Do I need to tweak my T3 or T4? After feeling ... - Thyroid UK

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Do I need to tweak my T3 or T4? After feeling so much better hypo symptoms have returned.

Divine1990 profile image

Hi

After introducing T3(Liothyronine)and reducing my T4 (Levothyroxine) I was feeling great for a couple of weeks. Full of energy and symptom free at last. Then for nearly 2 weeks I had frequent daily episodes of nausea, fatigue, headaches and brain fog. Although the nausea has now subsided I am experiencing a return of my hypo symptoms. I'm tired , miserable, my skin is dry, I feel dizzy when bending and the brain fog has not shifted. I generally feel rubbish again.

I have not alternated of my routines with regard to medication, vitamins, supplements or gluten free diet.

My question is am I still seeking my 'sweet spot? Should I consider changing my dose of T3 or T4? Any advice would be gratefully appreciated.

My most recent blood results:

12th January 2022 - NHS

Serum TSH - 0.05 (0.3 - 4.5) Serum Free T4 - 21.1 ( 10.0 - 22.0) 92.5% Serum Free T3 - 5.5 (3.1 - 6.8) 64.8%

Folate Serum 12.72 (>3.89)

Ferritin 58.20 (13 - 150) have increased supplements following result.

Vitamin B12 >150 (37.5 - 188) self inject EOD hydroxocobalamin due to PA.

Vitamin D 125.00

150mcg/125mcg Levothyroxine alternate days

15mcg - Liothyronine daily - divided dose. Commenced October 2021

As ever thank you so much for your help and support.

22 Replies

If those were my results and I had symptoms I would consider reducing my levo dose to 125mcg daily. Then eventually adding in another 5 MCG lio.

Divine1990 profile image
Divine1990 in reply to Lalatoot

Thank you so much . I am going to tweak the doses as suggested. Best Wishes .

SlowDragon profile image
SlowDragonAdministrator

How long have you been on current dose

Bloods should be retested 6-8 weeks after each dose change

Hi

I have been on current dose of 150/125 mcg Levothyroxine and Liothyronine since 15mcg since 18th November 2021.

Please see blood results below:

11th August 2021 - Medichecks

Levothyroxine 175mcg daily

TSH - 0.11 (0.27 - 4.2) Free T3 - 4 (3.1 - 6.8) Free Thyroxine 27.5 (12 - 22)

Following advice from Private Endo

24th September 2021 - Levothyroxine reduced from 175mcg to 150mcg daily

8th October 2021 - Commenced T3 (Thybon Henning Liothyronine) 5mcg x 3 daily (15mcgs)

12th November 2021 - NHS

Serum TSH - 0.05 (0.3 - 4.5) Serum Free T4 - 22.8 (10.0 - 22.0) Serum Free T3 - 4.3 (3.1 - 6.8)

18th November 2021 - reduced Levothyroxine from 150mcg daily to 150mcg/125mcg alternate days. No change to brand. Continue with 15mcg Liothyronine. All medication/supplements taken as recommended on forum.

12th January 2022 - NHS

Serum TSH - 0.05 (0.3 - 4.5) Serum Free T4 - 21.1 ( 10.0 - 22.0) 92.5% Serum Free T3 - 5.5 (3.1 - 6.8) 64.8%

SlowDragon profile image
SlowDragonAdministrator in reply to Divine1990

Perhaps reduce levothyroxine a little more and increase T3 to 20mcg

T3 at 20mcg per day

10mcg waking, 5mcg and 5mcg

What time do you take your T3 doses

Could reduce levothyroxine to 125mcg 5 days week and 150 twice week ……or try 125mcg 6 days and 150mcg once week

Do you always get same brand levothyroxine at each prescription

Same brand T3 at each prescription

What vitamin supplements are you currently taking

Hi

I take 10mcg T3 @08.00hrs( with Levothyroxine) 5 mcg @ 16.00hrs. If medication taken at night have trouble sleeping.

Supplements- Vitamin B12 complex, D3, K2 MK-7, Magnesium, Powered Liver Capsules, Zinc citrate

No change to brand.

Thank you

Hello,

Your TSH looks very low - probably due to being overmedicated. I know some people feel that only T4 and T3 are relevant but I had the same issue after taking T3 and it drove my TSH extremely low causing me to have hypo symptoms, sometimes worse than when I didn't take T3. You might want to try and get to a level where your TSH is between 1 and 2 and see if that helps. I gradually stopped taking T3, and focused on reducing my inflammation and I started to slowly feel much better. That was my experience in any case. You may have trouble converting from T4 to T3 so it's something you'll have to experiment with a little. It helps to reduce your inflammation, as your cells will then respond better to T4 and T3. Ferritin is one marker of inflammation as well as CRP. Until I reduced my inflammation, most of my symptoms still lingered.

Divine1990 profile image
Divine1990 in reply to lh22

Thank you for your reply. The road to any sort of normality certainly isn't going to be a smooth one, it would seem. Best Wishes

lh22 profile image
lh22 in reply to Divine1990

No, and your 'normal' might be different to someone else in terms of how much replacement hormones you need. It really is trial and error finding what works for you. Diet is also a key component so experimenting with different foods and times of eating may work for you. Reducing stress (chemical, environmental, emotional, physical) as well as inflammation are really important for any chronic health issue. You'll need to have lots of patience but it's worth it when you start feeling like yourself! Good luck :-)

BeeVel profile image
BeeVel in reply to lh22

Hi Ih22, may I ask what protocol did you use to bring your inflammation down please. Thanks, Billie

lh22 profile image
lh22 in reply to BeeVel

Hello Billie,

As a consequence of having low level undiagnosed hypothyroidism for many years, I found out that I had a bit of a fatty liver after a liver scan. I had generally eaten quite healthily and rarely drink alcohol so it was a surprise to find this out but hypothyroidism can cause many issues within all organs in your body. A lot of T4 to T3 conversion happens in your liver so a sluggish liver doesn't help with hypo symptoms. I researched ways to get my liver back to normal. I don't really consume much sugar but I decided to cut out sugar completely for about a month. I started having hot water and lemon in the morning, sometimes with apple cider vinegar. I tried to eat lots of leafy greens. I drink ginger tea with fresh ginger. Along with cinnamon tea. If you have blood sugar issues, the research about cinnamon and its effects are amazing. I also drink lots of green tea as it's a great antioxidant and helps inflammation generally. I also started taking a high quality probiotic. That might sound like a lot to do in one go if you're not used to it but start with one thing and build up your protocol gradually if it's too much.

I used to exercise regularly but I wanted to reduce the stress on my body so now I mainly walk and stretch regularly throughout the day rather than do one intense workout, until my body is able to cope with the stress of somewhat intense exercise. I also do breathing exercises whenever I feel a little busy or need to just slow down - look up something called the physiological sigh. It really works!

BeeVel profile image
BeeVel in reply to lh22

Hi Ih22, thank you for the comprehensive response, much appreciated. I am starting my journey to a better health, so all this info is very useful. Thank you.

lh22 profile image
lh22 in reply to BeeVel

You're welcome! Feel free to DM if you like and let me know how you're getting on or if you have any other questions

Lovecake profile image
Lovecake in reply to lh22

There’s no way my TSH could be between 1 and 2!!! If on levo only I would be bedridden and on a small amount of T3 (started with 2 x 5) my TSH dropped to 0.03 and my FT4 and FT3 levels were 40% and 70% through range. We are all different, and getting our levels good for us can be a nightmare.

I now take 12.5mcg T3 and 87.5mcg levo and my TSH dropped to 0.01 on last test (it’s done that before and then gone up). My FT4 is less that 50% through range and FT3 80%. I was feeling pretty good and certainly not over medicated.

It seems some people get very low TSH levels when on any T3. We are at a disadvantage as then it sets off the GP etc to panic mode, trying to lower our doses, making us ill, and not actually raising the TSH. 🤷‍♀️🙄

lh22 profile image
lh22 in reply to Lovecake

Hello,

The post mentioned that she was feeling unwell with the ranges posted. So I shared my experience and what helped me, which is partly what this forum is for. Obviously we are all different, but we can all listen to others' experiences and experiment a bit if we want, to see what works for us!

Lovecake profile image
Lovecake in reply to lh22

Agree with you. I just wish the medical people that oversee our medication etc knew this. Low TSH is the bane of my life on too many occasions. Very glad that you found what suited you.

TSH is usually suppressed with any sort of T3 medication. I also know that when TSH goes down, the conversion of T4 to T3 is reduced which could be your problem that as the TSH has gone down, you’ve started to convert less well. I agree with the comments above that a reduction in T4 and an increase in T3 might be helpful for you.

Thank you. I am definitely going to alter my doses as suggested. It certainly is a bit of a roller coaster trying to find what works for you. Best Wishes

Lovecake profile image
Lovecake in reply to Divine1990

Good luck. I’m sure you will get there in the end

Divine1990 profile image
Divine1990 in reply to Lovecake

Thank alot. I will have to keep in mind that on the road to any sort of recovery I'm probably going to hit a few potholes.

Best Wishes

I felt so unwell for about a week thought it was my thyroid and I just rode it out because Im tired of dealing with thyroid everything and guess what it did eventually subside and cleared up and I went back to feeling better.

Divine1990 profile image
Divine1990 in reply to Batty1

Hi I know exactly what you mean. It is so easy to blame everything on our autoimmune conditions. I initially thought it was something I had eaten. Just after 3 weeks of feeling rubbish I'm looking at other options. Fingers crossed.

Best Wishes

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