Levo or T3

[Geegee777]

Im not sure whether to try an increase in levothyroxine or start taking T3.

Recent blood tests attached

Any advice would be much appreciated 🌸🌸🌸🌸🌸🌸🌸🌸🌸🌸🌸

[SlowDragon Administrator]

Assuming you did test early morning, last dose levothyroxine 24 hours before test?

Ft4 42% through range Ft3 is only 13.2% through range

[Geegee777 in reply to SlowDragon]

Yes, no levo till after early morning test. Im not sure whether to ask my gp to increase my thyroxine or try T3.

[fuchsia-pink in reply to Geegee777]

So both are a bit rubbish. I'd go for an increase in levo first - an extra 25 mcg a day, and see what that does to both frees. Once free T4 gets to say 80% through range, it will be worth adding in lio if it's still lagging at that point x

[Geegee777 in reply to fuchsia-pink]

Thanks, im a bit of a scary pants approachinv my gp, but i think if i can explain my results he may work with levo, but not sure about T3.So its my ft3 and free thyroxine which require attention?just need to clarify what my reasons are, don't wish to be a blubbering mess when explaining

[fuchsia-pink in reply to Geegee777]

Most of us feel best when both frees are in the top third - or higher - of the lab range. We sometimes need free T4 to be right at the top of the range - or even above it - to get to adequate free T3 levels if (lke me) you are a poor converter. And remember ou are ONLY over-medicated when free T3 goes over - not if free T4 does, or if TSH is suppressed (low TSH is dangerous IF you are NOT on thyroid meds AND free T3 is waaay over-range)

Lio is endo-only, so another benefit of raising both frees with an increase in levo is that this is something your GP can manage - and which then gives you time to explore suitable endos (not all will prescribe lio in the NHS) if you should need it in due course

It can be a bit scary going to the GP and asking for the status quo to be changed, so put on your big girl pants and be brave x

[Geegee777 in reply to fuchsia-pink]

Big girl pants at the ready

[JAmanda in reply to fuchsia-pink]

Agree, try Levo first and only once that is high but you’re still not feeling well consider adding in T3. Plus ensure your folate b12 D etc are all good levelstosupport conversion to T3.

[Hashihouseman]

Looks like you need to increase levothyroxine and try splitting it into 3,4 or even 5 doses through each 24hr period. I found this evened out my responses and increased t4-t3 conversion to the point I could stop taking supplemental t3 and evidenced by total absence of hypo/hyper symptoms and blood tests. The healthy thyroid does not deliver 24hrs supply of t4 in one dose!

[Hashihouseman]

PS too much t4 suppresses t4-t3 conversion, taking too much t4 in one dose may trigger negative feedback which could significantly reduce conversion even if the total dose is what you would need for 24hrs.

[Geegee777 in reply to Hashihouseman]

Ok, if i had 125mg levo what would be the best way to dose through the day?

[Hashihouseman in reply to Geegee777]

I'm on 125, was on 100 with 5 liothyronine T3. Stopped the T3 and increased the T4 but taking it all together was problematic with side effects and unresolved symptoms. Split the levothyroxine T4 into 5 x 25 by asking GP to prescribe in 25 mcg pills which I take at approximately 10am 2pm 10pm 2am and 6am.... sounds annoying but waking in the night anyway and it doesn't disturb me, you could adapt a regime to suit. I dont worry about proximity to food etc even coffee although its easy to spare by at least half an hour or even an hour, doesn't need to be on a fasted stomach! I take iron supplement at 6pm which is well away. If I forget one or miss one in the night I double up the next dose but 5 x 25 definitely feels smoother. Takes a few weeks to settle into it and feel the benefits. Home Blood tests can be done just before the 10pm dose which gives a good 8 hours plus from last dose.

[Geegee777 in reply to Hashihouseman]

Thanks, ill give it a go, maybe starting with 2 doses and see how i get on

[playtime2]

Your free T3 is a little bit low. You could try taking 2.5 T3 and perhaps reduce your Levo by 10 since 2.5T3 is equal to about 10 Levo. See how you feel. Or do nothing different if you are feeling good on your current dose. Don't let the numbers only make these decisions. How you feel is very important as well.

[Geegee777 in reply to playtime2]

Lack of energy and aching joints, particularly my wrists, which is quite debilitating on a bad day.Ill arrange an appointment with my gp this week, big girls pants will be donned

🤞