Reduce my t3

[JBL312]

Please advise on my most recent blood tests please. I take 25mcg t3 and 150mcg t4.

[SeasideSusie Remembering]

JBLOVELL

When did you take your last dose of Levo and T3.

Last dose of Levo should be 24 hours before the test.

Last dose of T3 should be 8-12 hours before the test.

Once we know when you took these we can comment accurately.

[JBL312 in reply to SeasideSusie]

My last dose of levo was 24 hours before and my last dose of t3 was 11 hours. Thank you

[SeasideSusie Remembering in reply to JBL312]

JBLOVELL

OK, so you are overmedicated. You should definitely reduce your T3 to bring your FT3 down into range.

On combination thyroid medication we are all individual as to where we need our FT4 so we have to tweak doses to achieve optimal doses for ourselves. Some people are fine with a low FT4 others need FT4 higher in range, maybe balanced with FT3 in the upper part of their ranges. So you may also need to reduce Levo at some point, it's all down to trial and error.

For a first step I'd suggest reducing your T3 dose to 18.75mcg, retest in 6-8 weeks and see what your levels are like then, and decide if any further tweaking is necessary.

[JBL312 in reply to SeasideSusie]

Thank you so much. Sorry to be a pain but how do I get an accurate amount from a 25mcg tablet? Would halving it be too much of a drop?

[SeasideSusie Remembering in reply to JBL312]

JBLOVELL

I use 25mcg T3 tablets and I can quarter them fairly accurately with a pill cutter. Some people use a craft scalpel.

This is the pill cutter I use which I bought at my local pharmacy :

amazon.co.uk/Safe-Sound-Pil...

So you need to reduce to 3/4 of a tablet daily to start with and see how you feel and what your levels are like after 6-8 weeks. You might find that you want to try reducing Levo a bit next.

[Hashihouseman]

It’s not so much about when you took your dose in relation to the test sample time (unless they were within 4hrs or so) it’s that your total replacement thyroid hormones are clearly potentially excessive without even knowing your blood test results! TSH is clearly suppressed to potentially unhealthy levels and ft3 is straying into hyperthyroid territory, don’t you feel overmedicated??? Gradually reduce t3 and repeat tests within days then gradually reduce t4 and repeat tests in 4-6 weeks. Adjustment may cause discomfort because you may have become almost drug like addicted to those t3 levels so maybe don’t go cold turkey but in the long run try aiming for tsh 1-2 ft3 4-5 and ft4 about 16-18

[JBL312 in reply to Hashihouseman]

I have been feeling really hot and tired, which is why I had another test. The results seemed to have jumped up. I have Hashimoto’s, could that be why? Could too much t3 cause depression and fatigue, but not sleeping well?

[Hashihouseman in reply to JBL312]

Yes, for sure it could! It pushes metabolism beyond where it wants to be and potentially fatigues adrenal response, thyroid hormones should not drive metabolism but facilitate it!

[Hashihouseman]

PS I find 7mcg liothyronine and 110 mcg levothyroxine both in 3-4 split doses give near normal thyroid function test results, your body may be struggling to deal with all that thyroid hormone by metabolising it to reverse t3 and excreting more than normal to avoid excess (the body prefers to hoard thyroid hormone metabolites).

[AndiRiley]

How do you feel? Do you feel too hot or do you have lots of nervous energy? If you feel good, how are your blood pressure and resting pulse rate at various times of day. If these parameters are all normal, be VERY wary of reducing your doses. TSH is irrelevant in many people. I am one of those.

[JBL312 in reply to AndiRiley]

I overheat really easily and I’m tired.

[AndiRiley in reply to JBL312]

Overheating is a strong sign that you are over-medicated. The easiest experiment to do is to reduce your T3 dose by a bit and see if it helps. The beauty of adjusting T3 rather than T4 is that the effects happen quickly and you can increase your dose again and go back to your original state very quickly.The complication with all of this is that different parts of your body need different amounts of T3 and if you have localised deiodinising enzyme issues or more general conversion issues, then you will have to get into adjusting your thyroxine dose as well.

TSH as I originally stated can be viewed as irrelevant in assessing your thyroid hormone levels once you are on thyroid medication. Whether or not it affects other aspects of your bodily function is also largely irrelevant in a scenario where you can only feel satisfactorily "well" when your TSH is suppressed. Bone building can be addressed once you feel well enough to be bothered about it.

[JBL312 in reply to AndiRiley]

Would reducing my t3 make me feel nauseous? I have reduced and I feel sick. May be just a coincidence. Also can over medicating cause weight gain? I assumed as I wasn’t losing weight that I wasn’t over medicating. Sorry for my ignorance and thank you for your help .

[AndiRiley in reply to JBL312]

How much did you reduce T3 by? It probably wouldn't make you feel nauseous anyway. Weight gain won't be caused by over-medication - ever. However, feeling ill and down, not exercising and comfort eating as a result of feeling so bad WILL make you gain weight even if over-medicated.I think you need to find an endocrinologist who understands that some patients have needs which cannot be met by the "normal approach". Failing that, you need to start educating yourself; "Stop The Thyroid Madness" book and website is a good place to start, and the Paul Robinson books might just be your key to sorting this out.

[Hashihouseman in reply to AndiRiley]

TSH is far from irrelevant! It is involved in many complex pathways not least of which in bone osteoblasts for skeletal health. Suppression is only advocated for very specific clinical reasons such as thyroid cancer treatment

[Judithdalston]

I’ve been doing this fine tuning adding T3 for 3.5 years now, and still not ‘right’ as TSH ( well under range), FT4 in 50% and FT3 30% range...can’t get both up into 70% plus. Meanwhile Gp not understanding keeps lowering levo.prescription...officially in 8 months this has been reduced from 125 to 50 mcg