Starting t3 while breastfeeding?: Hi, I have been... - Thyroid UK

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Starting t3 while breastfeeding?

Spij profile image
Spij
14 Replies

Hi,

I have been on 150 levo for several years and while my TSH and t4 are relatively stable, I have been feeling symptomatic since the birth of my last child in December 2021.

In particular, I am struggling to lose the baby weight, despite a very strict diet and exercise programme. I have other symptoms such as dry skin and hair loss but as these are fairly typical post-partum, I’m not sure if they are thyroid or baby related.

I’ve ordered the Medicheck test and started on Metavive II this week, and if indicted by the blood work, would like to start a t3 trial.

I have read that t3 is contradicted with pregnancy, but can’t find information regarding taking it while breastfeeding.

Does anyone know if it is safe and whether it means altering the dose in any way?

Thanks I’m advance

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Spij profile image
Spij
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helvella profile image
helvellaAdministratorThyroid UK

There is depressingly little information. One thing I found (linked below) seems to end up saying that, because we don't know, "an alternate drug may be preferred".

Which simply ducks the issue. And entirely ignores that the only possible alternative is levothyroxine. (They phrase it as if you had a choice of dozens of potential alternatives.)

If the mother needs the liothyronine, then they need it - whether or not they are breastfeeding.

So much about T3/liothyronine is based on ignorance. We don't know, so "No!".

(I freely admit ignorance of the issues. There again, I am in no way medically qualified. But I do know that I'd be very, very cautious when reading what has been written. Don't believe anything without careful thought.)

Drugs and Lactation Database (LactMed) [Internet].

ncbi.nlm.nih.gov/books/NBK5...

SlowDragon profile image
SlowDragonAdministrator

I’ve ordered the Medicheck test and started on Metavive II this week, and if indicted by the blood work, would like to start a t3 trial.

Bloods should be retested BEFORE any changes in dose otherwise testing is irrelevant

Metavive will have already altered results

Spij profile image
Spij in reply to SlowDragon

Sorry, should have been clearer. Blood sample has gone back, first Metavive taken shortly afterwards…

humanbean profile image
humanbean

You might find this link of interest :

endocrine-abstracts.org/ea/...

You can get a better view of the picture by clicking on it.

.

Since you have recently had a baby I wonder if you had a higher than normal blood loss during delivery? You might be iron deficient or even anaemic - pregnancy and delivery make high demands on iron. Note that people can be iron deficient without being anaemic. Iron deficiency needs to be treated, with or without anaemia, to have a hope of feeling well.

Deficiency will severely affect energy levels and will adversely affect how well you feel.

.

In addition to affecting how you feel, low iron can also prevent weight loss. See this link :

healthunlocked.com/thyroidu...

.

Doctors, at best, will usually do a Full Blood Count and will also test ferritin (a measure of iron stores) when they suspect anaemia. But the best test is a full iron panel, which is rarely done by the NHS.

You can test a full iron panel privately - no doctor required and you can ask for feedback on your results on this forum.

medichecks.com/iron-tests/i...

There are discount codes available that can save money :

thyroiduk.org/help-and-supp...

Spij profile image
Spij in reply to humanbean

Thanks so much! I had a fortnightly FBC throughout my pregnancy due to an issue with my platelets but that also flagged that I was bumping along the bottom of the range with several measures for anaemia so I was on 2x FS a day during pregnancy and the first few weeks after delivery, and am now on one every other day.

I’m due to have another FBC in a couple of weeks but will also look into the test you suggested.

I saw an Endo a few years ago who tested my ferritin as I was having hair loss but it was normal. However he suggested I take a gentle iron supplement which I did for several years in between pregnancies so I hope my stores are ok.

I’ve also taken the Viridian thyroid support supplement for 5+ years but it doesn’t seem to feature in any of the recommendations on here, hence ordering the Metavive one this week.

It’s all such a minefield, I’m quite jealous of people with normal thyroids for not having to fill their brains with this!

Spij profile image
Spij in reply to humanbean

I’ve just found my full iron panel test results from 5 months ago. I’ll see if I can persuade the doctors to rerun the same test for comparison and if not, order it from medicheck

CRP - 2.2 (range 0-5)

Iron - 18 (range 9- 30)

Transferrin 3.2 (range 1.7-3.4)

Transferrin saturation 22% (16-25)

thyr01d profile image
thyr01d

I'm really quite alarmed at the thought of anyone taking T3 while breastfeeding. Presumably it would enter the baby and since it can affect the heart rate I'd be really, really careful. Is there any reason not to delay until your baby has finished breastfeeding?

Spij profile image
Spij in reply to thyr01d

Thanks… does that mean that t3 transfers into breastmilk even though t4 doesn’t? Obviously I haven’t had to stop taking levo while feeding so was hoping/assuming t3 wouldn’t transfer either, given that naturally occurring t3 doesn’t I was intending to feed for around a year as I had previously but not sure I can last another 9 months feeling this symptomatic ☹️

helvella profile image
helvellaAdministratorThyroid UK in reply to Spij

However, T3 would be present in the breastmilk of those not taking liothyronine - but without a thyroid disorder.

The NHS says that T4 does transfer to the baby - but in small amounts:

Levothyroxine and breastfeeding

It's OK to breastfeed while you're on levothyroxine. Thyroid hormones are a normal part of breast milk. When taken as a supplement they only pass into breast milk in tiny amounts that are too small to affect your baby.

If you're breastfeeding, it's important that you continue to take levothyroxine, as this is replacing what your body would normally be making. Your body needs good levels of thyroid hormones to make enough breast milk for your baby.

If you notice that your baby is not feeding as well as usual, or if you have any other concerns about your baby, talk to your midwife, health visitor, pharmacist or doctor as soon as possible.

nhs.uk/medicines/levothyrox...

Definitely, it would be a bad idea to take a large dose of T3 and then feed an hour later.

thyr01d profile image
thyr01d in reply to Spij

I don't know the answer to that I'm afraid but I can't see why it wouldn't and what concerns me is that T3 is the 'active' part whereas T4 is not, so I presume the baby would only receive the 'right' amount of T3 if it were converted in your body from T4, whereas I presume the baby would receive however much T3 you took. Since when we take T3 it's not gradually assimilated like T4 but instead it's in 'surges' it sounds concerning to me. I'm far from an expert, this is just an opinion.

tattybogle profile image
tattybogle

regardless of the breastfeeding side of things ...if i've read it correctly , that's a lot of changes to your thyroid hormone regime is a fairly short time ... and all at a time when your HPT axis is probably still in the 're balancing' stage after a pregnancy /birth. I wonder if you are rushing things a bit, by considering a T3 trial before you know what happens to symptoms and bloods on metavive.

can you clarify ... did you stop the 150mcg Levo and then add (how much ? ) metavive , or have you added it to a reduced dose Levo .

I think you would be wise to allow a few months to get used to and try to find the right dose of metavive (by testing after 6 weeks on a stable dose )before considering adding any more T3 .

Going from Levo to metavive you are already adding some T3 from the metavive.

and your recent test is from 150mcg Levo, so it won't tell you what your levels on metavive will be .

apologies if i've misunderstood .

If T3 does get to baby via breast milk ,then you are already doing it with the T3 in your metavive. .... you can't be certain of the dose as they can't declare it.. but it does have some.

Spij profile image
Spij

The only change I’ve made is adding Metavive to reduced Levo - going from 150 to 100

All other supplements (magnesium, vit D, FS, thyroid support multi vit) I’ve been taking for 5+ years

Lilacsocks profile image
Lilacsocks

Hello! I'm following your journey with this as I am in a very similar position, breastfeeding and considering a T3 trial, I actually hadnt considered it would be very different to taking T4 in terms of breastfeeding 🤔.

Lilacsocks profile image
Lilacsocks

So interested in metavive. I haven't come across it before, I didn't think you could buy supplements containinf thyroid hormones?

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