Latest bloods, appointment to review first months of T3 trial with endo looming

[malohant]

Hi all

Just had blood test results back from Monitor My Health, as follows:

TSH: 0.06 (0.27-4.2)

T4: 15.7 (12-22); 37% of range

T3: 5 (3.1-6.8); 51% of range

I started a trial of T3 6 weeks ago, but in all that time have only been taking 1/4 of a 20mcg tablet (ie 5mcg) for all that time. I did question with the endo but he basically ignored that, I'm happy enough to have patience if it means I can keep a good relationship with him as long as I can, and I keep getting medication which could help with my symptoms.

For reference previous blood tests were:

21/1/22

TSH: 0.81 (0.27-4.2)

T4: 18 (12-22); 60%

T3: 4.5 (3.1-6.8); 38%

and 20/09/21

TSH: 0.48 (0.27-4.2)

T4: 17.9 (12-22); 59%

T3: 4.3 (3.1-6.8); 32%

So, as I understand it nothing unexpected there - T3 has raised slightly, TSH/T4 has dipped slightly. I imagine my dose of T3 needs to go up a bit.

In terms of physical symptoms, nothing has really changed with starting T3. Still have persistent fatigue, and everything which goes along with it (brain fog, emotional fluctuation etc), however my digestive system has been a bit more volatile where it had settled down somewhat. This is all a bit frustrating as I had hoped to see a little improvement at least, however these latest results are more or less within the range I've had over the past couple of years since diagnosis so perhaps not surprising.

**** UPDATE****

I emailed him my results and he has said to increase my dose to 1/4 tab in the morning and 1/4 tab in the evening.

Am I right in thinking that I need to treat Lio like Levo ie no food for 4 hours before/1 hour after?

Many thanks in advance, as always

Much appreciated

M

[Lalatoot]

Malohant - it is early days yet. Took me 2 years of slowly and gradually altering doses of levo and lio (1 at a time) to get to where I felt it was okay.An increase in lio may slightly reduce your ft4 level. Some folks can manage with low ft4 as long as their ft3 is high in range; others need both ft3 and ft4 well up in range.

It is all trial and error when you are on combo. Once you have settled after this increase and done bloods again, if you are still symptomatic I would suggest that you consider an increase in levo. It will raise your ft4 and, depending on how well you convert, your ft3 a little.

We tend to treat lio T3 the same as levo with regards to food and vitamins.

You are so right to keep your endo on side. All the best.

[malohant in reply to Lalatoot]

Thank you Lalatoot ! Good to be told it might be a long journey, I guess I wasn't expecting a quick fix but it helps to be prepared in any case. My only concern is that he has mentioned he might be retiring in the next year or two, I would have hoped to be somewhat settled with regard to medication by then.

I am currently on 100mcg levo, the endo has told me to reduce it to 75mcg alongside the increase in lio.

Ah I was hoping Lio might be a bit less restrictive, I tried taking levo in the evening before but struggled with not eating after 6/7ish! Oh well, new regime to adapt to.

Thanks again for the advice x

[FancyPants54]

There is no need to leave such long gaps before and after Lio. I don't take it with food exactly, but I'm much less bothered by it. It is absorbed differently I believe.

[greygoose in reply to FancyPants54]

It appears to vary from person to person. So, when in doubt, it often pays to be cautious. I would always advise someone relatively new to T3 to treat it the same way as levo.

[malohant in reply to greygoose]

thanks for your responses FancyPants54 and greygoose ! I will do my best to leave a few hours before taking the Lio. Is the only way to know how I respond to it, to wait until I am stable (and good) on it and then try taking it with less of an interval after food and see if it has an effect?

[greygoose in reply to malohant]

I suppose it would be, but it's not something I've ever done. I take my T3 when I first get up, all in one go, and don't even think about eating for a couple of hours, but that's due to how I organise my day. I've been on it for many years but never thought about trying eating just after to see how I would do.

[shaws Administrator in reply to greygoose]

I do the same as greygoose. I take dose with one glass of water and feel well and have no clinical symptoms.

[DippyDame in reply to malohant]

Why risk upsetting things if you find leaving a gap works!

I take my T3-only in a single dose at bedtime, so it's well away from food and drinks

[malohant in reply to DippyDame]

Yes I suppose, my worry is that right now when I get fatigued I eat to restore some energy (and I do tend to get fatigue more later in the day) so its a bit complicated to not eat for 4 hours, but I guess the idea is that taking the lio will reduce the fatigue... eventually. I guess we'll see!

[greygoose in reply to malohant]

Who ever said anything about four hours? Thyroid hormone is best taken 2 hours after a meal, or 1 hour before.

You should leave four hours for certain medications/supplements: vit D, magnesium, iron, calcium, oestrogen, PPIs. Not a normal meal.

[malohant in reply to greygoose]

Oh osrry, don't know why I thought that. Probably just got confused

🥴 That certainly makes it easier!

[greygoose in reply to malohant]

It's all very confusing at first. But, yes, that does make things easier.

[FancyPants54 in reply to greygoose]

If you are split dosing it really upsets the day to do that. I have tried both ways and see no difference. Maybe some do, but the consensus and advice on the Canadian group is that it's not necessary with T3. You dose all at once now. I would love to do that, but can't at this stage. That's a very different way of doing things. Constantly thinking about if it's safe to eat or drink all day long makes us feel like sick people and that's not good for moral.

[shaws Administrator]

25mcg of T3 has the action of 100mcg of levothyroxine. The following is a link:-

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