Shall I reduce Levo?

[cazmania7]

Hey guys! Hope everyone is doing OK! Just seeking some feedback please!

I’m hypo and been on 125mcg levo for years. Started T3 a few weeks ago, started with a quarter, then half and about to take 3/4.

No changes as yet but had two nights of minor palpitations late at night.

I’m thinking to maybe reduce levo by 25mcg. Or shall I carry on and wait for bloods in a few weeks? Thanks guys!

[Hidden]

In my experience, it's always best to wait to have labs done before increasing or decreasing thyroid meds.

Some people need to decrease levo when adding T3, while others don't.

Your symptoms could be a sign of too much T3 and/or a cortisol issue (the latter is often discovered when T3 is added to the mix). There really is no way of knowing without labs.

Why did you add T3 in the first place? Do you have labs from when you were on 125 mcg levo?

[cazmania7 in reply to Hidden]

Hi Sanders, I have been unwell for years. Told it was depression CFS etc but after having private bloods done I found my T3 is really low and I tested positive for the DIO2 gene. So decided to self medicate! My T4 last test was 18 as I recall (12.00-22.00).

I have the cortisol saliva kit here but not got round to doing it yet!

[cazmania7 in reply to Hidden]

The palpitations feel like a flutter/tickle in my throat. Odd sensation. Feels almost like where my thyroid is, but my thyroid was nuked after RAI in 2015

[shaws Administrator]

You shouldn't add T3, without first having a blood test. Also it is normal to reduce dose of levo when adding T3. 25mcg of T3 is equal, in its effect, to 100mcg of levothyroxine. You are increasing dose too quickly,

Maybe this link will be helpful as it is by one of Thyroiduk's Advisers (now deceased).

nebula.wsimg.com/e0c9c9ed95...

[cazmania7 in reply to shaws]

Hi shaws! Thanks for your reply. I have indeed had tests done in order to compare and it was suggested that one would reduce levo if top end of range or over but have also read that some stay on the same dose.

I will reduce levo by 25mcg.

It’s been suggested that T3 is increased by 5mcg every two weeks until 20mcg is reached then hold for six weeks and test. That’s my plan anyway. Thanks for the link. I’ll have a peak!

[shaws Administrator]

You should go by your symptoms and if they're being resolved. Usually, when first adding in T3 to T4 we reduce T4 by an equivalent amount i.e. 25mcg of T3 has the effect of around 100mcg of levothyroxine so we may reduce levo by 25mcg and replace by 5mcg of T3 every few weeks and so on until we feel much better. I should also state I'm not medically qualified but take T3 only now.

[cazmania7 in reply to shaws]

Hey Shaws, thanks again for your reply! I have reduced my levo today to 100mcg and taking 3/4 of a 25mcg T3 for two weeks then will increase again and hold and test. Feeling very hopefully and positive! Just wasn’t sure what side effects to expect and stuff and if feeling a bit palpitation-y if that’s ok for a little while until tested next! It’s quite scary going alone but feel certain this is what I need to do 😀

[shaws Administrator in reply to cazmania7]

It's a shame we have to read and learn for ourselves and, hopefully, recover our health but that's what we have to do.