Is it safe to jump straight back to full dose of Liothyronine?

[Unsunghero]

If anyone read my post a few days back, I have had problems getting my Liothyronine which has ultimately meant no T3 from Thur until today. I have missed around 18 doses of 10mcg Liothyronine.

Thanks to the help of another member, I now have my T3 again.

My energy levels dropped pretty fast and I've had muscle aches and bad headaches all weekend, barely sleeping. A lot of which will be to do with the stress of it probably. Around mid day today I starting getting a stabbing pain in my chest which has been on and off and still happening now. Again, probably just from the stress and possibly also muscle aches?

I have never missed a dose of my Levothyroxine or Liothyronine before so am unsure what I should expect symptom wise.

Is it safe for me to go straight back onto 10mcg of Liothyronine 4 times daily after missing so many does or should I be working my way back upto this?

Thanks in advance!

[Lalatoot]

Mt instinct would be to work up to it. You know your body best so what does your instinct tell you? As you have asked the question I presume you are doubting the wisdom of jumping straight back in.

I got my next prescription sorted easily from the endo so things working out for me too.

Glad you got your t3.

[Unsunghero in reply to Lalatoot]

Yes, exactly that. Instinct says don't jump right back in.

That's great. I do like hearing when people are getting their prescriptions sorted!

[SilverAvocado]

Unsunghero, a tricky question, and I doubt there is any settled option about this.

Your body will be crying out for your hormone, and I'm sure the symptoms you mention are due to missing your T3. I will get very ill within a few hours of a missed dose, and when I have had to go off all hormone I've found I have a particular crash at around day 3. These are strong tablets and hypothyroid is a serious illness.

I should think it will take several weeks to get fully settled and back to where you were before you missed tablets, so it's also a matter of not wanting to prolong that.

Having typed that all out my impulse would be to go right back on your usual dose. In no way will your body be used to the 'new' dose in just a few days, and it will be a big stress to the body to suddenly have had the dosage removed. But I think it's a judgement call.

Make sure you get a lot more rest than usual and be very kind to yourself while you're going through all this!

[Unsunghero in reply to SilverAvocado]

Thank you for the advise.

I have ended up going straight back onto the full dose but taking smaller amounts more regular.

It is reassuring to hear people say how fast they are affected once they miss their T3. The feedback I was getting from my GP was that it would not effect me as fast as I told them it was. I was told that there was no way I would be feeling so ill after just a few days.

You are not the first to mentioned you feel it after missing one dose. It really has hit me hard and my doctor was making me doubt myself and start thinking it was in my head.

Unfortunately the resting is something I'm going to struggle with. I will try to get more and work are actually been extremely supportive and helping where they can. I'm just feeling at the point if I don't manage to get some real rest soon I will make myself worse.

[SilverAvocado in reply to Unsunghero]

Doctors tend to be manipulative to the extent of real abuse in my opinion. They talk as if this illness is very trivial and you won't have any discomfort. Missing your T3 for almost a week is huge! T3 has a half life of around 6 hours, so within a few days there is almost none left in your body. 40mcg per day is a pretty substantial dose, too, so you really need it.

I would be in bed all day with no meds, I don't think it would be out of order to take a week or two off work sick to recover. I agree with you that this is your long term health at stake, and sometimes these shocks do have a permanent impact on your body.

Thinking about it, when I've gone down to no hormone at all for radioactive iodine treatment it's been ten days off all hormone, so you are getting quite close to that! I've had to do that three times, and I'm sure that kind of ordeal has contributed to the fact thyroid hormone doesn't get into my cells properly.

With Levothyroxine it would be very different, as it's much slower acting. With nearly a week of no hormone you would probably feel a few symptoms, but T3 is super fast so they can start within hours.

[Unsunghero in reply to SilverAvocado]

I really do need to find a better Doctors surgery to be honest. The reception team are amazing, but the doctors, particularly the one I'm usually assigned and the practice manager are useless.

I just also worry about changing GPs while I'm still working on getting my levels stable.

I really do feel like I want to and need to just be in bed. I'll see how I am feeling after the weekend and if the T3 is kicking back in.

That sounds truly awful coming off it for ten days! Then throw the radioiodine in too! You haven't had radioactive iodine three times?

[SilverAvocado in reply to Unsunghero]

Unfortunately most GPs are pretty dire, and if you find one that is only okay then that might be the best you can get!

If you're in the UK and getting 40mcg of T3 per day prescribed then that is gold dust, and you should probably hang on to whoever started and maintains it for as long as you can. At the moment people are having their T3 taken away all over the place.

For my cancer treatment I had one treatment dose of RAI and two scanning doses (for the scan, the iodine is sucked into any thyroid tissue that remains, and the radioactivity can be picked up on the scan). I ended up having an extra scan a couple of months later because the first one was inconclusive. At the time I was very very hypothyroid so I hardly really knew what was happening.

Be as gentle with yourself as you can while you're going through it. I know from experience that it's always very hard to stand up and tell people that you're sick and need to be at home resting,