T3 started T4 lowered symptoms query please

[smilingjane]

Hello everybody

Hope your all managing to see a little sunshine 😊

After my recent endo visit (3 weeks ago),I started 12 and half MLS daily of T3 and at the same time followed instruction and reduced Levo from 100 to 75 MLS daily.

I thought that I would be seeing just a little more energy now. But instead I am spending nearly all day and night lying down. Before at least I could be up fir around 3/4 hours daily.

I have also started daily b12 jabs because I was deficient.

Does anyone have experience of fatigue getting worse before better when trialling T4/T3 combo?

Edit Also to mention keg pain and stiffness is still an issue

Thank you

Jane 😊

[SeasideSusie Remembering]

smilingjane

May:

TSH 0.06 (0.3 - 4.5)

T4 16.4 (10.0 - 22.0)

If those were the results that the decision to reduce your Levo when introducing T3 was based on then that was wrong. Your FT4 was only 53.33% through the range. There was no need to lower your dose of Levo. Taking T3 is going to lower FT4 anyway, so the reduction in your Levo will lower your FT4 and taking T3 will lower FT4 so I expect your level is now quite low. You may be one of those people, and there are a few of us here on the forum, that still need a decent FT4 level when taking T3.

For some reason doctors seem to think that Levo should be lowered in every case when adding T3, they fail to look at the numbers. If the FT4 is high in range then yes, it might be best to reduce Levo first then introduce T3, but when FT4 is only mid-range there really is no need.

[Hidden in reply to SeasideSusie]

I agree that it is good to trial levo at the same level when adding t3 at the beginning, but in my case, adding t3 increases my ft4 each time, which makes me quite sick. It seems that our bodies can do the opposite sometimes!

[smilingjane in reply to SeasideSusie]

OMGness!!

There was me thinking of my new endo with God like status, (and I do still appreciate his efforts) ..

However what you are saying makes absolute sense 😊

I upped the T3 to 25 daily 3 days ago, (was going to email him with my idea)

I think ow however, I might go back to the 10o Levo and stay at the half tablet daily. And let him know. NY bloods are due to be tested I around 6 weeks. So that should work well.

What do you think Susie?

Many thanks for responding

😊

[SeasideSusie Remembering in reply to smilingjane]

Smilingjane

I would go back to your lower dose of T3. We normally start with 5mcg (or whatever the equivalent in your liquid is) and stay on that for a couple of weeks to make sure we have no problem. Then we add a second 5mcg, stay on 2 x 5mcg for 2 weeks, then add another 5mcg, so 10mcg morning and 5mcg afternoon, stay on that for about 6 weeks, adding another 5mcg if necessary.

We only make one change at a time, so either Levo or T3 then give it a couple of weeks before making the next change.

As you have only been on 25 T3 for 3 days, I would drop that back to 12.5 then go back to 100 Levo. Then wait 6-8 weeks and retest.

When testing remember to take last dose of Levo 24 hours before the test and last dose of T3 8-12 hours before the blood draw. This will give the most accurate measure of your normal circulating hormone level.

[smilingjane in reply to SeasideSusie]

Thank you Susie

I am going to do exactly that.

Very greatfull for all your input and going to the trouble of checking my last b.t. results.

Hero!

[humanbean in reply to SeasideSusie]

Taking T3 is going to lower FT3 anyway

It's going to lower FT4, methinks - in most cases.

[smilingjane in reply to humanbean]

Hmmm.

Tricky times. I will take 100 mls tomorrow and see how the next few weeks go.

Thank you for your response humanbean

😊

.

[SeasideSusie Remembering in reply to humanbean]

Yes, it was a typo, ruddy arthritic fingers 🙄

I've corrected it now.

[Hidden]

Hey Jane, adding 12.5 t3 straightaway without building it up in a slower pace might be causing this. Some people lower levo when introducing t3, some don't. I personally can't have too much levo in my blood, but this is individual.

[smilingjane in reply to Hidden]

Ahhh

I was told to build up slowly but I dived straight in.

I am going to listen to you and Seaside Susie and up my T4 to 100.

Thanks so much for getting back

😉

[Hidden in reply to smilingjane]

No worries! the only thing to consider is that low TSH when we are on levo or t3, reduces type 2 deionidase - it reduces conversion of your levo, which is t4 to t3 in your liver etc. Going back to levo and adding t3 would mean that you suppress this process even more. See how you feel when you get back to 100 levo, check your bloods to see where your ft4 ends up after increase of t3 as well. Then you can make further decisions.

[smilingjane in reply to Hidden]

thanks Cupoa 😊

Do you think I should go back to the half tab of T3 whilst raisin 4 to 100?

My endo did say just the half until next tests ..

[Hidden in reply to smilingjane]

when is the next test? Are you still on that dose of t3?

[smilingjane in reply to Hidden]

I started on half a tab 3 weeks ago and the increased ti full tab 3 days ago.

I am going to increase Levo back up 2moro and go back to half a tab.

Tests in 6 weeks.

Thanks for all your responses and advice!

😊

[Hidden in reply to smilingjane]

Sounds good, best of luck

[smilingjane in reply to Hidden]

Thanks cuppa!!

😊

[smilingjane in reply to Hidden]

By the way thanks for the detail, complicated but understandable!!

[SlowDragon Ambassador]

All four vitamins need to be OPTIMAL

B12

Folate

Vitamin D

Ferritin

What vitamin supplements are you currently taking

What are most recent results of vitamin D folate and ferritin

As you have hashimoto's are you on strictly gluten free diet?

We really need all ducks in a row before trying T3

[smilingjane in reply to SlowDragon]

Thanks SD.

Currently taking sub D + K2 and a multi B. And B12 jabs. And Zinc and mag.

Diet is currently poor as have had no appetite for months

Recent results Ferritin, and Folate not too bad. Have been taking sups. 3 years back all test Inc D were low but wasnt taking sups then.

I am having all the vits tested in August along with the usual Thyroid and FBC.

I am not strictly G. free because I eat chocolate. I know its poor but apart from the odd liquidised smoothie it's all I can eat.

I will address the food thing when I email my endo next week.

I am attempting to arrange the ducks!

Thanks so much again for all the info.

Jane 😊

[SlowDragon Ambassador in reply to smilingjane]

Chocolate doesn't have gluten in

Most has soya In and best avoided

But some posb chocolate is soya free ...eg Devine, green and black dark, Montezuma

(Subject dear to me .... can't exist without chocolate)

[smilingjane in reply to SlowDragon]

Ah dosnt it ...

Thanks for that. But soya ok ..

Will head for the Devine and co then.

Thanks SD 😉

[SlowDragon Ambassador]

How are you taking your T3

Some of us find it important to take as 2-3 split doses per day

Initial dose - 1/4 tablet in morning

Assuming that's ok

Add a 1/4 tablet mid-late afternoon

Hold at this dose for 6-8 weeks and retest

Can make you feel better and worse when initially start on T3

Testing

Always get tested as early as possible in morning before eating or drinking any thing apart from water and last dose levothyroxine 24 hours before test and last 1/4 tablet dose T3 8-12 hours before test

[smilingjane in reply to SlowDragon]

Maybe that's something to try. 🤔

But wouldn't you think that I would *feel* the tab working if it us a whole half? If you see what I mean . As opposed to 2 quarters. But instead I feel knocked out!!

[SlowDragon Ambassador in reply to smilingjane]

That's because such sudden increase upsets adrenals

Personally I started on 1/8 tablet twice day ...yes a speck of dust

Then after week or so increased to 1/4 twice day ...hold at that 6-8 weeks before testing

Mix of feeling much better and much worse

[smilingjane in reply to SlowDragon]

Oh wow, I didnt think about upsetting my adrenals, of course!

All this absolutely makes sense.

It will take my body a week or two to deal with the trauma of the T3 invasion!!

Better stay resting

😊😊

[smilingjane]

Thanks to everybody for your invaluable advice and knowledge.

You've all been so helpfull and cheered me up.

Hope you all have a cosy evening.

Jane 😊