Lowered my dose of liothyronine and now I'm brain foggy, tired and my face is puffy again

[Zazbag]

I was on 22.5mcg lio and 150mcg but had blood test which showed my T3 was 8.1 (top of range is 6.8). I lowered it to 20 for a week then further lowered it to 17.5mcg. All this week I've felt really brain foggy, tired and my face has gone all puffy again. I've also been a lot hungrier and am eating loads more than I have been. I don't understand why, can anyone advise on what I should do about this? I was feeling fantastic on 22.5mcg. Even 20 was okay, but lower than that has me feeling hypo again. Should I try lowering my levo dose instead? On 125mcg my feet were always cold so that's why I increased it. Maybe I should prioritise the T3 though...

[Zazbag]

SlowDragon please can you advise?

[Kalicocat]

I take 75mcg T4 and have just reduced from 6mcg T3 slow release to 4mcg T3 slow release after stopping T3 altogether for 3 weeks to get my levels down. I have been feeling brain foggy and tired off and on since then (2 weeks). However, the last 3 days I'm starting to feel like my old self. It takes time for everything to adjust. I still may end up at 5mcg T3 per day (getting tested again beginning of March), but I ended up having too much T3 back in October so that is why I asked for a reduction in dose. I tried reducing my T4 but it only took a week to know that that was a big mistake.

You are on ALOT of thyroid hormone. Be careful, too much can cause lots of problems, one of them is weak bones, I just found out I have osteopenia. Not sure if it's just from age, post menopause status or from too much T3 over the last 2 years while we played with my dose. Or it could be a combination of all 3....

[Zazbag in reply to Kalicocat]

Thanks for replying, this is interesting to know. I felt okay on 125mcg levo, my feet were just noticeably cold all the time whereas when I'd been on 150mcg (before I tried lio) they were usually warm. Other than that I felt fine with 125mcg levo. I'm not sure what ratio they are meant to be with each other, would that be something to aim for?

[Kalicocat in reply to Zazbag]

From playing with my dosages, I really believe this article is bang on: ncbi.nlm.nih.gov/pmc/articl...

It states that the thyroid makes approx 100mcg T4 and 6mcg T3 per day (based on a certain body weight which I believe is higher than what I currently weigh). The rest of the T3 comes from conversion from various tissues in the body. My endo makes sure that my TSH is not suppressed, if you are getting the correct amount of both hormones it will normalize. Mine floats between 1 and 1.4 usually. If I were you I would target the correct ratios first and if things still don't normalize after 3 months then you can start increasing your T3.

[Mollyfan in reply to Kalicocat]

Please can I ask you where you get slow release T3? I was not aware that it was available. Thanks.

[Kalicocat in reply to Mollyfan]

I get T3 compounded into a slow release capsule. I really wish one of the drug companies would come out with one, they would make a fortune! Anyhow, I googled compounding pharmacies in my area to find which one of them would compound a slow release T3 formula. I also called various pharmacies in my area to find out which endos were prescribing T3. Then I called the doctors to see if they were taking patients and I now have a permanent endocrinologist! I really lucked out with her, she's fantastic!

Most endos in my area punt me back to my GP after writing me a new prescription. My GP will not change my meds without an endo's input, so I felt bad for a long time and wasted so much time running from doctor to doctor. BTW, my endo will not allow my TSH to become suppressed, and from 2 years of experience, it seems she is right, that it doesn't ever need to be suppressed if you are getting the correct amounts of both hormones.

[Zazbag in reply to Kalicocat]

What's the name of your endo?

[Kalicocat in reply to Zazbag]

PMed you.

[Mollyfan in reply to Kalicocat]

Thank you so much.... is that in the NHS or privately? It definitely seems a sensible way to go!

[Kalicocat in reply to Mollyfan]

I'm actually from Canada, so no, not in the NHS. From what I read on here you will likely be better off with a private endo.

[Mollyfan in reply to Kalicocat]

Very true! Thanks.

[jrbarnes in reply to Kalicocat]

I also tried to reduce my Levo to introduce T3 and couldn't make it past a week so I went back to my original dose, which was still too low, and added an extra 12.5 mcg of Levo for a few weeks. Today I started to add 2.5mcg of T3. I'm now on 100mcg of Levo.

[Kalicocat in reply to jrbarnes]

You'll find you don't need much T3 in order to feel a WHOLE lot better!

[Zazbag in reply to Kalicocat]

That's true, but it wears off if the dose is too low and you get massive energy slumps 6-8 hours after the dose. That didn't stop happening to me until I was taking at least 15mcg.

[Kalicocat in reply to Zazbag]

LOL, do I know that! That's why I get it compounded in a slow release capsule! It works perfectly and doesn't cause any slumps. I tried Cytomel and thought I was having a heart attack every afternoon. With the slow release I am not over medicated and not getting the slumps. That's why Pfizer needs to make a slow release Cytomel, they'd make a killing.