HOW DO I ADJUST T3 DOSE DOWNWARDS AFTER STARTIN... - Thyroid UK

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HOW DO I ADJUST T3 DOSE DOWNWARDS AFTER STARTING PROGESTERONE CREAM

Redlester
Redlester

I am currently on 50mcg of T3. Last Sunday I began using progesterone cream - which is working as I had hoped it would - and it is obviously "waking up" my own thyroid production and utilisation of hormones so I need a lower dose of T3. The overstimulation I have experienced was so awful that I haven't taken any T3 either yesterday or today. I clearly need to adjust it downward but don't know by how much - do you use the same principle as upward adjustment - ie by a quarter of a tablet at a time? What do you do if you find that even that reduction is not enough - do you have to wait 2 weeks with horrendous overstimulation symptoms before going down again by another quarter of a tablet? Would very much appreciate advice. Thanks

34 Replies
oldestnewest

Just drop it to where you feel it should be. There's no need to, indeed it is undesirable to slowly reduce if you know you are on too much.

Redlester
Redlester in reply to jimh111

Thanks Jimh111 - logic would suggest that should be the approach. Aside from anything else it would be miserable to struggle on taking too high a dose purely to follow a dictate to reduce slowly. Would it be too much of a reduction do you think to drop half a tablet in one go? I fear that if I suffered the severe symptoms I did this week of overstimulation on 50mcg that there wouldn't be much of a reduction of those symptoms to be gained by simply losing 6.25mcg which is why I am minded to drop a full half tablet.

I disagree with jimh111 . My endo started me on 40 mcg of lio (one tablet twice a day), which I suspect was a mistake, because six weeks later he halved the dose. I suffered physically with such a quick withdrawal. I don't know if you are taking you lio all at once, but I'd suggest taking it in two daily doses and reducing each by 1/4 tablet for a couple of weeks, then reduce by another 1/4 tablet for each dose etc. That way also you will hopefully find your new "sweet spot" - at which point you can go back to once a day if that's how you prefer it.

Fuschia -pink - I have been taking my dose in one go which is the recommended treatment modality for impaired sensitivity to thyroid hormone [form of thyroid hormone resistance] so unfortunately I cannot follow your suggestion as you set it out - but I could take half a tablet from my single T3 dose which is what I proposed in my reply to Jimh111 above.

If it's all in one go, then yes, I'd drop half a tablet at a time, as you suggested to JimH x

jimh111
jimh111 in reply to fuchsia-pink

I think we are both right! Redlester had skipped two days L-T3 without problem and I mentioned 'if you know you are on too much'. Someone starting on L-T3 would need to be more careful.

jimh111
jimh111 in reply to jimh111

I'm aware that some people recommend single daily dosing in cases of resitance to thyroid hormone (RTH). This seems to enable receptors to be saturated with T3 and binding to take place. I would recommend divided doses to give more stable T3 levels. In any event 50 mcg L-T3 is too little to overcome RTH. It equates to 150 mcg L-T4 (levothyroxine) and so is not supra-physiological. Put another way if you are responding to normal hormone levels do not have RTH.

However! In an earlier post you mention quite severe symptoms including fibromyalgia and CFS/ME. How have you responded to 50 mcg L-T3 in regards to your symptoms and what were the symptoms of overstimulation?

Redlester
Redlester in reply to jimh111

I'm not sure where the idea has come from that I was saying that at 50mcg I had overcome RTH. I am only in the early stages of T3 treatment and there is some way to go. 1) I've only been taking T3 since the end of January this year - starting with a quarter of a tablet and inching my way up in quarter tablet increments 2) I have suffered with below normal level ferritin for decades so it is probably a miracle that I have got to 50mcg at all and if I could get my ferritin up higher then I would likely also be able to raise myT3 levels and 3) I have the same problem with high cortisol and if I could deal with that I might also be able to raise my T3 level - I'm basically a work in progress with a lot of obstacles to overcome. It is true I was 'diagnosed with' FMS and ME/CFS - but if you read Hugh Hamilton's book on ISTH - which is what I am self treating - a lot of people with ISTH have been thus diagnosed when perhaps if they'd had a proper thyroid workup a hypothyroid problem might have suggested itself to the diagnostician - and Hugh's book was describing my symptoms (and my familial medical history) to a T - It was as if he had written it about me. I was doing fine on 50mcg - albeit tired at times with a concern about iron deficiency latterly .The overstimulation symptoms were a week of hypothyroid misery - crippling pain and exhaustion and brain fog which resolved overnight when I dropped my dose down to 50mcg after trying to raise it by the usual quarter tablet to what the next level up in the dosing schedule should have been.

As for now - I resumed the T3 after a difficult day on Sunday at 37.5mcg - maybe that drop by a full half tablet was too low - Sunday was ok, yesterday not so good (fatigue on and off and a headache threatening) and today was a bit of a disaster as I had a post exertion "crash" at 5.30pm after doing the weekly grocery shop. Any advice about how to modulate the T3 dose with the introduction of the progesterone cream would be very welcome. Am I stuck now for another 11 days at maybe too low a level waiting to raise it by a quarter of a tablet or can I try to add that quarter tablet back in and avoid the 11 days of misery?

Redlester
Redlester in reply to jimh111

well strictly speaking day one without T3 was ok but Day 2 was more problematic and I struggled with feeling hypo from the afternoon onwards

jimh111
jimh111 in reply to Redlester

By day two you would have as little as one quarter of the T3 left so it's not surprising.

Redlester
Redlester in reply to jimh111

Agreed

Hi Redlester

Have you had your Progesterone levels checked? It may be that you need to reduce your Progesterone Cream dose not the T3.

Balance is absolutely crucial.

I have used progesterone for years and it has never improved my thyroid function. What it does do is supports your cortisol production. I have low cortisol. If you have diagnosis of fibro, CF and ME that is related to low cortisol what you are feeling is your boost to the adrenals. You will need less thyroid hormone overall. I can't come off progesterone because of weak adrenals. So my advice fix your adrenals be careful how much progesterone you use as your body cries out for it. I can't come off it for more than a couple of days because my adrenals can't cope without it.

Jamima
Jamima in reply to magsyh

magsyh - would you tell me your brand of progesterone. I have low cortisol and DHEA and have read the pregnenolone or progesterone can help.

Redlester
Redlester in reply to Jamima

I purchased my cream from a US company called Elan Organics

elan-organics.com/product-c...

It is not exactly inexpensive and the shipping from USA takes almost a month at the minute. But as far as the ingredients are concerned it is all natural and contains no soy or chinese ingredients [which might be impure]

.

I am afraid I cannot help you with settling on a dose as I myself am engaged in an almighty struggle to work out my own dosage. The manufacturer advises 2 applications 12 hours apart.

Jamima
Jamima in reply to Redlester

Many thanks Redlester, I’ve already heard good things about that brand. I hope it continues to work well for you.

Redlester
Redlester in reply to Jamima

I have no qualms whatsoever about using it - GREAT product - does exactly what it says it will do - and my big concern was that I might have some sort of negative allergic skin reaction as I react badly to so many things - but no bad reaction at all if anything the skin areas where I apply it are really soft and smooth. I'm not sure other perhaps more bog-standard prog creams would do that (ie creams which contain progesterone but also other ingredients which might not be so nice for the skin). I just wish it was possible to get it ordered from the UK and that it was a bit more affordable!

Jamima
Jamima in reply to Redlester

Many thanks.

magsyh
magsyh in reply to Jamima

You have same problem as me. How are you coping with it? I get palpitations through the night that wakes me up, for me that is the worst.

I use biovea at the moment as I can't get supplement spot because of covid 19. I buy from UK but supplies come from America and that is why no supply right now. I have ordered liquid progesterone from America waiting to try that. I also have pregnenolone but haven't tried it. I bought it when I discovered I was low in dhea. My advice if I could turn the clock back try pregnenolone first. It is the precursor to all hormones and it lets your body choose what it needs. I think my progesterone has either stopped working or the extra stress over past few months I may not be using enough to keep up with demand? Unfortunately we are on our own as nobody to advise us. I prefer supplement spot over all the other brands of progesterone because it's the purest. I'm hoping this liquid progesterone as recommended by Ray Peat will work. According to him he uses both progesterone and pregnenolone so a bit confusing as I'm worried about overloading myself but all tests I have had show my hormones all low. That is why I don't know what has caused my low cortisol long term stress or pituitary damage?

Jamima
Jamima in reply to magsyh

Hi magsyh - yes, it’s not much fun. I’ve certainly had a lot of extreme stress over the past 3 years so it’s possibly attributable to that. I read some interesting things on pregnenolone from Dr Myehill who recommends it for low Cortisol/dhea so I think you’ve got a point. Which brand of preg did you order?

magsyh
magsyh in reply to Jamima

It's life Flo, years ago I used their progesterone too. I haven't used it though as not sure if it's good or bad along with progesterone? I am feeling pretty bad right now and just like you I want to be well again.

Jamima
Jamima in reply to magsyh

I think I’ve used their prog before and liked it. I’m trying to get a private endo appointment before I start supplementing with anything else, I’m too afraid to make things worse.

Redlester
Redlester in reply to magsyh

No offence Magsyh, but I'm not sure that we do have the same problem. If you read what this lady outlines here in this link it describes my situation precisely and in the reply she is advised it is due to estrogen dominance which is what I have going on.

progesteronetherapy.com/ext...

These hormones are all sadly very interconnected - my brain is almost fried trying to work it all out - and equally sadly, considering doctors don't even seem to recognise a real problem with adrenal gland function we are left to suffer and try to deal with it ourselves. I am not a doctor but have researched what is going on in my case extensively and it might be a problem with wiring in the limbic system which apparently can be corrected - but not with supps etc. Supps (and supplemental hormones) might help to provide symptomatic relief in the short term while you do the work to correct it. If you are interested I will PM you some of the research I have been looking at and you can see it for yourself.

magsyh
magsyh in reply to Redlester

I was referring to jamima! I have the same problem as she does. I also had estrogen dominance and only went through menopause at 61. I had fibroids, Adenomyosis and then thickened womb lining. The progesterone saved me from hysterectomy. I even had Lupron injections which I'm sure is to blame for all my low hormones now due to pituitary damage.

Redlester
Redlester in reply to magsyh

Oh you poor thing - sounds horrendous - but yes we don't seem to have the same thing - sorry, I thought you were addressing me because of your earlier reply to my post. I would imagine there must be a connection with those injections and the hormonal problems you have had. Have you ever had a consult with anyone about the pituitary damage?

magsyh
magsyh in reply to Redlester

No every time I bring up the subject they dismiss it without testing. I suppose they wouldn't want me to prove it was the fault of Lupron?

Redlester
Redlester in reply to magsyh

Forgot to ask Magsyh - do you have a link for this supplement spot progesterone cream you have been referring to. It's a new one to me and I'd be interested to have a look at it. I was thinking of trying the molecular progesterone oil from forefront health .

magsyh
magsyh in reply to Redlester

I ordered the oil from forefront health last week just waiting for delivery. If you Google supplement spot you should find it. I'm not any good with links.

Redlester
Redlester in reply to magsyh

Thanks Magsyh. I googled supplement spot just now - will have to look into that. Wish I had ordered the forefront oil - I liked the formulation with the vitamin E and I like the fact that he says you can use it up to 5 times per day or something like that if you need it. He had a 33% sale on which ended on Monday but next time he offers that I might put in an order - would you let me know how you get on with it - I'd be very keen to find out.

magsyh
magsyh in reply to Redlester

I will do x

Redlester
Redlester in reply to magsyh

Great - I'll look forward to it - Good luck with it

x

shaws
shawsAdministrator

25mcg of T3 is approx equal to 100mcg levo and some people are unaware of the difference. I wonder if that's why you didn't feel so well. If increasing dose I always do so by 1/4 tablet (or when reducing) and giving a week or two to see how my body settles down.

Redlester
Redlester in reply to shaws

I do the same - up or down by quarter of a tablet and giving a week or two to see how my body settles down. I'm not sure how from what I originally posted you got the idea that I was decreasing my dose by 25mcg.

Red Lester - would you tell me which prog cream you use and what dosage? Many thanks.

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