NHS Endo agreed to trial T4/T3 advice please.

[Flecmac]

My NHS Endo agreed to a trial of T4/T3 yesterday. He warned me of all the risks. He even said he has no idea why the NHS are so stuck with liothyronine and cost etc!!! Far more productive than I expected!! Only a trial of course. His registrar reduced my Levo in April alternating 75 mcg / 50mcg 5 days and 50mcg for 2. Yesterday Endo advised 50mcg Levo 10 lio daily. I do have palpitations and he warned that lio can make this worse. Any advice will be gratefully received.

Many thanks.

He isn’t on the TUK list but another Endo from same hospital is.

[SlowDragon Administrator]

Recommend starting very slowly

Reducing levothyroxine for 3-4 days before starting T3

5mcg T3 in morning

See how that goes

After week or so, add 2nd 5mcg dose mid to late afternoon

Retesting in 6-8 weeks

[Flecmac in reply to SlowDragon]

Thanks, I take Levothyroxine between 5-6.30 am, so 5mcg T3 at sane time as levo? Then introduce second T3 in afternoon? What about food/hot drink as with levo?

[SlowDragon Administrator in reply to Flecmac]

Yes T3 same time as levothyroxine at 5am

Frequently improves sleep, you may find you drop back off into deep refreshing sleep

Yes ideally avoid food and drink an hour either side of T3....though it’s quickly absorbed, so not as fussy as levothyroxine

[Flecmac in reply to SlowDragon]

Ahh thanks!!! I haven’t had a good nights sleep in over 10 years!!! xx

[Flecmac in reply to SlowDragon]

SlowDragon. Sorry that should have read 10mcg twice a day, so should I still do as you say and start on 5 mcg in morning fo while or 10mcg, then split dose 5 mcg morning then 5 mcg afternoon or 10mcg each?

Many thanks

[SlowDragon Administrator in reply to Flecmac]

Yes we recommend taking it slowly and increase slowly upwards in 5mcg steps

I take 20mcg per day - started 5mcg per day and then 2 x 5mcg. Roughly 12 hours apart

After bloods at 6-8 weeks dose was increased to 20mcg per day - 10mcg at 7am, 5mcg at 3pm and 5mcg at 11pm

[Flecmac in reply to SlowDragon]

I have edited my last post to you, so could you please clarify? Many thanks ☺️

[SlowDragon Administrator in reply to Flecmac]

starting on just 5mcg in morning

Waiting a few days .....assuming ok

Add 2nd 5mcg dose mid-late afternoon

Assuming ok....a few days later increase morning dose to 10mcg .......

or may be better to change to 3 x 5mcg at 8 hour intervals

Week later

Add final 5mcg

[Flecmac in reply to SlowDragon]

Ahhh thank you so much for your help xx

[Flecmac in reply to SlowDragon]

I have followed your suggestions above and currently on 5mcg 3x daily spaces 8 hours apart. So next should I go straight to 10mcg morning then 10mcg late afternoon? Many thanks for your help. 😊

[SlowDragon Administrator in reply to Flecmac]

I would strongly recommend waiting 6-8 weeks after getting getting to 3 x 5mcg - FULL thyroid and vitamin testing done

Last dose levothyroxine 25 hours before test

Last 5mcg dose T3 8-12 hours before test

Alternatively (as endocrinologist recommended 20mcg) you could increase morning dose to 10mcg .....then test 6-8 weeks later

Personally I wouldn’t rush to increase too much too soon

Come back with new post once you get results

[Flecmac in reply to SlowDragon]

Thanks.

[SeasideSusie Remembering]

mcdermott

He isn’t on the TUK list but another Endo from same hospital is.

Please forward his name and which hospital on to either Lyn Mynott or Dionne so he can be added to the list.

[Flecmac in reply to SeasideSusie]

Do you have a link for Dionne please? Thanks

[SeasideSusie Remembering in reply to Flecmac]

[e-mail]

[Flecmac in reply to SeasideSusie]

Thanks xx

[jrbarnes]

He warned you of the risks of better sleep, lower cholesterol, lower blood fasting glucose, better heart and respiratory function-thank goodness! I cut the liothyronine up and take it two or three times a day. I might get palps a little when it reaches its peak, which is why I split them. Many functional practice Doctors here in the US use compounded slow release T3 to avoid those peaks. I've just had to switch my prescription to another location to get a liothyronine manufactured by a different pharmaceutical company because the previous one felt like I was taking nothing.

[Hay2016]

Adding t3 to my levo stopped majority of my palpitations. I crept up in tiny 2.5mcg increments a week to ten. Endo suggests snd won’t budge on 5mcg As she doesn’t want me “thyrotoxic” but I supplement with own bought t3.

[Flecmac in reply to Hay2016]

Thanks, could you explain ‘Endo suggests snd won’t budge on 5mcg As she doesn’t want me “thyrotoxic” but I supplement with own bought t3‘ please? Thank you. ☺️

[Hay2016 in reply to Flecmac]

She won’t prescribe more than 5mcg, I bought thybonn and so take 10mcg a day. I have no idea what she means by thyrotoxic. My t3 is 50% through range on 5mcg but 60-70 on 10mcg and I feel well. So I’ll take 10mcg and monitor myself. I’m on yearly appointments now.

[Flecmac in reply to Hay2016]

Ahh thank you!! ☺️

[Babette]

I take liothyronine only and almost never get palps but had them several times a day on levothyroxine so it's really about what works for the individual. Fingers crossed this you'll feel better and it becomes more than just a trial.