Update, since adding T3. Now what?

[saritadelmar]

After several years of difficult symptoms, I am now finding that a very low dose of T3 (5mcg) added to now 75 mcg Levo (lowered from 100 to add T3) is helping, but I feel there is still room for improvement. My latest results after two months with 5mcg T3 added are:

TSH: 0.46, (0.40 - 4.50)

T3 FREE: 3.1 (2.3 - 4.2)

T4 FREE: 1.3 (0.8 - 1.8)

For comparison: Previously on 100 mcg Levo only, results were:

TSH: 0.18 (0.40 - 4.50)

T3 FREE: 3.2 (2.3 - 4.2)

T4 FREE: 1.5 (0.8 - 1.8)

Could lowering my now 75 mcg Levo dose to 50 mcg, and then add 2.5 more T3 by splitting a pill, help to achieve better results both in blood work and feelings of intermittent lethargy and aching? I have an Endo appointment in 5 days and would like to ask for a dose change then. I have an understanding, but not well-informed Endo. So any suggestions will be greatly appreciated as always.

[shaws]

The following link may be helpful. It was by an Adviser to TUK before his accidental death. He only took one blood test for the initial diagnosis and thereafter it was all about 'our clinical symptoms and were they being relieved'.

naturalthyroidsolutions.com...

[saritadelmar in reply to shaws]

Thank you for the link. I will read now.

[SlowDragon Administrator]

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 or splitting of dose day before test

Is this how you do your tests?

Do you have Hashimoto's? Diagnosed by high thyroid antibodies

If you have Hashimoto's are you on strictly gluten free diet?

When were vitamin D, folate, ferritin and B12 last tested?

What supplements do you currently take?

Suggest you consider adding 2nd 5mcg dose T3 8-12 hours after first dose

Retesting in 6-8 weeks

[saritadelmar in reply to SlowDragon]

Thank you for your response SlowDragon. I have followed all the instructions you mention at the beginning of your reply. I have Hashimoto's and am on a gluten-free diet. I've had all the tests you suggest and all were okay. I posted them here a few months ago and got confirmation on that. I take Vit D, Vit C, and Magnesium.

Are you suggesting that I add another 5mcg T3 instead of the 2.5 split of the pill? If so, then I would have to lower Levo to less than 50mcg, correct?

[SlowDragon Administrator in reply to saritadelmar]

Why would you need to reduce Levothyroxine?

FT4 has already dropped. FT3 has dropped slightly too

Your TSH has risen since reducing Levothyroxine. You don't want to drop Levothyroxine further

Many of us need good FT4 and FT3 levels.

[saritadelmar in reply to SlowDragon]

Okay, I will not lower Levo. But are you suggesting to add another 5mcg? Or should I start with adding a half pill of 2.5 to take 8 hours later? Thank you so much for your advice.

[SlowDragon Administrator in reply to saritadelmar]

A second 5mcg dose

5mcg T3 is roughly equal to 15mcg Levothyroxine.....so as your results show .....in effect you had dose decrease when Levothyroxine was reduced by 25mcg and only 5mcg T3 added

Presumably you will need to discuss increase in prescription with endocrinologist

Do you get 5mcg tablets or do you have to cut 20mcg tablets into 1/4's?

[saritadelmar in reply to SlowDragon]

I get 5mcg tablets. My Endo said it equaled 25mcg of Levo. We were trying to keep the level at 100mcg, as I was feeling better since raising dose from previous 88 mcg. Didn't feel well on that.

[SlowDragon Administrator in reply to saritadelmar]

Yes endocrinologists believe T3 is rocket fuel

Thyroid patients experience (and your blood test results) suggest 3 to 1 is more accurate

Your results since starting T3 show higher TSH, lower FT4 and slightly lower FT3

This suggests you need dose increase

[SlowDragon Administrator in reply to saritadelmar]

Your lucky to get 5mcg tablets (vast majority of UK patients have to cut tiny 20mcg tablets into 1/4's)

Obviously you could experiment with only adding 2.5mcg T3 as second dose

Retest 6-8 weeks later

[saritadelmar in reply to SlowDragon]

Thank you so much for your detailed reply. I will leave Levo at 75 and increase gradually with half tablet 2.5 and test 6-8 weeks later. It is so helpful to get feedback. I would never figure it out on my own. Thanks again.