T4/t3 combo: How would i go about adding some t... - Thyroid UK

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T4/t3 combo

14 Replies

How would i go about adding some t3 to my levo..curruntley on 150..should i drop levo to 125 and add 12.5 of t3?tia

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14 Replies
Lalatoot profile image
Lalatoot

Have you got any blood results and ranges? It is difficult to help when we don't have any reference. Is your Ft3 low? Are your vitamins optimal?

SeasideSusie profile image
SeasideSusieRemembering

For members to help you will need to post your current results with reference ranges for

TSH

FT4

FT3

and because nutrient levels need to be optimal before adding T3 then the following are also needed

Vit D

B12

Folate

Ferritin

SlowDragon profile image
SlowDragonAdministrator

Before considering adding any T3 it's essential to test thyroid and vitamin levels

Nether Levo or T3 can work if vitamin levels are too low.

Do you have autoimmune thyroid disease also called Hashimoto's? Diagnosed by high thyroid antibodies

Low vitamin levels are especially common with Hashimoto's. About 80-90% of primary hypothyroidism is due to Hashimoto's

For full Thyroid evaluation you need TSH, FT4 and FT3 plus both TPO and TG thyroid antibodies tested. Also important to test vitamin D, folate, ferritin and B12

Low vitamin levels are extremely common, especially if Thyroid antibodies are raised

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 )

Is this how you do your tests?

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

Add results and ranges if you have them already

in reply toSlowDragon

All vits are fine..tsh is 0.6 ft4 is 34 dont know t3..i have no thyroid due to pap cancer.zBeen up and down on t4 for 12 months and dont feel good..only time i felt good was the two weeks on t3 only before rai

SlowDragon profile image
SlowDragonAdministrator in reply to

Your FT4 looks too high. What's the ranges on that?

You are legally entitled to printed copies of your blood test results and ranges.

UK GP practices are supposed to offer online access for blood test results. Ring and ask if this is available and apply to do so if possible, if it is you may need "enhanced access" to see blood results.

In reality many GP surgeries do not have blood test results online yet

Alternatively ring receptionist and request printed copies of results. Allow couple of days and then go and pick up.

vitamin D at least around 80nmol and around 100nmol may be better

B12 at least 500

Folate at least over ten

Ferritin at least half way in range

TSH is especially unreliable after RAI and being suppressed due to being hyperthyroid

Many need the addition of small dose of T3

Depending on what FT4 results are, depends wether you need to reduce Levothyroxine dose

in reply toSlowDragon

I was on 175 when ft4 was 34 so thats why ive been reduced to 150.problem is whatever dose ive been on im always got fatigue..weight gain brain fog muscle pains.endo didnt want to listen when i asked if im over medicated why am i putting all this weight o etc,so thats why i want to trial adding my own t3 for 3 months to see if it makes a difference

NWA6 profile image
NWA6 in reply to

Hey hun. You’d for sure have to get a full Thyriod function test before adding T3. You need a base line to work from otherwise you’ll be yo-yo-ing with dosage. Your FT4 is Waaaay over, not just a bit but farrrr too much! This can easily give you weight gain. So here’s what I’d do if I were you

1. Get TSH/FT4/Ft3/ antibody tests

Along with vitamin check. Medichecks/Blue Horizon/Thriva all do these (£50 - £100 depending on when they have offers)

2. Reduce your Levo till it comes in range, supplement with Vitamins if necessary. Cancer and treatment almost certainly will have battered your body.

3. If conversion issues become apparent then add T3.

It’s a long protracted road to recovery but you must take your time and do it right otherwise you swap one problem for another.

pennyannie profile image
pennyannie

Hello Kwl

Just as a point of reference a fully functioning working thyroid would be supporting you daily with approximately 100 T4 plus 10 T3.

I just think it makes common sense that when there has been a medical intervention and the thyroid either surgically removed or ablated with RAI and left in situ, both these vital hormones should be on the patients prescription for if, and maybe when Levothyroxine alone doesn't " do it " for the patient.

Some patients can get by on T4 alone, some patients simply stop converting T4 into T3 at some point in time and some patients simply need both these essential hormones dosed and monitored independently to bring them into balance and to a level of wellbeing acceptable to the patient, which generally means both T3 and T4 being in the upper quadrants of their relevant ranges.

Conversion of T4 into T3 can also be compromised if vitamins and minerals are not optimal, so ferritin, folate, B12 and vitamin D need to tested as no thyroid hormone replacement will work effectively if the body's essential core strength isn't in place.

The thyroid is a major gland responsible for full body synchronisation including your physical, mental, emotional, psychological and spiritual well being, and also regulates your own body's internal clock and central heating system.

There is a book that has helped me to understand my own situation which I still use and refer to :- Your Thyroid and How to Keep It Healthy written by a doctor who has hypothyroidism, Dr Barry Durrant - Peatfield. it's an easy read, sometimes funny and insightful but very relevant since as we don't now have this amazing little gland, we need to know what it does, and where possible, compensate accordingly.

I'm with Graves Disease and had RAI in 2005, and became very unwell some 6 years ago. I found no help or understanding within the NHS system. More recently I was refused a trial of T3 by the NHS and am now self medicating having trialled both T3 and Natural Desiccated myself, and getting my life back buying my own thyroid hormone replacement.

There is a lot to take in, read and understand, and thanks to this amazing site, I'm getting there, and so can you, just keep reading, follow the recommendations, and you too can turn things around and find better health for yourself.

SassyMH profile image
SassyMH

Hello. I had thyroid removed and radioactive iodine due to pap thyroid cancer and struggled for 5 years with various complaints that my GP could not explain. I was on 175 T4 which kept my TSH suppressed, but my T4 level quite high, if it was lower I couldn't function well. I now take T4 175/150 alternate days and T3 10mcg every day and am so much better. I was advised by Endo (who wouldn't see me as I didn't meet NHS criteria) that he "typically converts 50mcg T4 to 20mcg T3. It seems from reading on this site that we all have very different requirements and the condition you suffer from and the treatment you've had has a huge bearing on that. Good Luck.

R2d2c3po profile image
R2d2c3po

It is very much down to the individual. I had RAI treatment. On my TSH test only my Gp had set me on 75mcg of T4 only And I felt I’ll. I used private blood tests which showed both T4 and T3 were bottom of range. To get my T4 in top half of range and T3 in top third I take 100mcg if T4 and 5mcg of T3. . If you add T3 then do it by small amounts. Good luck

Thanks all,been on the lowered dose a month now so ill wait another month and get a full thyroid test with medichecks and post results.Meeting my endo in the morning but hes dead against t3😂😂😂

GKeith profile image
GKeith

If your endo is dead against prescribing any T3, if I were you, I'd get another endo. But that's only me. Peace be with you.

in reply toGKeith

Not as easy as that where i live..i travel over two hundred miles to see this one

GKeith profile image
GKeith in reply to

Really? Where do you live, for god's sake?

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