Starting T3 with T4 advice please : I’ve taken... - Thyroid UK

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Starting T3 with T4 advice please

LECJ profile image
LECJ
15 Replies

I’ve taken T4 for over 20 years at around 125mg however over the past year my bloods have show I’ve been over medicated so I’m now on only 75mg having still shown a TSH of 0.01 on 100mg. Antibodies indicate hashimotos.

With my endocrinologists support I have sourced T3 by Uni-Pharma and am due to start taking it twice a day together with 50mg of T4.

Endo has advised that I may not feel very well & this has left me feeling somewhat anxious about introducing the T3

Can anyone say please how introducing T3 made them feel positives and negatives and if there is anything I should be aware of?

I’m also wondering if it may effect my already tricky blood sugars

Many thanks guys and gals xx

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LECJ profile image
LECJ
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15 Replies
fuchsia-pink profile image
fuchsia-pink

T3 medication is very strong and has a very short half-life. People react to it differently - but the best advice is to take it "low and slow" to start with.

Get a tablet cutter or a sharp scalpel and cut your lio into quarters initially. I assume you have been told to take 20 mcg (1 tablet) a day? If so, take 1/4 tablet a day for the first couple of weeks (with your levo is fine, fasting and just with water - 1 hour before other food or drink or 2 hours after, as you would (should!) with your levo. Then build up to 1/4 tablet twice a day (one bit in the morning and one bit at night); then add a third quarter, then 1/2 tablet in the morning and half at night.

The once you're stable, see if taking it twice a day suits - it doesn't suit me, so I take everything first thing - but there are no hard and fast rules.

Don't reduce your levo and start lio at the same time - if you don't feel "right" you won't know which change didn't suit you. If it were me, I'd get up to half my lio first, then drop down the levo, then build up the rest of the lio.

Good luck x

ps assume your key nutrients are good - ferritin, folate, vit D and B12; you need these to be at good levels to get the most from your lio

NWA6 profile image
NWA6

Huge drop in Levo!! Are you sure you were over medicated? What were your results while on 125mcg?

I hate to contradict fuchsia-pink but T3 is not ‘very strong’ I can’t think of it like that. It’s different and I take it because I can’t easily covert my Levo to T3 at a cellular level. Taking T3 doesn’t give me a ‘buzz’ I don’t feel like it’s ‘strong’ in fact I didn’t take it ‘low and slow’ when starting. I was prescribed 15mcg and took it in 3 doses from day 1. Didnt have any repercussions. I’m now on 25mcg. I can take it all at once or split. I’ve tried it all ways. No adverse effects. I’ve missed a dose and not ‘missed’ it as it’s not like a drug, there’s a build up in the system.

Anyway back to you. What were your results on 125 Levo and now after being on 75?

Lalatoot profile image
Lalatoot

Week 1 Reduce levo by 25mcg

Week 2 Add one quarter lio tablet. Can be taken same time as levo

Week 3 If all ok add and quarter tablet lio either as second dose

Wait 2 weeks

Then add another quarter tablet lio either to existing dose or as third dose.

Wait 2 weeks

Add last quarter tablet to existing dose.

Wait 8 weeks. Blood test.

adin profile image
adin

only 75mg from 125??? you don't feel sick?

SlowDragon profile image
SlowDragonAdministrator

Have you got recent results of TSH, Ft4 and Ft3 from reducing levothyroxine from 125mcg down to 75mcg?

Where Ft4 is within range on last test depends on wether you need to lower levothyroxine dose or not when starting on T3

For example if at last test Ft4 was 24 (12-22) you would lower levothyroxine 25mcg before starting on T3

If Ft4 was 16 (12-22) you wouldn’t lower levothyroxine

Adding T3 ....generally, most people need to add very slowly.

Starting with 1/4 tablet in morning

Assuming that is going ok ....after a week or so add second 1/4 tablet mid-late afternoon

Personally I would then hold at that dose for 6-8 weeks and then get FULL Thyroid and vitamin testing

Before considering adding any more T3

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

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)

If/when also on T3 make sure to take last half or third of daily dose 8-12 hours prior to test, even if this means adjusting time or splitting of dose day before test

List of private testing options

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

Thyroid plus vitamins including folate (private blood draw required)

medichecks.com/products/thy...

Thriva Thyroid plus vitamins

thriva.co/tests/thyroid-test

Blue Horizon Thyroid Premium Gold includes vitamins

bluehorizonbloodtests.co.uk...

If you can get GP to test vitamins then cheapest option for just TSH, FT4 and FT3

£29 (via NHS private service ) and 10% off if go on thyroid uk for code

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

monitormyhealth.org.uk/thyr...

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

medichecks.com/products/nut...

Medichecks often have special offers, if order on Thursdays

That was massive drop in levothyroxine from 125mcg to 75mcg and quite likely to have lowered your vitamin levels

When were vitamin D folate, ferritin and B12 last tested

Please add results and ranges if you have any

what vitamin supplements are you currently taking?

LECJ profile image
LECJ

I’ll pull up results Etc the reduction wasn’t quickly but over a period of about 1 1/2 years - my tsh was 0.01 Whilst my T4 was in range (I didn’t have the t3 Test at the time) I believe Those results can be indicative of over medication

My tsh was last 0.07 having been 0.04 (these have increased slightly since the t4 reduction) at last test - I’m due bloods again on Monday so will have good info on the starting place

NWA6 profile image
NWA6 in reply toLECJ

😞 you can’t monitor thyroid health by TSH value once treatment has begun. You did not need such a drop of Levo

LECJ profile image
LECJ

I’m not quite sure how to add photos any pointers pls

tattybogle profile image
tattybogle in reply toLECJ

You can add one photo to the original post but not in replies. Go to original post , click on 'more' then 'edit' then 'add photo' ....... i think (computers not my strong point !)

Or just type them out in a reply , [include range ] like this ;

Date /dose

FT4 0.00 [0.0-0.0]

TSH

FT3

ETC.

LECJ profile image
LECJ in reply totattybogle

Thank u I’ve managed to add one photo but it seems it won’t let me now add any others

tattybogle profile image
tattybogle in reply toLECJ

so thats;

On 75mcg /March 2020

FT4 17 [12-22] which is about 50% through range

FT3 3.8 [ 3.1-6.8] which is very low in range

I think the advice would be you don't need to reduce the levo any more before adding T3. But i don't take T3 so wait for someone who does :)

You can only add one photo , unless you delete that one and add another.

SlowDragon profile image
SlowDragonAdministrator in reply toLECJ

You probably don’t need to reduce levothyroxine as Ft4 is already only mid range

Important to test folate, B12, ferritin and vitamin D

Likely iron levels dropped due to dose reduction in levothyroxine

Ft3 is extremely low so gut function will be poor and then vitamin levels drop,

As you have Hashimoto’s are you on strictly gluten free diet?

LECJ profile image
LECJ

My haemoglobin was moderately low, I had an iron infusion 5 weeks ago - in the past my magnesium was low so i supplement together with Vitamin d

shaws profile image
shawsAdministrator

T3, for me, restored my health and resolved symptoms and its what I've taken for some time now.

I followed one of Thyroiduk's Advisers and expert on T3 (unfortunately he died through an accident) and he advised one daily dose. He, himself, took his T3 in one daily dose but in the middle of the night so that nothing interfered with its uptake.

I've even found that I was able to reduce the dose I'd been taking for sometime.

shaws profile image
shawsAdministrator

I have one word for T3 - and that is 'miraculous'. It is not a storage hormone and I take one daily dose with a glass of water and wait an hour before eating.

That's not to say that others might not have a different experience.

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