Dosing of T3, when to take and side effects

[KatieJohnson1977]

Hope someone can help, I have been Hypo for 20 years and taking Levo of different dosages. My current dose was 125mcg. After years of still not feeling great & still having active Hashimoto’s I paid to see a private endocrinologist who prescribed T3. She suggested I drop my Levo to 100mcg and take 20mcg of T3 every morning.

I have been experiencing tightness in my chest, fuzzy head & trouble sleeping. Could these be the effect of T3?

I have also just come off Paroxetine which I’ve been on for over 4 years so wonder if the side effects could be withdrawals from this?

[SeasideSusie Remembering]

KatieJohnson1977

How long since adding T3?

Can you please post your latest test results, with their reference ranges (as these vary from lab to lab) upon which your endo decided to add T3 and reduce Levo.

It's not always necessary to reduce dose of Levo when adding T3.

Also, that is a high dose of T3 to start off with, it's usually advised to start with 5mcg for 2 weeks, if no problem then add another 5mcg, wait another 2 weeks, if no problem and if necessary add another 5mcg. After reaching 20mcg, wait 6-8 weeks at least then retest TSH, FT4 and FT3. It may not even be necessary to go as high as 20mcg, I would retest at a lower dose.

Have you come off the Paroxetine by reducing dose gradually over several weeks?

[KatieJohnson1977 in reply to SeasideSusie]

hyroid function test (X77Wg)On T4 : 150 ug daily.0.10 miu/L [0.3 - 5.5] Outside reference range 25.1 pmol/L [12.0 - 22.0] Outside reference range 3.5 pmol/L [3.1 - 6.8]

187 ku/L [< 34.0] Outside reference range

Serum TSH level (XaELV)

Below range

Serum free T4 level (XaERr)

Above range

Serum free triiodothyronine level (XaERq)

Serum thyroid peroxidase antibody concentration (XabCy)

Above range

[SlowDragon Administrator in reply to KatieJohnson1977]

Was test done as early as possible in morning before eating or drinking anything other than water and last dose levothyroxine 24 hours before test

Assuming yes.....

So high thyroid antibodies confirms autoimmune thyroid disease aka Hashimoto’s

Ft4 was above range, so correct to reduce levothyroxine by 25mcg

Retest 6-8 weeks after adding T3

all thyroid blood tests should ideally be done as early as possible in morning and before eating or drinking anything other than water .

Last dose of Levothyroxine 24 hours prior to blood test. (taking delayed dose immediately after blood draw).

This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip)

If/when also on T3, make sure to take last third or quarter of daily dose 8-12 hours prior to test, even if this means adjusting time or splitting of dose day before test

Essential to test vitamin levels

Plus coeliac blood test if not already on strictly gluten free diet

[KatieJohnson1977 in reply to SeasideSusie]

I had reduced my dose of Paroxetine over the course of months, then weeks then stopped.

[SlowDragon Administrator]

Do you always get same brand levothyroxine Which brand

What were Ft4 and Ft3 results on 125mcg

We often don’t need to reduce levothyroxine when adding T3

Best to start on T3 EXTREMELY slowly

5mcg only in morning for first few days

Or 2.5mcg waking and 2.5mcg late afternoon

If going ok

5mcg waking and then add 5mcg late afternoon

After another week add 3rd 5mcg dose so that 3 x 5mcg at roughly 8 hour intervals

Essential to have optimal vitamin levels

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

What vitamin supplements are you currently taking

As you have Hashimoto’s are you on strictly gluten free diet