Slight Dose Change - help!

[Fmljkl]

Hi, I am desperate for some guidance. I've visited other sties but they just push MORE T3 which seems ridiculous to me.

Previously, I took 5mcg of T3 at 6am and 2.5 at 1pm. I took 88mcg of T4 at 10pm. My HR was uncomfortably high during workouts and I was EXTREMELY hungry from 8am - 6pm and no amount of food would fill me. I also felt really tired throughout the day and relied on coffee to stay awake until 9pm.

I was looking at old lab results and felt GREAT when my t4 was 1.24 (it is currently 1.14). SO, I decided to decrease t3 by 2.5 and just take 2.5 at 6am and 1pm and increase T4 to 100 at 10pm.

I tapered down my T3 for a few days before increasing T4. It's only been a week but I've literally gained 5lbs. Is this normal? How long should I give everything to level out?

OR would it be a better idea for me to simply space out T3 over three doses and take it at 6am, 1pm and 10pm?

HELP!

[Lalatoot]

There is no straight answer. Everybody is different and it is trial and error. The body does not like change and it takes 6 to 8 weeks for hormones and tsh to settle following changes.

You need to look at your Ft3 and ft4 results. Look at how far they are through their ranges and use that info to find your balance.

[Fmljkl in reply to Lalatoot]

I guess since I'm so early in the med change, I'm wondering if it would be wiser to start with spacing out the T3 (and taking it 3 times a day) instead of increasing the T4. Does that make more sense than increasing T4? I'm really weirded out by the immediate 5lb weight gain.

Can anyone advise what makes better sense? I'm guessing I should stick to T3 change b/c that is easier to tell if it works, correct?

[Lalatoot in reply to Fmljkl]

Taking T3 lowers Ft4 so if you want to raise your Ft4 then you would be better to increase T4 dose in my opinion. An increase from 88mcg to 100mcg is small and shouldn't have too much impact on your ft3 levels though it might increase them if you are a good converter.

You can try taking 3 doses of T3. You can take your T4 at the same time as T3.

To convert T4 to T3 you need calories so if you are working out and depleting T3 you will need calories to convert your stored T4 into T3. Are you sure you are not overdoing the workouts particularly if your levels are not stable?

The 5lb weight gain will be fluid. when we are hypo fluid can collect in the soft tissue.

You need to have optimum vitamin levels as well for T3 to be effective.

Make one change - wait 6 weeks and then test TSH, Ft4 and Ft3. Only by taking things slowly and monitoring bloods will you settle on the correct balance for you.

[Fmljkl in reply to Lalatoot]

Honestly, now I'm kind of thinking it's better to manipulate the T3 first since it's so fast acting. I think I would have a better idea of results within 2 weeks instead of 8.

I would take 2.5 T3 at 6am, 1pm and 10pm (with my T4). Then, check levels after a month and then increase T4 if I'm still feeling tired.

Does that make sense?

[Lalatoot in reply to Fmljkl]

No you will not get a true picture of results within 2 weeks. Yes t3 acts differently and has faster reactions but the knock on effects do not. Taking t3 affects ft 4 levels and tsh levels and these along with the changes at a cellular level take longer than 2 weeks to settle. Blood tests after 2 weeks would be meaningless.

[Fmljkl in reply to Lalatoot]

OK. What do I do? I’m lost.

[Lalatoot in reply to Fmljkl]

I would read grey goose's advice. She has a lot of experience and knowledge.

[Batty1 in reply to Fmljkl]

Fmljkl, I think the 5lb weight increase is freaking you out a little, just relax a little as sucky as it is and try not to add more exercise to combat you quick weight gain which is very unlikely true weight gain.

It takes eating and extra 3500 per day to actually gain 1 pound of fat and it's very unlikely anyone eats 3500 extra calories per day (possible) it seems unlikely.

I think lalatoot is right it's probably water.

[fuchsia-pink]

I was taken off T3 and put just back onto T4 and in 2 weeks had gained 2 kg in weight and started some brain fog and lost cheekbones. Happily my GP restored the T3 and this has all reversed. So yes, it can be very quick! I think you need to be guided by you, and tweak things until they seem to suit you properly, then keep stable for 6 to 8 weeks and re-test bloods.

[Fmljkl in reply to fuchsia-pink]

I'm just thinking it's better to have T3 circulating in your body all the time - I'm assuming that's how the body works when someone doesn't have hypothyroid/Hashimoto's.

Realistically, I just can't take T3 in even increments so I would have t do 6am, 1pm and 9 or 10pm. Is that terrible?

[greygoose]

Why do you think telling you to increase your T3 is rediculous when we don't even know your FT3 level? You are only taking a tiny, weeny dose of T3 - and a small dose of levo - so it could very well be that you need to increase your T3. But, it would have been better to get full testing before changing anything. Now, you are groping around in the dark with no idea where to go next.

I was looking at old lab results and felt GREAT when my t4 was 1.24 (it is currently 1.14).

Maybe so, but were you taking T3 at the time? T3 is far more likely to affect how you feel than T4, because it is the active hormone. Besides, old lab results are not much help, because things change, your needs change, and that level might not be so great anymore. But, if it was great, why did you change things?

[Fmljkl in reply to greygoose]

I have lab results. I'm just asking for advice on what's better to tweak first...

I didn't change anything medication wise since 2018. That's when I felt great, I'm trying to manipulate my levels to match what they were in 2018.

[greygoose in reply to Fmljkl]

I have lab results. I'm just asking for advice on what's better to tweak first...

How can we know without seeing the results?

[Fmljkl in reply to greygoose]

TSH: 0.341 (0.45-4.5)

T3: 3.4 (2.0-4.4)

T4: 1.14 (0.82-1.77)

[greygoose in reply to Fmljkl]

T3: 3.4 (2.0-4.4) 58.33%

T4: 1.14 (0.82-1.77) 38.68%

I think, if it were me, I would have increased the levo and left the T3 as it was. Most hypos need it higher than that.

[Fmljkl in reply to greygoose]

I wanted to tweak the T3 b/c my HR was really high during easy workouts and I was STARVING in the morning after taking 5mcg. I just wanted to see if spacing it out more would be beneficial to appease those symptoms. Also, b/c of these symptoms, my doctor wouldn't increase T4 unless I dropped T3.

Since dropping T3 by 2.5, my HR and hunger has dropped. BUT I've gained the 5 lbs which isn't good.

I guess I will just try spacing out T3 for a couple weeks and see how I feel before tweaking T4.

[greygoose in reply to Fmljkl]

Spacing out the T3 dosing works for some people. You would have to try it to know. Others need to take theirs all in one go to flood the receptors.

Have you had your nutrients tested? The excessive hunger could have been due to low nutrients. But, gaining 5 lbs does suggest that you are now under-medicated.

I think your doctor is totally unreasonable in saying that he won't increase the levo unless you drop the T3. Shows that he has little understanding of dosing thyroid. Your FT4 is quite low and lot's of hypos would need it higher - but, at the same time, a higher FT3. Doctors are very prone to under-medicating!

[Fmljkl in reply to greygoose]

Greygoose, thanks for helping. What do you suggest I do?

1) Stick with 88mcg of T4 and space out T3 at 6am, 1pm and 10pm

2) Go with 100mcg of T4 and T3 at 6am and 1pm

3) Other option(s)??

[greygoose in reply to Fmljkl]

To start with, I'd go for number 2.

Do you make sure you always take your T3 on an empty stomach and leave at least an hour before eating and drinking anything other than water, just like levo? What don't you take your levo at 6 am, along with your first dose of T3? That would make life easier.

[Fmljkl in reply to greygoose]

OK, thanks for your help. All this stuff makes me feel crazy. I appreciate your help.

Yes, I always take meds at 6am and don't eat or drink for an hour and 15 minutes. I don't eat or drink an hour before or after my 1pm dose, as well.

Taking t4 at night is better for me so I don't want to change the timing of that.

[greygoose in reply to Fmljkl]

OK, fair enough. Good luck with the experiment, then.

[Batty1 in reply to Fmljkl]

I don't think that's possible to be what you were the body is forever changing and what worked 2 yrs ago may never work again. It's like exercise eventually your body gets use to it and you no longer see the results and must change up your exercise in order to see the results and the same goes for dieting and Im betting for medications... Our bodies are amazing.

I 100% feel your stress I was just like you until my darn thyroidectomy in 2016 and my whole world turnt upside down. I'm a certified fitness instructor and use to be a running coach and a beast in the exercise world now I'm a lumpy old worn out has been in hypo hell..... just relax a bit cut back your calories to accommodate this change ...better yet sit down track, weigh and measure everything you eat and see how many calories your really eating or drinking ....stress is a life sucker don't let it get you...like I did.

[Hidden]

Hey Fmljkl, re old lab results when you felt good, was that on Levo only or combination?

It seems you have gained water if it happened so quickly, it happens to me too, and t4 doesn't build up so fast so it makes sense.

Do you have any ft3 lab work? T3 can also suppress Levo, so when you take more t3 you can feel more tired for a while, happened to me. Or you take too much, another possibility, but without ft3 can't really tell.

[Fmljkl]

I've been on T3 and T4 combo for about 5 years now.

Labwork:

TSH: 0.341 (0.45-4.5)

T3: 3.4 (2.0-4.4)

T4: 1.14 (0.82-1.77)

My frustration lies with another online group that just says to always increast T3 no matter what. I don't agree with that logic.

[Batty1 in reply to Fmljkl]

You can't listen and react to everything everyone says on any forum. It's your body and your health what works for one doesn't work for another.....listen try the advice if it seems reasonable and doable for you.

I currently take 100mcg synthyroid and 10mcg cytomel. I take 50mcg synthyroid with 5mcg Cytomel in early AM and the other 50mcg Synthyroid and 5mcg Cytomel later in the morning.

I split my meds (people think this is nutz) to me I feel better and I have less side effects. Try splitting doses 5-6 hours apart see what you feel. I dont think their is a wrong vs. right way to take your meds it what works for you. Don't take vitamins or other meds around you thyroid meds this is gold standard.

[Fmljkl]

I’m already freaking out bc I’ve gained so much weight. What should I do? Please help.

[humanbean]

A fast heart rate could obviously be related to you being wrongly dosed on your T4 and T3. It can happen with levels which are too low or too high.

But you also have to consider your nutrients levels. Very low iron can cause tachycardia (medical name for fast heart rate), palpitations, and even chest pain if the deficiency is extremely severe. Low B12 affects the heart too.

On this forum we suggest that people get vitamin B12, folate, vitamin D, iron and ferritin tested, and they should make sure they get copies of the results and reference ranges. If those results and reference ranges are posted in a new post we can give you feedback on them, and if your levels are below optimal then we can suggest what you can supplement to improve them. Note that just being in range is not good enough - we need optimal. And optimal is not necessarily at the top of the range - more is not always better.

The other point about nutrients is that optimising them makes it easier for the body to tolerate thyroid hormones.

And something I found out from personal experience is that having high levels of blood sugar gives me tachycardia as well. Those tubs of ice cream that I would sometimes eat all by myself were extremely bad for my heart rhythm and heart rate as well as making me fat!

[Jazzw in reply to humanbean]

Oh, me too on the blood sugar-heart rate thing.

Absolutely terrified me until I figured out what was causing it. My pulse is normally in the late 60s/early 70s but a sugar rush can make it go well over 100 and it’s not fun at all.

On the topic of T3 Fmljkl , my husband’s heart rate was always rather high until being prescribed sufficient T3 (which turned out to be 20mcg T3 along with 100mcg levo). And then the rate came right down to normal, blood pressure too.

So it’s not always a question of T3 making hearts race. Sometimes you need more to make them slow down.

[humanbean in reply to Jazzw]

I had the same problem with T3 - I have a fast heart rate if levels are too high or too low.

Regarding the blood sugar issue, once I worked out that eating too much of my favourite ice cream causes my heart to race I actually started getting embarrassed about it rather than worried and anxious as I used to. Unfortunately it still hasn't made me give up ice cream!

[Jazzw in reply to humanbean]

No, me neither. I seem to accidentally forget about it until I’ve done it, and then, well...

[Batty1 in reply to humanbean]

Fast heart rate could also be coming from her stress levels being so high from the weight gain.....boy oh boy I think her and me are sisters across the pond...lol

[Fmljkl]

Can’t stand this anymore. The 5 lb weight gain isn’t coming off. I’m going back to old dose of t4 and going to space out t3 three times a day. This disease is so frustrating