Feeling under medicated in spite of t3/t4 lévels being better than ever

[Piggyoink]

Hello lovely community, I am wishing you all improved health with the coming new year and beyond.

I’ve been titrating slowly since April and trying not be be frustrated however I’m still suffering from terrible constipation, some brain fog, huge lethargy and generally off.

My recent bloods on 75mcg thyroxine and 20mcg lio ( all taken first thing) were:

T4 16.5 ( 10-20)

T3 6.4 (3.5-6.5)

TSH 0.01

Vit D 98 (50-200)

B12 458 (90-800)

Folate and Ferritin all in good range

Tests always carried out as per advice here

Understandably Vit D has gone down slightly so will supplement a little in these winter months as I’d previously gone over range

I want to increase t3 however I’m worried of the side effects. I’d previously gone from 25 to 20 just because I’d gone slightly over range but I didn’t have the associated side effects at all ( in fact I still felt sluggish and undermedicated)

I’m gluten free and have a very good diet, mostly plan based but with lots of fish and loads of veggies, but currently finding it very hard to work or exercise. I just want to get back to normality!

I’ve been so slow and thorough with titration that I know I haven’t yet found my ‘sweet spot’ but I’m so tired... so very tired of hoping for a miracle. I’d previously tried porcine metavive and probably felt my ‘best’ on it (although not quite ‘there’,) and I’m considering going back on it although I’m petrified of the repercussions given the colossal fight I had to get T3 prescribed. I’m at a loss as to what to do.

Would I cause any damage if I took an extra 5mcg of T3 even though I’m at the top of the range now and have not had ANY symptoms of over medication previously? Or if I was to change back to Metavive what dose should I be replacing my current thyroxine and T3 with and how would I go about it? Would a straight ‘like-for-like’ dose swap be ok or too brutal on my poor old body?

THANK YOU ALL SO MUCH AGAIN IN ADVANCE FOR TIUR INVALUABLE ADVICE

💜🙏🏾

[SlowDragon Administrator]

How do you take your T3?

As single dose or as 2 or 3 split doses?

Do you supplement a good quality daily vitamin B complex?

Or magnesium?

Magnesium can help improve constipation

How long before blood test was last dose of T3?

Was this a 5mcg dose?

[Piggyoink in reply to SlowDragon]

Hello SlowDragon rh all you so much for your swift response! To answer your questions:

1. I take T3 & t4 as soon as I wake up and do t eat anything for at least an hour but usually longer . No split doses

2. Yes I take great supplements under the care of the London clinic of nutrition, who are excellent and knowledgeable thyroid supporters

3. Magnesium citrate x 2 capsules every night before bed

4. I took the full 20mgc dose of T3 around 11hrs before the blood test ( I have done the same each time, with T4 24hrs previously)

Thanks so much for any light you can shed on this! 🙏🏾🙏🏾🙏🏾

[SlowDragon Administrator in reply to Piggyoink]

Personally I think you should definitely split dose the day before testing...just taking 5mcg dose 8-12 hours before blood test

Perhaps experiment with splitting dose everyday. Some people need to split dose to get best effects

Others find single dose is best

Everyone is individual

[Piggyoink in reply to SlowDragon]

Thank you - I tried this but feel so very punch drunk when I wake up and need the full blast! Will try the split dose for the next test to see if that helps... would you know however, how many porcine metavive I should take to roughly mirror the T3/T4 dose I’m currently on? And would it be wise for me to swap all in one go? I don’t think I can go through any more months and months of titration! 😭😭

[SlowDragon Administrator in reply to Piggyoink]

Sorry no idea. I couldn't tolerate NDT

And can only tolerate T3 as split doses

I would always change anything over slowly and cautiously

[adin]

I wonder if you should not increase the dose of t4(to 100mcg)