenever I take more than 5 to 7.5, no matter how I divide it, I get worse. I’m going to try 5 mcg of t3 divided in half and 75 mcg of levo for a few weeks. If that doesn’t work, I’ll have to try something else. I know I’m discouraged as I’m ill everyday. This group keeps me going. Some days I’m hopeless. Brain fog is terrible. So, it’s helpful to read the responses over and over. I know I’m looking for the magic bullet. I appreciate the reminders that it’s going to take time. Best

[Greekchick in reply to Coachgeorge]

Whatever you do please stay on the same dose for the next 6 weeks! You need to have a consistent blood work reading and your doctor is right 🤗 you are chasing your tail as she said.

[Coachgeorge in reply to Greekchick]

Thanks for staying on me. Grey goose is doing the same. Feel like a child who needs constant reminders from adults 😭

[Greekchick]

Coach,

You are far from a child - you just need to stay the course for awhile and stick it out. All the best.

[Coachgeorge in reply to Greekchick]

Thank you.

[NWA6]

I just gave myself an increase of 25mcg per day x 5 days (so Mon- Friday) and I decided to add it to my nighttime T3, just for shits and giggles! 😂 I’ve no idea scientifically if it makes any difference but yesterday and today I’m feeling the benefits. So based on my own personal experience I’m going to say 2wks before you ‘feel’ the changes. HTH 🤗

[Coachgeorge in reply to NWA6]

I’d be happy with two weeks if I could be functional. Happy for you!!

[MichouVP in reply to Coachgeorge]

exactly! I’d just be happy with 2 days in a row!

[MichouVP]

For me it took several 2-3 weeks to start to feel any effects.

That’s a big jump up according to some like my doctor who only I created me from 50 to 62.5 Levo and said to stay there 6 weeks before increasing. So if at 75 you start feeling side effects of it being too much (like sweating & increased blood pressure) and have half life withdrawals later in the day (like heart pounding & feeling strangled), you could try splitting the dose morning + night.

Good luck