T4/T3 combination therapy - day 30

[Lotika]

I started an NHS trial of T4/T3 therapy and was told to cut levo from 100 mcg to 50 mcg (ouch!) and introduce 2 x 5 mcg T3 daily. My vitamins were within NHS range, but I am upping ferritin, B12 and D on advice from the board.

I've been keeping a symptom diary, so this is an attempt to unpick the themes for broader consumption.

- I feel a general uplift in my sense of well-being almost immediately on starting T3 and am less depressed than I have been at any time in the past 5 years.

- I am struggling with low energy/tiredness more than I did on T4 only; I think this is because the endocrinologist cut my T4 too drastically, but the tests will tell.

- I think my female hormones are doing a little better, so the painful heavy periods I had a very long time in the past are back and my boobs are starting to look like my boobs again. I can only think this is because my woman hormones are now more like my hormones used to be?!

- I had what I think was a hashi's swing, where I felt great for a few days (8-11) or maybe it was just that moment where the sudden reduction in T4 and introduction of T3 met in the middle, before the residual T4 from my old dose left the system? Don't know. Anyway, the amusing part for me was that I was my ADD old self, brain buzzing around jumping from one thing to another like it ever did. I'd forgotten that part of "old me" as having a butterfly brain can be a bit annoying and I used to do yoga and meditation to get a grip on it. I look forward to having it back, because my memory tells me that butterfly brain on yoga feels really good

- Over the last couple of days I can wear my wedding, engagement and eternity rings all the time because the swelling in my fingers is significantly reduced.

- My shedding hair didn't form the usual knitted knuckledusters around my fingers when I washed it earlier this week.

- I took a long walk this weekend (day 26) and felt exhausted afterwards, just like some of the experiences I thought were T3 crashes before. That surprised me as I thought the medication should stabilise my T3 levels. There's probably a lot to unpick.

- I have also knocked out gluten properly (finally) over the last couple of weeks and been a bit intermittent with dairy... I still have stomach pains when I am both GF and DF, so I have done a food intolerance test to see what that comes back with. I don't get tummy pains when I go full-on paleo, but I don't want to live that way forever, not least because I would like more carbs in my diet! I don't have the patience to reintroduce things gradually at the moment, but I know there is something going on with my diet and intolerances more generally... maybe the test will yield some clues, or if not, I'll just have to bite the bullet and be methodical about it.

- My joint pain hadn't completely disappeared since starting T3, but it had dropped considerably until day 25, which was, coincidentally, also the day I decided to reintroduce dairy. That having been said, my joint pain was lessening before I cut dairy, so I consider the dairy link to be inconclusive but requiring further investigation!

I can't wait to test in 12 days time! My working conclusion is that they will prise T3 from my cold dead hands, but I need a bit more T4 to get back to me properly!

Lotika.

[SlowDragon Administrator]

Sounds like you are evaluating the situation well

Exhausted after long walk....not surprised...it’s early days

Would agree, likely to see significant drop in Ft4

[Lotika in reply to SlowDragon]

Thank you! I think I am going to get an iron and vitamin D test done at the same time. These were last done 24th Nov, so it's probably too soon to tell much, but I'm guessing a test will tell me a little bit of something, reassure me that I'm going in the right direction at least...

[MMaud]

Lotika - As someone who lives a low carb lifestyle, I wonder what it is about Paleo that really irks you? For my world, Paleo can be pretty carby, bearing in mind you can have apples, bananas, and it seems the jury's out on potato for a Paleo way of living.

I have a bit of a theory about food intolerances, which I always try to talk myself out of, until it hits me between the eyes, yet again. (For me, right now, I'm trying to ignore what I think dairy does to me, rather than for me)

To be clear, I'm not criticising you for wanting to eat what you want to eat, and one thing is sure, whatever you do, you are the one who lives with impacts, so sometimes things are a real compromise, in terms of benefits and effort/restrictions, or whatever.

[Lotika in reply to MMaud]

Thanks, MMaud, that's a really great question and it has made me have a good long think about my relationship with diet! This is probably a bit boring to read, but it's been really helpful for me to write it, as it has helped me sort out my thinking a little!

First, I completely feel your pain with this food intolerance business. I think I spent years in denial and probably still am to some extent! Dropping dairy is for the most part fine, except I really really miss a cup of tea. I have't found an alternative milk I can use happily in tea. People say oat milk is good, but I don't think it is GF.

I spent most of my life thinking that everyone had a permanent stomach ache until I tried a few days of GF when I first found the board and discovered that they don't! I then found that my stomach was happy that I could have gluten sometimes as long as I didn't have too much of it... And that there are other things as well.

I would say that my (psychological) resistance is, in general, to cutting anything.

The first reason is because I want to be able to eat as many things as possible because I love food, I love sharing food, I love showing my appreciation for people by cooking for them: it's an integral part of my life and I've obtained a professional cooking qualification on the side and developed a dish which is on the menu at a local pub, for example. Food is a big creative outlet and I want to be able to paint with as many colours as I can. The second part of that psychological resistance is that I'm a bit "all or nothing" so sometimes I can't be bothered and want to whack two slices of bread in the toaster for lunch and have the whole operation over with in 10 minutes. Annoyingly, I think there is something even in GF bread which disagrees with me. But, in general, I find glutenous products or GF imitations so much more convenient. Paleo, for me, seems to take quite a bit of expense and organisation! Third, one of my big treats in life is eating out (and I used work in sales, so there's that whole business lunch issue) and I really don't want to be *that person* who can't have this, that or the other in a restaurant... who can't even eat off the menu at certain pubs... it sounds really life-limiting and scary.

The fourth is I am just as mad as hell with my thyroid for wanting to run my entire life and limit my food choices as well as all the other things it has done! I think this is where I end up falling back into that denial loop with food intolerances on a regular basis. I just think "ah, to hell with it" too frequently. I think I can only manage GF properly right now because pubs and restaurants are shut.

I find carbs comforting... but... I don't think I have any issues with rice or rice noodles, quinoa or potatoes. And, for eating at home at least, restricting to meat, vegetables, rice, quinoa, potatoes, fruit and maybe the occasional dollop of creme fraiche in a wonderful French style stock and wine reduction with whatever herb springs to mind, is perhaps not the end of the world! But oh for a decent cup of tea!

Lotika