Two weeks into T3 Trial - what's 'normal'?

[Thyroidrunner]

Hi all,

I'm a couple of weeks into taking T3 - I am following my consultant's guidance in that I have reduced my T4 dose from 137/150 on alternate days to 125 daily (I assume this is because my TSH was very low already). But rather than going straight to three doses of T3 a day as advised by him, I am building up to it and am currently on 5mcg in the morning and 5mcg at lunch. I feel like I might be feeling a slight improvement in energy levels but my mood is all over the place. Is this to be expected? Does it take a few weeks for the benefits of T3 to really register? I wonder if the sudden reduction in T4 is part of the mood issue? Should I be taking T3 on an empty stomach?

This is a trial and at the 6 week point the consultant wants to review my progress - can I ask what a successful trial looks like? Presume higher levels of T3 in blood test and T4 and TSH within the normal range and hopefully me saying I feel generally better? I have had none of the adverse effects such as palpitations or difficulty sleeping. In fact I have noticed that my heart rate is actually lower than it was before I started the trial.

If helpful, these were my last blood tests take just before I started the trial:

TSH= 0.04 (0.27 - 4.2)

FREE T3= 4.3 (3.1 - 6.8 )

FREE THYROXINE= 19.2 (12-12)

I'd be very grateful for any advice or experiences of people in the same boat!

Many thanks

RB

[greygoose]

can I ask what a successful trial looks like?

The whole concept of a 'trial' of T3 is a nonsense! Especially if it's only six weeks. It can take months of slowly increasing the dose to feel any benefits. But, most endos set their patients up to fail, anyway, by prescribing too much as a starter dose, meaning the patient feels worse, so the endo can say 'see, I told you it wouldn't work!' Or words to that effect.

Frankly, I've no idea what an endo thinks a successful outcome would look like - would he even recognise a successful outcome if it punched him on the nose - which is what I feel like doing to most endos.

Obviously, your FT3 should rise if you take it correctly - and, yes, I think you should take it on an empty stomach, just like levo, for maximum absorption. But, your TSH is probably going to be suppressed on 15 mcg - which he probably won't like and doesn't know is almost inevitable! - and your FT4 will also drop. So, unless your FT4 was very high on levo only, there was no need to reduce it.

I think the best thing you can do is just be enthusiastic and tell him how wonderful T3 is - even if it isn't that wonderful after such a short time on it - and how much you love it. And let him try and wriggle out of that.

[DippyDame]

I'm afraid there is no such thing as "normal", it's a totally misleading term.Replace "normal" with the word optimal and you are closer to your aim!

We are all different with different needs and the aim is to find the dose that makes you feel well.

A six week trial is a farce! It only tinkers round the edges of the issue in a timescale that will generally lead to failure. Then, as far as medics are concerned, " job done, we offered T3, she/he didn't respond well...stop prescription". Result, patient remains unwell!

Your labs shout poor conversion ( high FT4 with low FT3) so you need to add T3 which is the active thyroid hormone essential to every cell in the body and available in a constant and adequate supply.

Low cellular T3 = ill health!

Your high (unconverted) T4 is causing the low TSH which freaks medics out because they don't seem to understand how TSH works.

Have you optimised vit D, vit B12, folate and ferritin, this is essential to boost/ support conversion. It should have been done before adding T3.

I take T3-only, and apart from one farcical visit to an ill- informed endo who blew any suggestion of T3 dosing out of the water, I have self medicated with the priceless support of members here. It took time, patience and much reading to find the solution....but, a solution there was, despite the opinions of medics.

"Does it take a few weeks for the benefits of T3 to really register".

It might, but it might also take many months depending on how low your T3 level has become and for how long this has been the case. In my case, based on much "digging", most likely all my life! I'm (possibly) an extreme case but it has taken about 2 years since I dropped levo to begin to feel considerable improvement.

Bottom line...don't let them tell you T3 doesn't work, if the body needs it, it will work...it needs adequate time to reach the nuclei of the cells.

I love the suggestion made by greygoose, I agree, play them at their own game and see how they react. It is much easier if you can have T3 prescribed, but if not all is not lost, go for the last resort, take control and self medicate. Many of us do just that.

Here's to an Oscar performance!!

Best...

DD

[Lalatoot]

Agree with greygoose .- go for the Oscar performance. My endo was a diabetes specialist but she did give me a trial of 6 months to a year of T3. she realised that having been ill for a long time things take time to re-adjust and settle particularly if you need to alter doses of levo and lio. After a year my T3 prescription was transferred to the GP.

[DippyDame in reply to Lalatoot]

Gosh!

Pity we can't clone that switched on endo!!

So pleased for you.

[Lalatoot in reply to DippyDame]

Oh don't go thinking I had an expert - that was her one out of character moment of brilliance. Think several pages of her "Endocrinology for Dummies" stuck together that morning and she skipped to chapter ten as a result.

[DippyDame in reply to Lalatoot]

Ouch!

Ah well, spilling her coffee over her text book worked for you!Thyroid treatment is a monumental scandal, we all know that, yet they persist in thinking that we are the dummies!! Grrrrr!!