My Levo was increased to 75mcg on the 02/10/2019 and I initially felt better, but more recently I’ve been feeling like I need an increase. Symptoms are nowhere near as bad as they have been, but I don’t have the ‘get up and go’ energy I would like with 2 kids, a dog and a job!
I have an Endo appointment on the 04/12/2019, and a full thyroid blood panel scheduled for Monday next week.
I bought some T3 (Tiromel 25mcg) when on holiday in Turkey in the summer but thought I’d give the Levo increase a try before giving it a go.
My question is, would it be worth trying the T3 for a few weeks, after my blood test on Monday, before I see the Endo? Would the T3 be out if my system before my Endo appointment if I came off it a week before my appointment?
Your advice, as always, would be greatly appreciated.
Many thanks
Rob
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DaddyCool2001
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No don't touch the T3. You are undermedicated on levo. When fully treated our tsh should be 1 or lower. Yourft4 is nowhere near the top of the range so you have plenty of room for an increase. This will raise your FT3 level and for me I would like that to be in the 5s.
I don't think there is evidence of a conversion problem yet.
If you start T3 it takes a while for your body to adjust same as levo so you are talking weeks - that is once you have built up to a therapeutic dose. You would be adding different hormones to your system and your body would need to go of and re-adjust itself to a whole new ballgame. Plus you don't know how you will react to T3. It is not a magic wand and not an easy solution.
Take the Patient Information leaflet for levo as it explains that you need to increase by 25mcg and have blood test every 6 weeks until you reach optimal dose for you. Think its between 100 - 200mcg from what I recall. You can print one off if you google it. I was on 75mcg for years and obviously undermedicated. The cardiologist even said to keep me at that dose to keep my metabolism right (every time I tried to go up I would get palpitations!). Stupid thing was he even commented that I had a goitre and never once suggested I see an endo, but I knew nothing about health matters back then, and so of course believed him! You can give the PIL t the endo if she refuses to raise your dose!
Highly likely you need next dose increase in Levothyroxine
75mcg Levothyroxine is only one step up from starter dose of Levothyroxine
The aim of Levothyroxine is to increase the dose slowly in 25mcg steps upwards until TSH is under 2 (many need TSH significantly under one) and most important is that FT4 in top third of range and FT3 at least half way in range
NHS guidelines on Levothyroxine including that most patients eventually need somewhere between 100mcg and 200mcg Levothyroxine.
Also what foods to avoid (eg recommended to avoid calcium rich foods at least four hours from taking Levo)
All four vitamins need to be regularly tested and frequently need supplementing to maintain optimal levels
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)
Levothyroxine should always be taken on empty stomach and then nothing apart from water for at least an hour after
Many people take Levothyroxine soon after waking, but it may be more convenient and more effective taken at bedtime
All medication at least two hours away from Levo. Some like HRT, PPI's, magnesium, iron or vitamin D, at least four hours away
Many people find Levothyroxine brands are not interchangeable.
Do you always get same brand of Levothyroxine at each prescription
Once you find a brand that suits you, best to make sure to only get that one at each prescription. Watch out for brand change when dose is increased or at repeat prescription.
Many patients do NOT get on well with Teva brand of Levothyroxine. Though it is the only one for lactose intolerant patients. Teva is the only brand that makes 75mcg tablet.
Cheers SlowDragon. Yes I always get bloods first thing in morning before taking any meds, take Levo an hour before food or other meds and supplements after lunch. I was on 50mcg of Activas and my GP added 25mcg of Teva to my prescription to make it up to 75mcg. I have reduced my gluten considerably since joining here. I used to eat bread for breakfast, lunch and tea. Now I never buy shop bread and make my own sourdough with my own starter, the difference has been amazing.
I absolutely agree with Lalatoot and SlowDragon. Do not take the T3, it will screw everything up. You're doing OK on the Levo at the moment, your TSH is still far too high so that indicates a dose increase is needed. Your FT4 and FT3 are reasonable levels for that TSH with FT4 being 41% through range and FT3 being 46% through range so they are balanced - absolutely don't show the need for T3 with those results. But wait until you are on enough Levo to get your TSH down to 1 or below then check how your FT4/FT3 look, if still balanced then there is no need for T3, your body will be doing a good enough job of conversion.
If I may ask, what part of Turkey did you visit on your holiday? I'll soon be out of Tiromel so I have to plan a Turkish holiday/supply run, but I am not sure where I can get it exactly. Do resort town pharmacies have it in stock?
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Just gotta convince the Endo to increase Levo now.
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