T3/T4

[27ah]

Hi there. I am struggling to optimise my T3 T4 dose as many people seem to be. I have been on a rollercoaster for the last 2 years but have had improvement adding T3. I am now on 20mcg T3 and 125mcg T4. I cannot tolerate more T3 with the same T4. I am feeling well on this dose with my fatigue much improved and many other symptoms resolved. I still have issues with managing stress but by far my biggest issue at the moment is my gut. Apologies in advance for the next bit. I get really constipated and it leads to inflammation and a very sore abdomen - perhaps because of the abdominal wall getting irritated. I have tried many natural things to ease this (increasing fibre, prunes, Fybogel) but it keeps recurring. I am wondering if I should try and increase my t4 despite feeling well on this dose. My bloods 3 wks ago

TSH less than 0.02 (0.27-4.2)

FT4 18.3 (10.8-25.5)

FT3 7.2 (3.1 - 6.8)

I reduced t3 by 2.5mcg after this and I am now on 20mcg t3 (10 twice a day) and feeling good other than my gut.

I worry that if I reduce t4 the abdominal issues may get worse. If I increase t4 I may lose the other gains. It also takes weeks for a change to manifest so frankly I'm scared.

I feel my t3 is right, increasing or decreasing both make me feel worse.

Any advice would be much appreciated

[Meanbeannyc]

I never got it right for myself. But I’d say if making any changes up or down make you feel worse, I’d consider that success!

[SlowDragon Administrator]

Essential to regularly retest vitamin D, folate, ferritin and B12

What vitamin supplements are you currently taking

If supplementing vitamin D, recommended to also supplement magnesium

Magnesium can be excellent at improving constipation

Calm vitality magnesium powder is cheap and easy to use. Best taken afternoon or evening. Starting on low dose and increase until get desired effect…..too much can cause diarrhoea

All magnesium supplements must be minimum of 4 hours away from levothyroxine

Have you had coeliac blood test done

Are you on absolutely strictly gluten free diet

If not…..it’s ALWAYS worth trying Gluten free. Test for coeliac BEFORE cutting gluten out

[shaws Administrator]

Just to mention that 25mcg of T3 is equal 'in its effect' to 100mcg of T4. T3 beng the active thyriod hormone.

[27ah]

Thank you for your replies.

I am taking a general vitamin supplement. I had a coeliac test done and it was negative. I haven't tried gluten free.

Slow dragon. Am I right in thinking I should leave t4 as it is and focus on getting the vitamins right?

Shaws- are you suggesting perhaps I need to increase t4 as the effect is less than where I started?

[greygoose in reply to 27ah]

I am taking a general vitamin supplement.

Do you mean a multi-vit? If so, very, very bad idea. These things should not all be taken together in one pill because they can cancel each other out. Very important to get the key nutrients tested and supplement individually according to results.

It's not very helpful to be told that x amount of T3 equals y amount of T4, because it doesn't always. There are so many variables that can affect the results. Saying that 25 mcg T3 equals 100 mcg T4 is pretty meaningless for several reasons:

* T3 is easier to absorb than T4. You might put 100 mcg in your mouth, but that doesn't mean you will end up with 100 mcg in your blood.

* and however much gets into your blood, it won't all be converted to T3. At best, about 30% will be converted to T3, 30% to rT3, and the rest stored/excreted.

* T4 is a storage hormone and doesn't do much until converted to T3, so there is no real equivalent in effect.

And, over-all, it doesn't matter, anyway. Could be you need a small increase in levo, but not necessarily. And, the only way to find out is to try increasing it slightly - but not too much! You don't want it going over-range. It's all trial and error, anyway.

[shaws Administrator in reply to 27ah]

If you want to draw a member's attention to your query/post put an @ sign before their name and they will be notified. 27ah

[27ah]

Thank you for your comments. I'm having such a bad flare up of my abdominal symptoms. I will get a blood test for the vitamins and minerals and consider a trial of maybe 25mcg t4 when my pain calms down a bit.

[June25]

If you are feeling well on your current dose of thyroid hormone then maybe leave that alone and target your gut issues another way.

Have you ever had colonic irrigation with a private practitioner? This will clear possible toxins out of your colon and you can also get advice on how to do a home enema safely. After being constipated for a while, the colon needs to be re-habituated to evacuating every day and this is where a partial enema can be useful, along with a good quality supplement of gut bacteria to re-establish a healthy gut ecosystem. For example I use Udo's Choice super 8. It also needs a diet with enough fibre but not too much. This is all a process which takes time and needs to be incorporated as part of a healthy lifestyle. Your colonic irrigation practitioner can advise. When you get the toxins out and healthy flora established it should make a significant difference.

[27ah]

Thanks for this June25. No I haven't thought about that and will look into it. I have taken Alflorex which was a probiotic my gastro advised to take. I didn't notice much improvement. But my thyroid meds were all over the place at that point. Probably worth another try.

[27ah]

Here are my recent bloods. I have currently bad constipation with lots of abdominal inflammation. I would welcome help in interpreting these. I am on 125mcg thyroxine and 20mcg T3. I am worried that the poor motility is a thyroid issue (which then aggravates my diverticular disease causing the abdominal swelling etc). I cannot tolerate any more T3. Considering increasing the thyroxine? Not sure what the autoimmunity bit means. I know I need to sort my vit D. Can this contribute to the gut issues? Many thanks in advance

Blood test results