T3

[SueHG]

I have been on self sourced T3 for a few years and was doing well. I had to stop taking Tramadol and then found that T3 was giving me diarrhoea. I cut the dose of T3 which helps a bit but am under medicated even on 25mg a day. I feel bloated, can’t lose weight and becoming depressed in general not great. I have considered changing to Armour but since I wasn’t converting T4to T3 I wonder if this would be suitable for me. Does anyone have any suggestions.It was Dr P who I saw a few years ago who guided me through going onto to T3. It is very difficult when there is no one to consult. My GP doesn’t want to know.

[SlowDragon Administrator]

When did you last get FULL thyroid and vitamin testing done

For full Thyroid evaluation you need TSH, FT4 and FT3 plus both TPO and TG thyroid antibodies tested.

Also important to regularly test vitamin D, folate, ferritin and B12

What vitamin supplements are you currently taking

Low vitamin levels are extremely common, especially with autoimmune thyroid disease (Hashimoto’s or Ord’s thyroiditis)

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

Do you normally split T3 the dose

Day before test split dose of T3 into 3 smaller doses, taking at approx 8 hour intervals, with last dose 8-12 hours before test

Is this how you do your tests?

Private tests are available as NHS currently rarely tests Ft3 or all relevant vitamins

List of private testing options

thyroiduk.org/getting-a-dia...

If you can get GP to test vitamins and antibodies then cheapest option for just TSH, FT4 and FT3

£29 (via NHS private service ) and 10% off down to £26.10 if go on thyroid uk for code thyroiduk.org/getting-a-dia...

monitormyhealth.org.uk/

NHS easy postal kit vitamin D test £29 via

vitamindtest.org.uk

Medichecks Thyroid plus antibodies and vitamins

medichecks.com/products/adv...

Blue Horizon Thyroid Premium Gold includes antibodies, cortisol and vitamins by DIY fingerprick test

bluehorizonbloodtests.co.uk...

Thriva Thyroid plus antibodies and vitamins By DIY fingerpick test

thriva.co/tests/thyroid-test

Thriva also offer just vitamin testing

If TPO or TG thyroid antibodies are high this is usually due to Hashimoto’s (commonly known in UK as autoimmune thyroid disease).

About 90% of all primary hypothyroidism in Uk is due to Hashimoto’s. Low vitamin levels are particularly common with Hashimoto’s. Gluten intolerance is often a hidden issue to.

Link about thyroid blood tests

thyroiduk.org/getting-a-dia...

Link about Hashimoto’s

thyroiduk.org/hypothyroid-b...

List of hypothyroid symptoms

thyroiduk.org/if-you-are-un...

[SueHG in reply to SlowDragon]

I will be taking private tests shortly to see what’s going on. My surgery took tests unbeknown to me a month ago when I was there for a kidney function test! Of course I had taken my thyroid meds before I went. I had to explain the test results to my GP who didn’t understand why my T 4 was so low! Hopeless. Results were fine last year but they may have changed recently .

[DippyDame]

According to Drug Bank, "Tramadol may decrease the excretion rate of Liothyronine which could result in a higher serum level."

How long is it since you stopped Tramadol?

Tha half life of Tramadol is roughly 7 hrs so elimination is fairly quick.

Without Tramadol you were possibly overdosed for a time....but you worked that out!

How much T3 were you taking before reducing your dose?

By how much did you reduce your dose?

How long ago did you reduce your T3 dose?

Might you have reduced too much?

Symptoms of undermedication appear to be returning!

You were doing quite well on your higher dose...

I'd be inclined to let the body settle for a few days then try increasing your dose by a quarter tablet and see how you feel after a couple of weeks.

You may need to repeat this until you reach your original dose.

A bit of trial and error required I guess!

I'm T3-only, (75mcg/hormone resistance). so done a bit of that!

Hope you feel better soon

[SueHG in reply to DippyDame]

Thank you for all that. I stopped the tramadol two years ago and have been struggling with the t3 dose ever since as tramadol causes constipation so now it’s the other way round. I’ve tried everything over the two years believe me and am sure I’m under medicated with t3. I was on 37.5 mg a day before and am on 25 now but have to take Imodium everyday to keep it at that level. I cannot increase t3 so that’s why I’m wondering if armour would be more sympathetic to my system. As I said that could be a problem because of the level of t4 in it as I wasn’t converting.

[DippyDame]

Given that you have tried a few things a full thyroid test is the best way forward.

However expect the TSH and FT4 to be low if on T3 only, so TSH and FT4 labs are of limited use, but it will show if your FT3 is out of range and that is the most important result because it's the active thyroid hormone.SlowDragon has given details of tests advised.

I understand how frustrating it is, it can be a lonely journey when medics are involved and not helping. I have self medicated since I dropped T4 and took T3 instead. My T3 dose isn't perfect (being aged 75 doesn't help!) but it is a huge improvement on when I could barely function.

It isn't always possible to get all tissues euthyroid so you can be left with both over and under medicated areas of the body depending on how much T3 is needed to saturate the various tissues. In time this may balance out but I think it depends on how long undermedication has existed....in my case decades, which is possibly why my dose needs tweaking occasionally.

I'm sorry, I have no experience of Armour but your conversion rate as you know may still cause a problem.

Can you source another brand of T3, excipients used in different brands can make a difference?

Another thought, It's just possible that you have a form of resistance to T3 and actually need a higher dose of T3 to overcome your symptoms. The symptoms of under and overmedication can be very similar which doesn't make things any easier.

I just bit the bullet in the end and slowly increased my T3 dose but you need to do a lot of background reading first and feel confident that this is your problem....it is the last resort. I monitor my resting heart rate and waking temp almost daily to check for overmedication....both are fine as is my (scanned) heart. My GP nearly had a fit when she discovered I was self medicating...we now understand one another!

There is very little readily available information about Thyroid Hormone Resistance beyond research papers but I was recommended this well referenced ebook which is on Amazon for £3.56 or free if you have Amazon Prime. It is called "Impaired Sensitivity to Thyroid Hormone (Thyroid Hormone Resistance)" by Hugh A Hamilton. I found it helpful.

Hope something here points a way forward,

[SueHG in reply to DippyDame]

Thank you for your suggestions will get the booklet. Your case is similar to mine including age it’s just my stomach’ s reaction to t3 which is the problem, I know t3 is what I need.

[redherring]

Hi, I found that taking Lepicol ( which is psyllium husk with added probiotics) with my breakfast really helps with diahorrea from meds. Might be worth a try? All best Helen

[SueHG in reply to redherring]

Thank you I’ve never heard of that but will investigate, very kind.