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 😊
Written by
smilingjane
To view profiles and participate in discussions please or .
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.
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!
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.
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.
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.
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.
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
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!!
Content on HealthUnlocked does not replace the relationship between you and doctors or other healthcare professionals nor the advice you receive from them.
Never delay seeking advice or dialling emergency services because of something that you have read on HealthUnlocked.
Starting T4/T3 combo therapy
starting t3, t4 combination 
? Drop in T4 with starting T3
About to start T4/T3 combo. 3 questions - just needing a bit of reassurance please. 
T4/T3 Prescription Query
