Gp recommendation on T3, 😔 I'm Trully lost😢

[birkie]

I posted on here a week or 2 ago and got some brilliant advice as always ❤️. I'm now perplexed as to what my gp wants me to do now!!

Quick run down on T3( 20mg) for 15/16 weeks it's (lactose free teva).. the last bloods done on 12 Dec 2020,..( TSH 19.32), range.. (0.30--4.50..mU/L

T3..4.3),,Range...3.10..6.80..pmol/L

T4..2.6,) ,Range..11.00,,22.00pmol/L

Next bloods 1st Feb 2021....

TSH..14.5mU/L...range 0.30..4.50.

T3..3.pmol/L..range 3.10.. 6.80

T4..2.8.pmol/L..range 11.00.. 22.00pmol

On this test on the 1st Feb the gp contacted an endo who suggested introducing T4 at 50mg in a combo of T3, T4,.. I only took 25mg T4 as I did not want to introduce a large amount, I've never done good on T4 at all and 12 days in to the T4 and I felt awful bedridden as before hyper symptoms not being able to get up without my heart beating out of my chest which in turn made me feel dizzy and sick, I posted my concerns on here, my intention was to just increase the T3 from 20 to 25g, I am going up slowly so my body can get use to the medication as I've found I go hyper when taking to large of an amount, I discontinued the T4 and continued on 20mg, I'm feeling a bit better as the T4 is leaving my system, I spoke to a gp yesterday as I had results back from a scan which has shown a gal stone but nothing to bother about according to the gp, I explained about the T4 and that I had Again discontinued it as I can not stomach it, he agreed and encouraged me to continue on T3 but increase it by 5mg to 25mg, and he would prescribed me 5mg T3 teva tablets, honestly I no they don't do 5mg teva lactose free tablets, but he insisted, OK upshot, got a phone call today from reception to say.... "teva do not do 5mg lactose free medication,, YOU DON'T SAY!!!! 😠 so doctor has prescribed you 10mg, you should take one of these EVERY OTHER DAY... what!!! 🤔🤔🤔 I've been splitting the T3 in to 10mg one at 7am the other I've changed from 4pm to 8 pm as I think slowdragon recommended taking the last dose later on, but what is he thinking saying ever other day at 10mg, I'm trying to increase my T3 to get to a desierd amount 50mg/60mg and to try to lower my TSH, which the increase of 20mg seems to have done going from 19.32 to 14.5,but T3 has lowerd from 4.3 to 3.???.. I've to pick the medication up on Monday so I will read the instructions on the bottle, I'm sure these instructions are wrong🤔🤔🤔🤔

Thanks everyone for any replys. ❤️❤️❤️❤️

[FancyPants54]

Surely they mean that the doctor has prescribed you an extra 10mcg tablet to go with what you are currently taking now? So he's suggested you take the extra every other day because he can't get you a 5mcg tablet to take every day. But you could just as easily cut it in half and get the extra 5mcg a day to go with what you already have if that's what you want to do.

[birkie in reply to FancyPants54]

Hi fancyPants54❤️It's weird, the gp knows I'm splitting the T3 medication so the recommendation should just have been continue to split your dose adding the split 10mg making the overall amount 25mg split in the day... I only have 20mg T3 medication and it's really hard splitting the 20mg tablets up, I use a pill cutter, sometimes they just crumble a bit but I dab the crumbs up, I will look at the instructions on the bottle, but just going with my plan to increase my T3 by 5mg hopefully I can get to 30mg before my next blood draw at the end of march... Crossing everything 🤞🤞🤞🤞

[SlowDragon Administrator]

Teva only make 20mcg T3

If prescribed 10mcg it won’t be Teva and won’t be lactose free

Just get GP to increase the number of 20mcg tablets per month

Cut 20mcg in half and take

10mcg at 7am

10mcg at 3pm

Cut 20mcg into 1/4’s

Take 5mcg at 11pm

After 2-3 weeks assuming all going ok .....increase last 11pm dose to 10mcg

Retest 6-8 weeks later

Always ESSENTIAL to take same dose every day

[birkie in reply to SlowDragon]

Hi slowdragon and thanks for the response ❤️ receptionist assured me the 10mg are teva lactose free... Yes I have my doubts because any T3 I receive as always been 20mg, I don't mind the 20g I've been splitting the dose, did split it 3 ways on 15mg 5,5 5, but I take other medication especially pain meds( I'm always careful to keep these meds away from my thyroid medication) but it was hard doing 3 spilt doses and I found my self in a lot of pain because I needed to wait at least 2 hours or more before taking the pain meds after thyroid meds, changing to 20mg I did 2 split doses which was OK.. Only went wrong when endo introduced the flipping T4, to which I've now discontinued, back on 20mg T3, I am increasing to 25mg I'm using a pill cutter but find it quite hard cutting 20mg tablets up in to quarters they usually crumble a bit, but I dab the crumbs up😁.. I must say I feel much better coming off the T4... I really don't know what those tablets do to me but its not nice, 😔Thanks again slowdragon much appreciated ❤️

[SlowDragon Administrator in reply to birkie]

The only 10mcg T3 tablets are Morningside healthcare brand. They have lactose in

I use a craft scalpel to cut into 1/4’s

amazon.co.uk/Modelcraft-Sof...

[birkie in reply to SlowDragon]

Thanks slowDragon ❤️ will purchase one of those knifes.. I can see me going bk to my surgery to rectify the thyroid medication 🙄🙄

[DippyDame]

So sorry you've had the run around from clearly incompetent medics....not surprised you are confused.

TSH being high indicates under medication....but, not particularly relevant on T3 only

FT4 is abysmally low, but you are not taking levo so that explains that.

FT3 the active hormone required by almost every cell in the body is struggling to even reach into the range

FT3 is the important result

You don't take levo/T4 so you have very little T4 hormone to convert to T3

On T3 only 25mcg isn't enough, you may need at least 50mcg

In your shoes I'd be very slowly increasing the T3 dose

I currently take 100mcg T3 ( but I have thyroid hormone resistance - RTH) in a single dose ( ref the late great Dr John Lowe) at bedtime

Splitting didn't work for me

We are all different so trial and error is really the only way forward to discover correct dosing and timing for you.

The general rule is to increase very slowly (6 -8 week intervals) in small doses (5 or 6.25 mcg) until you feel better

Important to monitor resting heart rate and waking temp to avoid overmedication

Do not exceed FT3 range....unless you are confident that you have RTH

I self medicate so not constrained by GPs and/or endos

Concentrate on how you feel, you seem to have a better handle on things than the medics treating you!

I think you will feel better when you increase your dose.....just be very patient. It took me a very long time to find the dose that suits me.

Good luck

DD

[birkie in reply to DippyDame]

Hi DippyDame❤️Thanks for your reply, yes I'm increaseing slowly as going on a high dose immediately after thyroidectomy made me go back to what I was like before my thyroid was removed (hyperthyroidism graves) i was very toxic hence the removal, my surgeon who I was under for several months after my op dealt with my medication after months of getting nowhere and having bad stomach /bowel problems i found out the medication contained lactose I'm lactose intolerant I've been on T4, not getting any where with it even had liquid form again no good eventually put on T3, higher dose first again has hyper symptoms 😠 both myself and my gp agreed I would start on a lower dose and work up, that's what I've been doing, can I just tell you after my phone conversation with my gp yesterday I noted my increase from 15mg to 20mg has made my t 3 actually drop, I would have thought an increase in T3 meds would have made the T3 higher🤔 but it was 4.3 on 15mg T3 and the last bloods it is 3 after7wks on 20mg..i put this to my gp but he said.. Your T3 fluctuates so we're not interested in that only your TSH.. They really have no idea do they, and he is looking after my care... 😠😠😠😠😠

[FancyPants54 in reply to birkie]

They don't have a clue. I have nothing to offer you, but going by how I feel at the moment, which is terrible, I think some increases in T3 hit a point that has another go at dropping our T4 by a chunk and we end up under medicated. I am fully expecting my T3 and T4 to be worse after this coming blood test on 20mcg T3 and 125mcg Levo than they were last time on 15mcg T3 and 125mcg Levo.

[birkie in reply to FancyPants54]

Hi FancyPants54Although I'm increasing the T3 slowly, because I've found that taking the higher doses always make me feel hyper, I did an experiment on my meds.. When I was on the higher doses I discontinued them for more than a week, all the hyper symptoms started to diminish I felt OK... But having no thyroid I knew I couldn't do this forever! I started taking the meds again but droped them by 10mg again after a few days I noticed the hyper symptoms returning, so in the end myself and my gp agreed that I should start lower down at 10mg T3.. I've been doing this till I've finally got to 20mg.. I wouldn't say I'm feeling well at all i still have hyper symptoms mostly sweating and feeling hot all the time, slight tremors, fast heartbeat especially on getting up and walking about, just going to the kitchen from the livingroom my heartbeats like I've just run upstairs, I'm always hot never cold, my mum was hypo and my friend is hypo, they always complained about being cold, my mum could never ever get warm, she always went to bed like she was going out in freezing weather I'm the opposite, my bedroom window is open I have a thin blanket on and a thin nighty, I'm pleased I've got to 20mg,im now going up to 25mg, I'm aiming to get to 50mg/60mg🤞 the last 2 days have been awful exhausted, sweating, no sleep, jittery, its just awful.. 😩😩😩