help taking T3

[Saintrockz]

Hello all of you beautiful people. My Endo has prescribed 5mg t3 three times a day with 75mg of T4. I take my T4 at 615 on an empty stomach with no tea or coffee or food till 10am. I have read on the forum that i should introduce slowly over a period of days, but would love some expert advice of what to avoid and how to maximise the benefits.

I know in my previous posts i had shared my bloods, and many had said my T4 dose was too less and should have more given but Endo wasn't happy to up it so added the T3 instead.

here are my last bloods

Tissue Transglutaminase IgA - Final - 15/06/2021 09:00

Comment Coeliac disease unlikely (please note that if the

patient has no dietary gluten results may appear

false negative).

Tissue Transglutaminase IgA 0.2 u/mL 0 - 10

Thyroid Function Test (TFT) - Final - 14/06/2021 12:23

Thyroid Stimulating Hormone 2.52 mIU/L 0.27 - 4.20

Free Thyroxine 13.7 pmol/L 12.0 - 22.0

Reverse T3 - I

Reverse T3 Pending

Thyroid Peroxidase Antibodies (TPO) - Final - 14/06/2021 16:01

Thyroid Peroxidase (TPO) Abs <9 IU/ml 0 - 34

[SeasideSusie Remembering]

Saintrockz

Unfortunately, your endo hasn't got a clue. Is this a private one or an NHS endo? Most endos are diabetes specialists and really don't know how to treat hypothyroidism. He is making a big mistake and if this is an NHS endo it's absolutely unheard of to prescribe T3 at this point.

As explained in previous posts, it's your Levo that needs increasing until your TSH is low in range to give the highest possible FT4 and then see where your FT3 lies to know if you need the addition of T3.

Here is some information that you could discuss with your endo about where TSH should be:

From GP Notebook

gpnotebook.com/simplepage.c...

Target level for TSH during thyroxine therapy

Fine tuning of the dose could be necessary in some patients

* aim of levothyroxine treatment is to make the patient feel better, and the dose should be adjusted to maintain the level of thyroid stimulating hormone within the lower half of the reference range, around 0.4 to 2.5 mU/l. If the patient feels perfectly well with a level in the upper half of the reference range, then adjustment is unnecessary

From GP online

gponline.com/endocrinology-...

Under the section

Cardiovascular changes in hypothyroidism

Replacement therapy with levothyroxine should be initiated in all patients to achieve a TSH level of 0.5-2.0pmol/L.

From the British Thyroid Foundation:

btf-thyroid.org/thyroid-fun...

How can blood tests be used to manage thyroid disorders?

.....

Occasionally patients only feel well if the TSH is below normal or suppressed. This is usually not harmful as long as it is not completely undetectable and/or the FT3 is clearly normal.

There are also certain patients who only feel better if the TSH is just above the reference range. Within the limits described above, it is recommended that patients and their supervising doctors set individual targets that are right for their particular circumstances.

.....

Also, Dr Toft, past president of the British Thyroid Association and leading endocrinologist, states in Pulse Magazine (the professional publication for doctors):

"The appropriate dose of levothyroxine is that which restores euthyroidism and serum TSH to the lower part of the reference range - 0.2-0.5mU/l. In this case, free thyroxine is likely to be in the upper part of its reference range or even slightly elevated – 18-22pmol/l. Most patients will feel well in that circumstance. But some need a higher dose of levothyroxine to suppress serum TSH and then the serum-free T4 concentration will be elevated at around 24-28pmol/l. This 'exogenous subclinical hyperthyroidism' is not dangerous as long as serum T3 is unequivocally normal – that is, serum total around T3 1.7nmol/l (reference range 1.0-2.2nmol/l).*"

You can obtain a copy of this article from Dionne at ThyroidUK:

[e-mail]

You could print it and highlight Question 6 to show your endo.

I believe he is wasting your time by introducing T3 now, maybe he wants you to fail the trial, many endos set patients up to fail because they don't want the NHS to pay for an expensive medication.

If you are going to go ahead then you will find it is 5mcg (micrograms) not 5mg (milligrams) you have, 1mg = 1,000mcg. If you were to take 5mg it would blow your head off!

If you are going to take the T3 then you should start with 5mcg for 2 weeks. You can take it with your Levo in the morning. If everything is OK you can add the second 5mcg after those 2 weeks and perhaps take that in the afternoon. Wait another 2 weeks and if all OK you can add the third 5mcg and maybe take that at bedtime.

Personally I treat T3 the same as Levo and follow all the guidance about taking it on an empty stomach, one hour before or two hours after food, with water only, and keep away from other medication and supplements although you can take it with Levo.

[SlowDragon Administrator]

How much levothyroxine were you taking when these results were done?

Which brand of levothyroxine are you currently taking

[Yeswithasmile]

Hi

You posted a month ago after being on 50mcg levo for a month and your level for ft3 was 4.4. Have you any result for your ft3 now?

I am sorry. I know you feel urgh! But SeasideSusie is correct in my experience. Your tsh still has room to be reduced by taking an increase in your levo. It will be much easier for you to take and is much easier to keep hold of prescription wise.

As much as you want to feel better quickly neither t4 or t3 can do that. I can only stress that t3 is no more of a magic pill than you feel t4 will be and t3 is short lived in the body compared to t4 which can make it peak and trough. This can be very uncomfortable and give worse symptoms whilst your body gets used to it which can take a long time.

If I had your tsh I would ask for a raise in levo first. You couldn’t assume this early on that you are a poor converter and need t3. If you can improve on levo only that is a massive bonus.

I can’t believe I know what you should do and I’m still learning but your endo 🤷‍♀️ What was he thinking??!

[shaws Administrator]

I don't believe in splitting dose of T3 (I take T3 myself). With one dose of T3 taken with one glass of water saturates all of our T3 receptor cells and it then sends out 'waves' throughout the day. and that one dose can last between one to three days. I trialled that and found that, yes for me, the dose lasted three days. I only did this once and take my T3 when I awake with one glass of water and wait an hour before I eat.

Dr John Lowe, scientist, researcher, doctor and took T3 himself (his dose was taken in the middle of the night when he awoke to go to toilet). He was able to carry on his work and research and also help those who had dysfunctional thyroid glands.

Unfortunatley, he had a bad fall which damaged his brain and caused his death.

I've even reduced my dose of T3.