Do I need T3?

[Paulatwin1]

I take 150mg levothyroxine. Still have hypo symptoms. Exhausted, weight gain, low mood. Do I need T3 to feel better?

[Lalatoot]

Based on those results. Yes. You are not converting efficiently.

[Paulatwin1 in reply to Lalatoot]

Have you had the same problem ?

[Lalatoot in reply to Paulatwin1]

Yes I had similar results on 100mcg levo. Suppressed tsh ft4 of 19 and Ft3 of 4.17.

You need to make sure your vitamins are optimal as this is important for levo and t3 to work well.

You are looking for ferritin folate vit d and B12 all to be well over half way through their ranges as a rough guide.

I was very lucky to get t3 prescribed on NHS as I was able to convince endo that I had 4 years of following her treatment with levo only and that we had exhausted all possibilities.

It has taken 10 months of adjustments of dose to feel that I am nearly there. So it is not a quick fix.

[SlowDragon Administrator]

Do you always get same brand of levothyroxine?

For full Thyroid evaluation you need TSH, FT4 and FT3 plus both TPO and TG thyroid antibodies tested. Also EXTREMELY important to test vitamin D, folate, ferritin and B12

Low vitamin levels are extremely common, especially if you have autoimmune thyroid disease (Hashimoto's) diagnosed by raised Thyroid antibodies

What vitamin supplements are you currently taking?

Do you have Hashimoto’s?

Ask GP to test vitamin levels

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)

Is this how you do your tests?

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

List of private testing options

thyroiduk.org/getting-a-dia...

Medichecks Thyroid plus ultra vitamin (doesn’t include folate)

medichecks.com/products/thy...

Thyroid plus vitamins including folate (private blood draw required)

medichecks.com/products/thy...

Medichecks - JUST vitamin testing including folate - DIY finger prick test

medichecks.com/products/nut...

Medichecks often have special offers, if order on Thursdays

Thriva Thyroid plus vitamins

thriva.co/tests/thyroid-test

Blue Horizon Thyroid Premium Gold includes vitamins

bluehorizonbloodtests.co.uk...

Improving vitamin levels can improve conversion of Ft4 to Ft3

[fuchsia-pink]

Agree with Lalatoot .

It's possible - but tricky - to get lio prescribed on the NHS. It has to be prescribed by an endo - and not many will, because it's expensive, they don't understand it, and it has a very short half life so is difficult to measure.

I'd suggest (a) emailing Dionne at Thyroid UK - [e-mail] - for the list of T3-friendly endos to see who is reasonably close to you. You don't have to see the nearest person but must obv be reasonably convenient.

(b) a separate post asking if anyone can recommend anyone near-ish to you, or if they have any experience of an endo you've looked at

(c) if there's no-one really suitable, googling the hospital thumbnail biographies of the endos who are near-ish to you and seeing if any of them mention thyroid or of they're really all diabetes specialists.

You will need to show that you convert badly and still have hypo symptoms despite high in-range free t4. Worth taking someone with you to emphasise how you're still not properly well.

Good luck x

[Hashihouseman]

That’s what happens to me on 150 levothyroxine, 125 levothyroxine and 5 liothyronine works much better. If you can get it! Another thing to try is split your levothyroxine dose bedtime and waking or even into three if you can keep it away from food and coffee etc during the day.

[HashiFedUp]

Your TSH is too low and could be making you feel worse. Ideally TSH should be something between 1.0 and say 0.3. I need mine to be around 0.6 to feel well.

Your T4 and T3 should be about 75% up through the range.

See if you can achieve this before adding T3. If not, then you might need T3 as an addition. Good luck.

[NWA6 in reply to HashiFedUp]

I don’t understand this advice? 🤷‍♀️ to me TSH is irrelevant when supplementing. How would you suggest the poster raise the TSH whilst also raising FT4/3?

This is not a loaded question genuinely interested in different views.