for the last week I have now upped my T3 dose to one and a half Tiromel 25mcg tablets whilst also taking 50mcg Levo
I take half a tablet of tiromel in the morning along with 50mcg of Levo then roughly every eight hours take another half tiromel twice after
Thing is I starting feeling better until yesterday then I started feeling like before and although still not sleeping
Wondering if anyone has taken T3 up higher than this whilst taking levo?
Since upping the dose I noticed my blood pressure had reduced (although up again since yesterday) but my temperature is around 34/35.5 and heartbeat has went up slightly from 50/55 when resting to around the 60's to 70 after dosing eventually going back down
Still feel fatigued and wondering if it's safe to up my dose in a week being on both Levo and T3?
Have a lovely new year and take care!
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jacobite33
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Ratios are for healthy people. They have nothing to do with people on thyroid hormone replacement. You need what you need, both in T4 and T3. I for example, need 75 mcg T3 and zero T4. Other people have varying needs. You need to experiment to find out what's right for you.
Do you have any lab results to share with us? That plus how you feel will tell us if it's ok to increase your T3. But, from what you've said, it does sound like it's time for an increase in dose. It happens all the time that you feel wonderful on a dose for a while, and then the hypo symptoms start creeping back in again. And all that means is that you're ready for the next increase, and to hell with the ratios.
If I don't convert very well why take it I'm thinking?
Yeah, but it's not just about converting, is it. Some people who don't convert well still need quite high levels of FT4. I used to convert perfectly well, yet still couldn't tolerate T4. Beware of people full of absolutes!
As to this 'last resort' thing, what does that even mean? If it means that you should try levo first, then T4+T3, then NDT only to finally end up on T3 only - as I did - well, yes, it was a last desperate resort. But, the question is: how long to do you give these other combinations - how much of your precisous life do you waste - before deciding to give in to that last resort. I feel I wasted far too much time - won't go into details here, but you can read all about it on my profile. If you really feel that T4 isn't for you, and you have all your other ducks in a row - nutrients, cortisol - then give T3 only a try. You can always go back to taking levo if T3 only doesn't suit.
But, one of the worst things you can do is change your dose too often, by too much, too soon. Which it sounds like your doctors were doing. But, what do they know!
I think it would be worth it to stick with your 50mcg Levo for a while to see if you can make it work while varying your T3. The reasons are :
- At 50 your FT4 will likely be under range. The D2 enzyme is much more efficient at converting T4 to T3 when T4 is more scarce. You could even bring your FT4 up to just inside low end of range and this would still be true.
- FT4, FT3 and TSH all work together in your metabolic ecosystem. So the lower your FT4 is, the higher your FT3 needs to be to compensate. It is more difficult to dose T3 'properly', therefore having some T4 provides a bit of stability, sort of smoothes out the ups and downs of T3 peaks and troughs.
Having said that, we are all different and some people are best on T3 monotherapy, but I think you'd be better off giving combo a good try first. Keep your T4 low and raise your T3 cautiously in line with protocols till you get relief of all symptoms. Be patient, it could take a while.
Yes that's right, to maximize your conversion of T4 to T3 your T4 should be low which upregulates (increases) your D2 enzymes. In addition, your T3 should be high but not too high, which upregulates your D1 enzymes. Both D2 and D1 convert T4 to T3.
I'm on 50mcg T4 myself. As Paul R. says, it would be unusual not to get issues along the way and I've had issues with raising T3 too quicky / too much at once, which have set me back. Slow and small is the way to go, at least for me.
Another tricky thing I've found is that it can be hard to tell if you have gone a bit hypo or a bit hyper as they can feel much the same, so don't just assume that it's hypo and you need another T3 raise. Use a range of indicators, like body temp, pulse, resting heart rate, BP, etc to confirm which way it is. Nothing worse than thinking you've gone hypo and raising your T3 and getting an overdose. Been there, done that.
Wasn't a big question for me. I'd tried everything else, so why not? Don't over-think things. It's all trial and error. I made about 15 years worth of error until I found what suited me.
I’d wait another three weeks then test to see where your levels are before making any further tweaks. You could still see improvement in symptoms as your body acclimatises.
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Is there a T3 to T4 ratio
T3 started T4 lowered symptoms query please
T4/T3 morning dose time 
Does it matter what ratio of T4 to T3 I take?
