morning temp 35.3: Adding T3 onto my T4 seems to... - Thyroid UK

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morning temp 35.3

jrbarnes profile image
12 Replies

Adding T3 onto my T4 seems to be lowering my T4 judging by my temperature and how terrible I feel. Now I'm starting to get swelling in my face and fingers and my limbs are freezing. Not sleeping. Does anyone know what's happening here? Currently on 88mcg T4 and 15mcg T3. Last blood test were on 88mcg and 5mcg T3.

T4 1.6 (.82-1.77) ng/dl

T3 3.1 (1.2-4.9) pg/ml

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jrbarnes
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SlowDragon profile image
SlowDragonAdministrator

Was this test done as early as possible in morning before eating or drinking anything other than water and last dose levothyroxine 24 hours before test and last 5mcg T3 8-12 hours before test

When were vitamin D, folate, ferritin and B12 last tested

What vitamin supplements are you currently taking

Have you ever had high thyroid antibodies and if yes.....are you on strictly gluten free diet?

jrbarnes profile image
jrbarnes in reply to SlowDragon

Tests are done before 9am and fasting. Always the same way for the past ten years. Vitamin tests were recent. I'm on methyl B12/folate, liquid VitD/K by Thorne, and Solgar zinc/copper/msm. I tried Thorne B complex but it was too much so I've ordered another brand with a gentler b complex. B12, D, and folate have been brought into the optimal range. I'm still working on ferritin as it was not extremely low but sub optimal. I've been gluten free for 2.5 weeks. I had a rare hurthle cell adenoma which is a benign form of hurthle cell cancer, therefore a partial thyroidectomy 13 years ago. Only symptoms prior were slight fatigue, hypoglycemia and acne. The surgery pushed me into overt hypo. Despite a TSH of 5 and half a thyroid I always felt better without Levo. I only got on Levo because I fear another growth. No TPO antibodies. TGA was flagged high as "4 H" with no ranges given. I don't consider "4" to be very high but as no ranges were given it wasn't helpful. The only way I've ever felt normal on Levo is when I'm dosed over the reference range in FT4. It only gets my FT3 levels to 70%. It hasn't been long enough for me to test again but I feel terrible adding this T3 to my usual dose of Levo. I'm certainly not over medicated. My body aches and my bones are cracking, fingers and neck hurts. I can't think and my vision is poor. I have no appetite and barely sleeping. My hypoglycemia is worse. I'm not sure if it's the Levo. When I reduce to 75mcg I feel better mentally. I can sleep and my appetite returns however the body weakness and fatigue is worse. I was doing 75mcg + 12.5mcg of T3. Do you think I wasn't taking enough T3 to compensate? Thank you

SlowDragon profile image
SlowDragonAdministrator in reply to jrbarnes

Was last 1/4 tablet of T3 8-12 hours before blood test

How are you taking T3

As 2 x 6.25mcg at roughly 12 hour intervals

Or if on 18mcg - as 3 x 6.25 at roughly 8 hour intervals

It’s not easy getting started on T3

Almost as soon as start on any dose of T3 TSH becomes suppressed and your own thyroid output ceases virtually completely. So it’s essential to be taking enough levothyroxine/T3.......but it’s trial and error what dose you need and timing of T3 can be critical too

jrbarnes profile image
jrbarnes in reply to SlowDragon

I have the Sigmapharm T3 in 5mcg tablets. I've been experimenting on when to take it and how many times. 15mcg split into three doses, 8 hours apart. Levo has created a real problem for me all these years by lowering my TSH and slowing down the T4/T3 conversion. Despite low T4 levels after my surgery my body was doing a better job without Levo. It's making me start to think that the high T4 levels and Levo is standing in the way of getting the T3 I need. I checked my raw DNA and my rs2235544 DIO1 shows the CC allele which is associated with lower T4 levels and an increase in free T3/T4 ratio. This also makes me wonder if having high T4 levels is going against the grain. I read all the stories about people adding T3 and instantly come alive. It's frustrating.

SlowDragon profile image
SlowDragonAdministrator in reply to jrbarnes

When I first started T3.....it made me feel better in some ways....mainly could actually walk and far more useable energy....but that didn’t mean it was easy....far from it......getting use to it and rest of endocrine system trying to catch up.....nearly chucked whole lot in the bin several times. I always find weeks 4-8 approx after any dose change is grim

I could never tolerate T3 when tried many years previously due to (undiagnosed) low vitamins and gluten intolerance

jrbarnes profile image
jrbarnes in reply to SlowDragon

I finished reading your bio page and it was helpful and informative. Looks like I'm taking the T3 at the same times- 7am, 3pm and before bed. I took 5mcg T3 last night with an extra pill of Levo. Felt terrible this morning and took another Levo pill with no T3 and I feel a little better. I looked for my DIO2 gene and have the TT allele so I don't think I have the poor conversion gene. It's possible I may have to hold off on adding the T3 again until I get my Levo sorted. I'm curious if some people need over the range T4 levels to make Levo work because I have to be at 113% or higher in the range to feel functional and normal. Trail and error. All I can do is add an extra pill over 6 weeks and see what happens. Thank you for the help.

SlowDragon profile image
SlowDragonAdministrator in reply to jrbarnes

Common to need high Ft4 if only on levothyroxine

But not everyone can tolerate higher Ft4 ...then need to add T3 instead

Dr Toft, past president of the British Thyroid Association and leading endocrinologist, states in Pulse Magazine,

"The appropriate dose of levothyroxine is that which restores euthyroidism and serum TSH to the lower part of the reference range - 0.2-0.5mU/l.

In this case, free thyroxine is likely to be in the upper part of its reference range or even slightly elevated – 18-22pmol/l.

Most patients will feel well in that circumstance.

But some need a higher dose of levothyroxine to suppress serum TSH and then the serum-free T4 concentration will be elevated at around 24-28pmol/l.

This 'exogenous subclinical hyperthyroidism' is not dangerous as long as serum T3 is unequivocally normal – that is, serum total around T3 1.7nmol/l (reference range 1.0-2.2nmol/l)."

(That’s Ft3 at 58% minimum through range)

You can obtain a copy of the articles from Thyroid UK email print it and highlight question 6 to show your doctor

 please email Dionne at

tukadmin@thyroiduk.org

Important to stick on same dose levothyroxine for at least 6-8 weeks before any blood tests

jrbarnes profile image
jrbarnes in reply to SlowDragon

Thank you. I'll take a look at this article.

SeasideSusie profile image
SeasideSusieRemembering

Jrbarnes

Last blood test I've converted to SI units

I might be being dense here, but what do you mean by you've converted them?

We only need the result and reference range as given to you, we don't need to convert them to anything else to understand them. So if those results/ranges are not how they came to you, can you post them exactly as you had them to avoid any confusion.

jrbarnes profile image
jrbarnes in reply to SeasideSusie

I had some issues with others stating that they didn't understand my results since they weren't in pmol/L so I converted them from ng/dL. I've edited and posted the original results above.

SeasideSusie profile image
SeasideSusieRemembering in reply to jrbarnes

It looks like it was just one member. Everyone else seems to be happy enough with seeing the original results without the need to convert. Messing around with converting units could possibly lead to inaccurate numbers which doesn't help anyone.

jrbarnes profile image
jrbarnes in reply to SeasideSusie

I should rephrase that to "one issue" which led me to assume others might refrain from answering if they don't recognize those labs. I'll stick to the originals from now on. I've been reading some bio pages and old posts to better understand how people are approaching T3, which is helpful.

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