I am currently undergoing dual therapy trial with 100 mcg Levothyroxine and 25 mcg Liothyronine. Twice my consultant has tried to increase my T4 to 125 mcg and after a few weeks I get a racing heart which leads to poor sleep as it is more obvious at night and exhaustion during the day and I often go to bed in the afternoon. My dose has been reduced back to 100mcg each time it has happened and after a couple of weeks things have settled.
The addition of T 3 has really helped me. The last increase a few weeks ago from 20mcg to the current 25mcg gave me a real boost with energy levels and wanting to get out and exercise again. I honestly thought we had it right. The last two weeks have seen a gradual increase in heart rate and my borderline hypertension is on the rise. I believe it is because of the medication rather than anything else. Last night was hideous. No sleep at all and a heart rate is abnormal for me in the high 80s. It still is as I type this.
I haven't taken any of my medication today and my heart rate remains too high. I didn't think I needed any more stimulation until it returned to normal.
I have tried to contact my Endo for advice but no response yet.
Because my heart rate hasn't decreased I am wondering if the culprit is the Levo. Increasingly I feel it is not good for me although I was fine on it for many years and think it all started going wrong around the menopause.
I would like some guidance - if possible - about what I should do today. Not take anything and restart tomorrow with a decreased Levo to 75mcg or Lio down to 20mcg?
When I was on 100mcg T4 and 20 mcg T3 I felt ok but knew I could be better. I feel it is the T3 that is helping me more right now and am loathed to decrease it although I will as a temporary measure.
I have a blood test booked for a weeks time but will cancel as cannot continue on this current regime for another seven days. Ideally I would like try and stabilise my medication before any blood test. I don't need a blood test in a week to tell me something is very wrong and I don't intend to stay on my current dose for it either.
I am still hopeful my Endo will respond ...but in the meantime any suggestions would be gratefully received.
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Carna
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I am not coeliac. I am not gluten completely free and have no apparent gut issues. I have tried going strictly gluten free for long periods but it does not appear to make any difference to me or how I feel or my body behaves. I do, however, not eat anything like the amount I used to and bread (only good stuff not cheap supermarket) is a treat.
The only thing that affects me - in a positive way - is addition of T 3.
I was going to check vit levels this time round when I had blood taken so no I haven't recent levels. I have been keeping up with Vit D and zinc as well as a multi vit and mineral.
Yes I am splitting my dose but only in last few weeks since increase. I had been taking 20mcg in the morning previously but my Endo asked me to split it last time before she increased it to 25mcg. I had it split from the beginning but I read on here that someone found there was no detriment to them to taking it in one dose so I tried it and thought the same but right now it is split. Well I say right now I have had nothing today so far. I don't whether I should take anything or not and start again tomorrow with a lower dose of either T4 or T3. I will try and call the Endo again soon.
These symptoms are, I think, a result of too much medication but I don't know which.
I am on 100mcg of Levo now. I have just heard from Endo via practice manager and she has suggested I lower Levo to 75mcg and keep T3 at 25mcg and see how I go. That is what I hoped she would say really.
Ok try that (I thought you were still on 125mcg levothyroxine)
Getting bloods tested 6-8 weeks time
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).
I on T3, make sure to take last third or 1/4 of daily dose 8-12 hours prior to test, even if this means adjusting time or splitting of dose day before test
Yes I do that. I was thinking about taking my Levo at night but will leave as it is in morning until I see how this new dosage pans out! My Endo has asked for a blood test in six weeks but to go back if I am concerned or things don't settle down. Thanks for your support. I was feeling a bit anxious.
That's a very good suggestion. Your endo actually sounds sensible. Keep that T3 going, it gave you a boost and gave you energy. Drop the T4 down. If I were you I would take my T3 today and just skip the T4 until tomorrow.
I'm no T3 expert, but I have used it a little and will be starting again soon. I am experienced in altering T4 doses. I seem to react to T4 very quickly, although people say you can't. Perhaps because I'm a poor converter. If I take an extra 25mcg T4 tomorrow morning I will feel much better tomorrow and then it will wear down. I've been taking an extra 25mcg tablet once a week to try to nudge my level up a tiny amount. It has worked like that for me every week. Now in preparation for T3 I've stopped it and feel more even.
I hope you manage to get yourself right. I am now coming to the conclusion that I should do the tweaking myself and when I feel ok/better then blood test and say this is what I need to feel like I should - or as near to it as possible. I also don't think dosage can remain static. Things change and it has to be adjusted when they do. Most GPs I have met say don't change it at all!
I'm sure you are right. We need the doctor's advice perhaps to get us going. But then it's up to us and yes, we might need more or less of something at different times of year/life. Ultimately it's us that knows how we feel.
I'm dreading the experimentation because I live with atrial fibrillation anyway and thus, even with beta blockers, my resting heart rate is high 80's or more likely in the 90's. But at least the BB's mean I don't feel it so much. GP would freak out at T3 with atrial fibrillation because they don't understand it. But endo has prescribed so I'm OK to try. I need to adjust something else first, so I will be starting T3 in around 4 weeks time.
Good luck. I hope you feel better tomorrow, but remember that T4 takes time to reduce.
I feel less anxious already that a positive step has been taken. I have hunted down some 25mcg and 50mcg Levo to take tomorrow. I am not expecting immediate results but feel I am on the right path now.
That heart rate is disturbing - especially at night. Hope your T3 trial goes how you want it to. Taking control of our lives and demanding better for ourselves when we don't feel well is a struggle but it is important to battle on.
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