T4 and T3 advice

[Hollren]

Ok so I know this isn’t recommended but I’m giving it a shot. I’m trying T3 with T4 I currently take 150mcg of T4 and I have 25mcg of T3. Would it be reasonable to take my usual T4 amount and take 25mcg of T3 at the same time, or should I half the T3 and gradually add it in? Please no negative comments I just need to try something for myself as I’m going insane with feeling tired and gaining weight.

[SlowDragon Administrator]

Previous post shows you were very under medicated with TSH of 63

healthunlocked.com/thyroidu...

So you need 25mcg dose increase in levothyroxine and retest in 6 weeks

Absolutely essential to test vitamin D, folate, ferritin and B13 and get these optimal BEFORE adding T3

[SlowDragon Administrator]

Low vitamin levels mean it’s difficult to utilise levothyroxine or T3

If you MUST add T3 before testing start with just 5mcg

[SlowDragon Administrator]

When test was done in January and TSH was 63, how much levothyroxine were you taking?

How long have you been on 150mcg ?

Strongly recommend you get FULL thyroid and vitamin testing via Medichecks before adding any T3

[Hollren in reply to SlowDragon]

I was taking 100mcg when my last bloods were done which is when it came back at 63, this was back in January. My next bloods aren’t due until January 2021 and then at the GP I’ll get them done in September. Thanks for your reply it’s appreciated.

[FancyPants54 in reply to Hollren]

Sorry, but you need to insist on another blood test 6-8 weeks after every increase in Levo you have. None of this waiting until next year nonsense. Book an appointment with the GP and tell him when your Levo dose was increased and ask for a blood test now to check the results of the increase. Also tell him that you still feel very under medicated, tired and cold etc.

When you get your results you will undoubtedly need another increase in dose.

You don't want to use T3 if you don't have to do so. You might be fine on the right amount of T4 only.

If you did need to add T3 because you were not converting T4 very well, there is no way you should swallow a 25mcg T3 tablet all in one go with your full Levo dose. You could make yourself very ill doing that. A quarter of your 25mcg tablets at a time is still a big hit of T3. But you are not in that category yet. You need to optimise your Levothyroxine dose first with regular increases of 25mcg and retesting 6-8 weeks later to reassess.

[Hollren in reply to FancyPants54]

I don’t get my blood tests regularly at the GP I have to travel 40 mins away to get them done at a hospital, I had my thyroid removed due to a cancer gene so it has to be checked by a specialist. It did say on my letter that my bloods would be checked 6 weeks after my increase. However with everyone going on at the moment it hasn’t happened, I’m not talking nonsense just following what I’ve been told.I’ll have to request them with the GP ASAP. Thank you for your reply and for the help.

[FancyPants54 in reply to Hollren]

I didn't mean the nonsense was coming from you. Rather the medics.

You can't optimise your dose if you are stuck in such a slow cycle. You will need to push it. Maybe test yourself privately and ask GP to increase your dose based on that until you can see the hospital again.

Everyone on here (almost everyone) can attest to GP's and endocrinologists being very undereducated where thyroid problems are concerned. They have one set of rules that they apply blindly to everyone and ignore symptoms. We have to be our own advocates and we have to fight for what we want and need.

[SlowDragon Administrator in reply to Hollren]

Bloods should ALWAYS be tested 6-8 weeks after any dose change (or brand change) in levothyroxine

Getting FULL thyroid and vitamin testing strongly recommended

Thousands upon thousands of uk patients are forced to get full testing privately to make progress

For full Thyroid evaluation you need TSH, FT4 and FT3 tested. Also EXTREMELY important to test vitamin D, folate, ferritin and B12

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)

Private tests are available as NHS currently rarely tests Ft3 or all relevant vitamins

List of private testing options

thyroiduk.org.uk/tuk/testin...

Medichecks Thyroid plus ultra vitamin

Currently on offer with 25% off

medichecks.com/products/thy...

Thriva Thyroid plus vitamins

thriva.co/tests/thyroid-test

Blue Horizon Thyroid Premium Gold includes vitamins

bluehorizonbloodtests.co.uk...

Come back with new post once you get results

If you were considering adding T3 yourself you would absolutely have to test privately after every dose change....so getting full testing first before you start is good practice

Always do blood tests as early as possible in morning on Monday or Tuesday only and post off straight away

[Lalatoot]

First you need to consider whether to reduce your levo dose before adding T3 and whether you have an adequate supply of T3. You will need enough for 6 months to give it a fair test. It is not a quick fix. Whether or not to reduce your levo dose will depend on how far through the range your FT4 result is.

Then T3 should be added very slowly. 5mcg daily for a week and then an additional 5mcg added to the dose every fortnight until you reach one tablet. Hold dose for 8 weeks and then have blood tests. Blood tests must include FT3 as it is essential to know what your level is.

You need to balance your FT4 and FT3 levels at the optimum for you. Some folks manage with low FT4 levels but others need to have both FT4 and Ft3 levels well over halfway through their ranges. Again it is a case of looking at blood results and considering how you feel then altering either your levo dose or the lio dose (only one at a time) then waiting 8 weeks for blood tests - then altering levo or lio waiting 8 weeks then bloods until you feel well.

When on a combo of levo and T3 blood results need to be interpreted differently than when on levo only.

Adding T3 isn't an easy process or a quick fix. You need to start low and take it slow.

Now your instinct, as you state above, tells you that adding T3 is not recommended and I am definitely not recommending that you add T3 at the moment. Reading your comments below you really need to pursue blood tests so you have current ranges for TSH , FT4, FT3 and vitamins before considering the next step.

[dianadoors]

I have been told that the conversion of T4 to T3 takes place in the liver and therefore perhaps we should look at the health of the liver?

[helvella Administrator in reply to dianadoors]

Conversion of T4 to T3 takes place in many locations. Yes, liver is an important organ. Kidneys. Thyroid. And many cells are able to convert aat least some T4 into T3 effectively for their own use.

Some GPs make sure they do liver function tests regularly. Others never. Seems to be a matter of luck what your GP thinks or knows.

[dianadoors]

I have never had a liver function test after almost 20 years of taking thyroxine.I am looking to reversing the condition and have been listening to naturopaths .

[Maryam_1 in reply to dianadoors]

dianadoors how are you going to reverse this with naturopath? please share your process.

[dianadoors in reply to Maryam_1]

I am listening to some US naturopaths Keeshers Ewers?Dr Osborne etc.I am reducing my thyroxine too. As there are many causes of auto immune you have to take a multi pronged approach.I have also increased my vitamin intake, seaweed etc and have been using frankincense.I am not there yet but know it is possible and I desperately want to come off my medication.I got up to 150mg and am now at 75 mg of thyroxine a day.

[Evie7851]

I understand how you feel I was gaining weight and tired also I have been on ndt just t4 and now t4and t3 which seems to be the best for me I have gradually tweaked the dose my doctor had me on 150 tirosint and 20 mg t3 and I was over medicated I went down to 150 and 10 but my t3 was still low so I’m now on 125 T4 and 17.5 t3 split 7.5 mg around 6am 5 at noon and 5 around 5pm I would start with 5 mg and document your pulse your blood pressure and your weight and then increase the dose every one to two weeks it has stopped the weight gain and I have more energy I found the book by Paul Robinson the thyroid patients manual helpful good luck it definitely is a process

[Hollren in reply to Evie7851]

Thanks so much for your reply it’s so hard going through this. I’m really glad to hear that worked for you, I’m going to try it and then keep an eye on my weight etc. I’ll have to give that a read, it’s just nice to read that I’m not alone in this I’m so glad I found this forum. Thanks so much again for your reply that’s been helpful!