I’m currently taking 50mcg of levothyroxine & 4 weeks ago I added 5mcg of Liothyronine split into 2 doses. I am feeling dizzy now & don’t know if it’s the T3. I don’t know if I should stop the T3 and see if I feel better.
These are my lab results just before I started the Liothyronine & whilst I was on 75mcg of Levothyroxine.
TSH 0.707 (0.27 - 4.2)
FT3 3.47 (3.1 - 6.8)
FT4 17.700 (12 - 22)
Reverse T3 48 (10 - 24)
Cortisol blood test
8 am. 907.000 ( 113 - 456)
Cortisol saliva test
8am 8.670 (6.0 - 21.0)
12pm 10.500 (1.5 - 7.6)
4pm 9.349. (0 - 5.5)
Before bed. 4.670 (0 - 2.0)
Vit d is optimal
B12 is optimal
Iron is good.
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The problem may not be the T3. The problem may be that your levo was reduced when it didn't need to be and you may be suffering from the lack of it. Your FT4 result was nowhere near the top of the range which is why I feel that your dose should have stayed the same. If you reduced your dose and introduced T3 at the same time you won't be able to tell which one might be the problem. Plus it has only been 4 weeks so things have not had time to settle.
If you stop the T3 you will leave yourself short of hormones.
I understand what you are saying but I thought you had to reduce the T4 when starting T3 because of the high reverse T3. Maybe I should go back on the 75mcg of levo. When I started the T3 I didn’t feel as bad as I do now.
High reverse T3 is a red herring. Other things can cause high RT3 not just the thyroid. RT3 has its own functions and own receptors. It used to be thought that RT3 blocked the T3 receptors on cells but this has been disproven.
You only need to reduce levo prior to starting T3 if your FT4 is near the top of its range.
You could go back to 75mcg of levo let things settle for 8 weeks. Then have a re-think. You might then want to try 100mcg levo as there is room for an increase or as you are currently not converting well you could slowly re-introduce T3.
We have to go with our instinct - so do what you feel is best for you.
I thought you had to reduce the T4 when starting T3 because of the high reverse T3
There are many, many reasons for high reverse T3, only one of them is connected to thyroid and this is when there is a build up of unconverted T4 which you obviously don't have because your FT4 was only 57% through range, your FT4 would be high (over range) if it was the cause of your high rT3.
Other conditions that contribute to increased Reverse T3 levels include:
· Chronic fatigue
· Acute illness and injury
· Chronic disease
· Increased cortisol (stress)
· Low cortisol (adrenal fatigue)
· Low iron
· Lyme disease
· Chronic inflammation
Also selenium deficiency, excess physical, mental and environmental stresses. Also Beta-blocker long-term use such as propranolol, metoprolol, etc. Physical injury is a common cause of increased RT3, also illnesses like the flu. Starvation/severe calorie restriction is known to raise RT3. Diabetes when poorly treated is known to increase RT3. Cirrhosis of the liver. Fatty liver disease. Any other liver stress Renal Failure. A fever of unknown cause. Detoxing of high heavy metals.
Looking at your cortisol test, it's quite likely that your high cortisol may be the cause of your high rT3.
Goodness me Seaside Susie, and thank-you. Although I have been on here for years that's the first time Iv'e seen a list of all the things that can cause RT3.
If you felt better when you first started the T3, it could also be that your thyroid system has sensed the T3 and reduced it's output. That, combined with the unecessary reduction in Levo, would leave you feeling more hypo. It's a minefield😕 I hope you feel better soon.
• Morning at the top of the range - yours is very low
• Noon approximately 75% of the range - yours is over range
• Evening close to 50% of the range
• Nighttime at the bottom of the range
This is obviously a Medichecks test which is not particularly helpful. The last two samples don't have proper ranges but your levels have come back high for both. Ranges are based on healthy people, anyone with a level of zero is very far from healthy. Also they don't include DHEA and that is important to test alongside cortisol as this helps with determining stages of adrenal fatigue. In the initial stage, both cortisol and DHEA will be high, the more we struggle to produce stress hormones then DHEA will lower, and more advanced adrenal fatigue then cortisol will lower too.
Could that be why I was feeling ok for the first 2 weeks of taking T3 & then the decrease in T4 meds caught up on me? If I stop the T3 & reintroduce the 25mcg of levo then wait for 6-8 weeks would that be a better way to go? I just can’t stand the dizziness & nausea any more.
Could that be why I was feeling ok for the first 2 weeks of taking T3 & then the decrease in T4 meds caught up on me?
Seems very likely. T4 has a half life of 7 days, so if you took, say, 100mcg Levo, after 7 days there would be 50mcg left, after another 7 days there would be 25mcg left, then after another 7 days 12.5mcg, etc. So yes, after a couple of weeks you'd probably notice the difference.
If I stop the T3 & reintroduce the 25mcg of levo then wait for 6-8 weeks would that be a better way to go?
No. You will be changing two things at once. It's important to only change one thing at a time, that way you will know what is making a difference. You know you need the T3, that's very obvious from your results, so why would you want to stop taking it? You now know that you shouldn't have reduced your Levo, so just reinstate your Levo to it's original dose and carry on with your T3. Retest/reassess in 6-8 weeks.
I can't help I'm afraid, I'm not medically qualified. You don't have straightforward high or low levels across all four samples, you have a low morning level which needs raising and high other levels which obviously need reducing, but of course you haven't had the best test anyway because there's no DHEA.
I suggest you read through Dr Myhill's articles on cortisol test results, there's this one and links to related articles further down the page:
Thank you all for your input. I seem to have a few problems that need addressing before I can expect to be optimal. I just hope my Endo will be able to help me. I’m going to go back up to 75mcg on the levo & stick with taking the 5mcg of Liothyronine. I also need to find out what’s causing my high reverse T3.
Your cortisol levels show the typical pattern of worsening Adrenal Fatigue.
In a normal healthy person, cortisol is highest early morning in order to get you out of bed, fed and ready for the day.
So, that's where the Fatigue shows first. The adrenals have trouble making enough cortisol first thing. But, they keep struggling all day to make their daily quota, with the result that you have high levels at night, when it should be lowest so that you can sleep.
What you need to do is help your adrenals raise the level in the morning, and the other levels will fall back into place. Do not make the mistake of trying to reduce the bedtime level, because the effect will carry on into the following morning. Concentrate on raising levels in the morning.
Firstly, your adrenals should be well nourished. They need lots of B vits, lots and lots of vit C, and plenty of salt.
Have you heard of the adrenal cocktail? A lot of people find that helps, but recipes vary. Try googling it.
Adrenals also need plenty of good protein, so start your day with a high protein breakfast as soon as you rise. That will mean taking your thyroid hormone at night, but that could actually be beneficial. And, for the time-being try taking all your T3 at the same time. With such a small dose, splitting it can be like not taking any at all. So, take all your hormone 2 to 3 hours after your last meal.
You could also try taking a glandular, like Adrenavive. It helps some people, not others. But, first, I would give the nutritional approach a go, if I were you.
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