O.K, I'm now more confused than ever before. I was under the impression that I would be on a combination T3/T4 process but now I'm told to drop from 200mcgs a day to 50mcgs with 20mcgs a day split into two doses. I'm barely functioning on 200mcgs a day let alone dropping from 200mcg to 50mcgs. She mentioned that my RT3 would be affected or something.... Throw into the mix that I have just had 3 embryos transferred on Monday 21/10/2019...The more I learn/know, the more I don't understand. I do NOT want to go from years on T4 only to being on T3 only for the rest of my life!!
Maybe I should just give up on the fallacy of ever being a mum and resign myself to living with all the symptoms of underactive thyroid and eventually suffer from Dementia like my mother - ignorant bliss to end my life with!!! - Fed up and P'd off!!
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Yammie1973
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Ummm… can you give a bit more detail, please? Are you saying that you have been reduced for 200 mcg levo only to 50 mcg levo + 20 mcg T3? That is sheer insanity. You cannot drop levo by 150 mcg in one go. The 20 mcg T3 is hardly going to make up for it. I think you should question this thoroughly before doing it. It doesn't sound to me like the doctor in question has the first idea what they're doing. Normally, one would drop levo by 25 mcg and add in 5 mcg T3, to be increased by 5 mcg every two weeks until you get to 20 mcg. Ease the body into it gently. This regime the doctor is suggesting is more like a blow from a sledgehammer than a gentle slide.
Oh thank God, I thought that I was going crazy!! So far I have reduced to 175mcg T4 with 10mcgs per day off my own bat!! and seeing how I feel with it, so far very little change for me but early days. The doc mentioned that I should be taking basal temps etc, but I'm confused when to start doing this either??
Basal temperature is normally taken early morning, before getting out of bed. Not something I can do because I'm always dying for the loo! lol But, that's the way I read it. I thought that was démodé, these days. I didn't know doctors still recommended it.
Whether or not you continue to reduce the T4 depends on your blood levels and how you feel. We're all different when it comes to T4 needs in a T4+T3 combo. For the time being, I would leave it were it is, if I were you. You can adjust it later. But, yes, continue to increase the T3 by 5 mcg every two weeks. When you get to 50 mcg, hold for six weeks and retest. And, see how you feel, of course.
As far as T4 is concerned, noted I will leave it at 175mcgs and gradually increase the T3 by 5mcgs every 2 weeks, till I get to 50mcg and then stick at that level for six weeks and get my bloods done via medichecks and display them on the forum for interpretation.
I think you should consult your IVF clinic urgently about what this doctor is saying you should do. As greygoose says your doctor is mad. And not only that I think she is drastically reducing your chances of becoming pregnant.
The TSH is not a good way of determining whether or not you are properly treated for hypothyroidism (or hyperthyroidism, for that matter). Nor does the level of TSH cause any symptoms.
The most useful result is the Free T3 - it is the active thyroid hormone required by every cell in the human body. Hypothyroid symptoms are caused by having too low a level of Free T3. Hyperthyroid symptoms are caused by having too high a level of Free T3. It is important to point out that some people make mistakes when identifying which symptoms are connected with hypothyroidism and which are connected with hyperthyroidism. Some symptoms can occur in both conditions, for example, developing a fast heart rate or having high blood pressure.
Unfortunately for us, doctors are taught that TSH is "the gold standard" measure to identify whether levels of hormones are correct or not, and its nonsense in many situations.
A 25mcg drop in Levo is, perhaps, okay. But you don't have enough information to be sure one way or the other with only a TSH to go on. The doctor who suggested a 150mcg drop in your Levo should be avoided like the plague! I would agree that too high a level of Levo is not a good idea for a woman who is pregnant or hopes to be pregnant very soon. But too low a level of Levo is a bad idea as well.
So, who told you to drop by 150 mcg and add in T3? And did they do that without even testing the FT4/3? I think your fertility clinic is wrong in saying that your dose was too high just based on the TSH only. It is a very poor indicator of thyroid status. Your TSH would be suppressed but your FT3 still too low. This is beginning to sound complicated.
The FMS told me to stop all T4 for 3 days except for 50mcg and then start on T3 of 10mcg in the morning and 10mcg in the evening and gradually build the T3. This was based on my last medichecks results in July. The fertility clinic said that they were not happy with me taking 200mcg after drawing their own blood samples from me, so I am assuming that they were reliant on NHS info. Now you can see my confusion.
It is very confusing, yes. Even more so as I have no idea what an FMS is! Whatever it is, it knows nothing about thyroid and has given you very bad advice, setting you up for a very, very bad fail.
Have you posted your last medichecks results?
The fertility clinic doesn't seem to know that much, either. They are just going by the TSH, which is so very wrong. I would have expected better from them.
FMS - Functional medicine Specialist - she is a GP as well as a thyroid patient and functional medicine specialist. Yes, I did back in July, had to wait till September to see her. The fertility clinic specialise in fertility issues, not thyroid so rely on the NHS guidance for thyroid issues - I agree they should know better but then there is only a hand full of endocrinologists, thyroid trained, who know what the H$%% they are talking about. The chances of the fertility clinic choosing one of them is slim to none!
Luckily I always go off instinct and how by body feels and independent bloods - I'm beginning to think that is the best way forward!!
Well, the way forward is obviously not with an FMS! She has no idea! How well is she herself, if she's hypo? Because she's not going to make her patients well with her crazy ideas.
But, I should have guessed what FMS was, because these doctors always have weird ideas about how to treat hypos, and no actual knowledge.
The most common way of starting on T3 is as greygoose said....
Reduce Levothyroxine by 25mcg and add in 5mcg twice day, (waking and mid/late afternoon )
Hold at this dose for 6-8 weeks and retest
Recommended on here that all thyroid blood tests should ideally be done as early as possible in morning and before eating or drinking anything other than water .
Last dose of Levothyroxine 24 hours prior to blood test. (taking delayed dose immediately after blood draw).
This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, best not mentioned to GP or phlebotomist)
If/when also on T3, make sure to take last dose 8-12 hours prior to test, even if this means adjusting time of last dose day before test
There are very few endocrinologists who will allow any T3 whilst pregnant. But there have been few members on here who have done so. You still need good levels of FT4 during early stage (while baby is relying on your thyroid hormones until their own thyroid starts working)
So it would seem utter madness to
A) drop Levothyroxine so dramatically for anyone
B) especially if about to have embryo transfer
You might need to retest sooner than 6 weeks to check levels aren't going haywire
Obviously before Levothyroxine was invented, hundreds of women had babies whilst taking NDT
Hi slowdragon, I had 3 embryos transferred on Monday 21/10. Luckily I went on instinct and reduced my T4 by only 25mcg to 175mcg and am only using 10mcg a day of T3. As I went with a private fertility clinic, they relyed on NHS guidelines, which surprised me no end, so T3 is not mentioned and that's the way I'm going to keep it. I"m not stupid but I will be cautious.
i thought id read somewhere that fertility clinics tested for T3 due to it being so important in pregnancy, but from what s said on here, it sounds like i m probably wrong
I have been with the same fertility clinic for over two years and they have never tested for T3 ever...only TSH which you have probably read all over this forum is SO wrong!! I agree this should be the gold standard but it isn't, sadly.
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- Fed up and P'd off!!
Medichecks new instructions?
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