What to do now?

[lisan1]

These are my latest results on 75t4 15t3 Now 2 different doctors have adviced me to increase t3 by 5mcg to 20mcg (a whole pill) Do you agree?

tsh 0.03

FT3 4.4 (3.6-6.3)

Ft4 12 (12-22)

[SeasideSusie Remembering]

lisan1

Are they not concerned with your FT4 just scraped into the bottom of the range?

We are all different as to where we need our individual hormone levels to be, but your FT4 level would have me bedbound (I am also on Levo plus T3). I need both FT4 and FT3 in the upper part of their ranges, around 70%, to feel well.

If those were my results, with my own personal experience, I'd increase Levo first by 25mcg, retest in 8 weeks to see where levels are then, both FT4 and FT3 should rise. Then based on the new levels I'd decide if it's T3 that needed increasing.

However, I don't have to answer to an endo!

[Lalatoot in reply to SeasideSusie]

I agree with Susie. I have spent 2 years slowly altering doses of levo and lio at separate times waiting 8 weeks and looking at blood results. Then considering those results along with symptoms.At your stage it becomes very individual and you must do what you think.

I started out on 100mcg levo. The endo prescribed 50mcg levo and 20mcg lio. I slowly worked my way to her prescribed doses over 3 months. My current dose which I am staying on longer term is now 100mcg levo and 7.5 lio which I take as 2x50mcg levo and 3x2.5 lio.

We need what we need and unfortunately it takes time, guesswork and luck to work it out.

[shaws Administrator in reply to Lalatoot]

I would add T3 and that's because the more I reduced T4 and increased T3 the better I felt. Initially T3 resolved my symptoms and unwellness improved. When I went onto T3 only, that improved my health even more. and I now take T3 only.

I am not on a high dose and just recently reduced it and have had no symptoms - at present

[lisan1 in reply to shaws]

How much do you take? Where's your ft3 levels?

[shaws Administrator in reply to lisan1]

I go by how 'I feel' i.e. fit and well or symptomatic'. At present I have no symptoms and feel well. A number of weeks ago, I reduced my dose slightly. I take one 20mcg tablet of T3 when I awake a.m. with one full glass of water and wait an hour before I eat.

I don't need to get a print-out of my results now as I feel well.

I'd rather take account of how my body 'feels' and that my clinical symptoms have resolved than the whereabouts of the T3.

[Josephineinamachine in reply to Lalatoot]

Hallo Lalatoot.

Could I ask what benefits you feel from splitting the Levo dose? I’m taking 75mcg Levo with 10mcg Lio at 4am.

This helps rid the morning pain in feet and legs and lasts until late evening when I start hobbling a bit (but it’s okay because I just go to bed). I’m generally a bit better but still experience fatigue and brain fog (sometimes quite badly) and body temp is around 35.5 in the mornings.

I have to stick with this for now as have a blood test in a couple weeks so don’t want to make changes until I’ve had that.

Depending on test results (although I don’t really believe they accurately represent symptoms for me anyway) I was thinking of including an afternoon small dose of T4. I can’t seem to tolerate T3 in the afternoon because I get sleepy.

I’m a bit stuck because I start teaching next week. The afternoon sessions are going to be slightly foggy as it is and I can’t risk an afternoon T3 when teaching!

Would T4 help with afternoon fatigue do you think?

Sorry - didn’t mean for this to be such a long detailed question!!

[Lalatoot in reply to Josephineinamachine]

I split my dose because I never could manage to take more than 50mcg in one go without feeling ill.I have always done this so I don't know if it benefits me in any other way.

It does have the benefit that if for some reason absorption is compromised say one morning because of eating early or whatever then it is only half of your daily load that has been affected.

You can only try and see if it helps.

Glad I'm retired from teaching!!!

[Josephineinamachine in reply to Lalatoot]

Thank you for responding Lalatoot. It may be the way forward so will keep in mind. Yes, I like teaching but it has started to be very anxiety provoking when not sure if I’m going to have oomph or not! Or a working memory…! 😳

[Lalatoot in reply to Josephineinamachine]

Don't know if it would be my career of choice in this day and age. I am old school pre national curriculum.

[Josephineinamachine in reply to Lalatoot]

I teach in a university. I think it’s probably much easier to work in adult education than in schools or colleges 😊

[lisan1 in reply to SeasideSusie]

Do you think I could try 87.5 +20? Would that maybe be a good idea?

[SeasideSusie Remembering in reply to lisan1]

lisan1

You can't change dose of both Levo and T3 at the same time. If you do you wont know which one has helped. You should only change one, give it 6-8 weeks minimum, retest, see how you feel, then reasses and decide what to change next.

[SlowDragon Administrator]

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

Day before test did you split T3 into 3 smaller doses

Last 5mcg dose T3 approx 8-12 hours before test?

As per previous post

healthunlocked.com/thyroidu...

Personally I would increase levothyroxine by 25mcg or 12.5mcg daily

Retest in 6-8 weeks including vitamins

[shaws Administrator]

T3 is the 'active thyroid hormone' and our brain and heart have the most T3 receptor cells. I would certainly not doubt an increase. If, for instance, you had severe palpitations after a dose, then you can reduce slightly.

[lisan1 in reply to shaws]

Would you increase lio or levo?

[shaws Administrator in reply to lisan1]

lio definitely. The more I increased lio the better my body felt especially when symptoms resolve.

[JAmanda]

Yes I’d want an increase in both t4 and T3.

[lisan1 in reply to JAmanda]

Maybe try 87.5+20then?

[JAmanda in reply to lisan1]

I’d take 100 and 20 then test in six weeks and likely you’ll need another increase. Docs don’t like to help you get your levels higher in range but for me that was the only way to feel well.

[jamjar67]

I guess it’s trial and error, I was similar to you, my Endo increased my T4 to try and raise my T3 however I couldn’t stand it, I felt dreadful, so I have recently lowered my T4 further (to 50) and am slowly increasing my T3 - 3rd week in I’m feeling better than I was but still not right but am hoping as the T4 leaves my body I’ll feel better 🤞 I would have preferred to increase my Levo as it’s easier but my body really didn’t like it.