Why do Drs insist on taking T4 along with t3? Is it really necessary for the body?
I have been asked to include it along with my t3. I'm not actually sure if it suits me. I'm just on 25 mg at present along with 1x10mg t3 3xpday. I'm feeling awful. My pulse is about 70- 75 resting
I know my cortisol is on the low side even though I'm on 5 Pred pday.
So could it be cortisol?
Forth blood test results were 159nmo/L. Ref range ( 166-507 )
NHS cortisol results will follow.
Thank you for any advice please.
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Everdean
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As far as i understand, testing cortisol once on replacement is meaningless. I take methylprednisolone and when gp tests cortisol it's always at the bottom of the range, but i feel fine. I take 6 mg which is equal to about 30mg hydrocortisone. Your 5mg pred = 20mg HC if i remember correctly. That's not low but maybe not high enough depending on your needs. Do you have signs of under-replacement? Is this a permanent thing? Addison's or secondary? Is the endo or gp prescribing it? I will try to remember to send some resources tomorrow. Sorry for all the questions. Edit: yes cortisol/cortisone is very important for thyroid. Edit 2: And I agree with others that issue may be incorrect doses of T4/T3 (and not necessarily cortisone).
Here is some information on low cortisol from the standpoint of Addison's disease or secondary adrenal insufficiency. You might see if the symptoms fit, which may mean you need slightly more than 5mg pred.
I8 days ago your post heading read, Starting 100mcg t4 along with 40mcg
Who prescribed that whopping dose?
An endo?
So what is going on....
your dose levels are completely erratic!
No wonder you feel awful....poor you!
In this post you say you are now taking 25mcg -levo I assume - with 10mcg 3 times daily
That is some change of dose after just 18 days.
Have I understood that correctly?
2 years ago your FT3 was dropping off the ref range which meant that your serum T3 was abysmally low....but your GP thought you were overmedicated because your TSH was suppressed. That was absolute rubbish, he was possibly wrongly relying on TSH and ignoring your symptoms and the Frees
FT3 is the important lab ( along with FT4) and unless your FT3 lab result is over range you are not overmedicated.
That GP was making you unwell!
You would benefit from having a full blood test but you'd be best to be on a steady dose for 6 weeks first.....your current dose?
You may not feel great for a while but your serum level will have settled enough in that time to give steady results that can be analysed
Full thyroid test =
TSH, FT4, FT3, vit D, vit B12, folate, ferritin and thyroid antibodies TPO and TG
I had a private test for thyroid after having been overmedicated by my Endo. At least that's what Dr in A&E said . I had rapid heart and palpatations. I had to lower fairly quickly to bring heart rate down. My blood test before that showed T3 over range too. I still get palpitations some times but think it might be the low cortisol. I have made an appointment for a private Endo who's been recommended. But not till July. I've got the faulty Dio2 gene from both parents. Dr admits she doesn't know how to treat me.
I just don't know what I'm doing now.
Thank you for your advice.
I know my ferritin is very high. I had that done privately. I will request the vits and minerals you said. And post the results.
I’ve just read your last post (which turned into rather a long thread didn’t it? ) and see you have an Endoknob. Frighteningly common these days…
No, technically you don’t need T4 but I think doctors get twitchy about it because if you miss T3 dosing for any length of time they fret that you haven’t got the back up of having some available T4 to convert into T3. But if you do have a nice steady supply and you make sure that if you’re ill / have an accident that the paramedics and medics know you need T3, it’s fine. A bit last resort but fine, especially if Levo really doesn’t suit you.
I’m trying to remember what you said you were taking before the 100mcg Levo / 40mcg Lio debacle—was it simply 25mcg of your own self-sourced Lio? Were you taking any Levo then?
Like Jazzw , I’m still a little confused about what thyroid medication you’ve been advised to take/ what you’ve actually taken
Feb 22: taking 25mcg Liothyronine from overseas (I’m unsure if this in addition to any Levothyroxine?)
March 22: endo prescribed 60mcg Levo but this resulted in over- range T3 and needing to go to A and E (again, were you taking any Levothyroxine in addition to this?)
Start May 22- advised to take 100mcg Levo and 40mcg Liothyronine (Forum members advised that this is too much)
Currently taking 25mcg Levothyroxine and 30 Liothyronine (How long have you been on this dose?)
Hello Buddy 195. I wrote a reply yesterday with a long explanation . I thought I'd posted it but now I see it's not here. I will do it again when I have the energy. Not well today. Sorry.
I recommend you start a new post if you have further updates, as then it’s visible to others, not just myself. It’s always good to have a wider audience, as people come up with different suggestions.
There are quite a few people on this forum who don't take T4, they just take T3 only. Some of them have been doing this for years.
Doctors have been taught that T3 is really dangerous stuff, and they seem to think of it as being like taking dynamite.
If any doctor ever tells you that T3 is dangerous tell them that the Yellow Card system in the UK hasn't (at time of writing - 19/05/2022) got a single death recorded that puts the blame on T3 or NDT (which contains T3).
I wrote about this fear of thyroid hormones here, and why it is unjustified :
The one major fly in the ointment with taking T3 only is that if someone has a serious accident or illness and can't advocate for themselves, and doesn't have someone to do it for them, they could go into a coma through lack of thyroid hormones. At least for people taking T4 they have a reservoir of thyroid hormone to survive on for a bit longer than those who are on T3 only.
When I asked my GP to help me with a trial of Tiromel that I had sourced and paid for myself, he was horror stricken, said T3 was an illegal drug and I was never to say'T3' in his presence again. That was in 2020.
So I had to go it alone. Now I am on T3 only and doing very well. I was diagnosed in 1999 and I was never well after that, on Levo only and I was told that I couldn't have anything else.
It took me a long time to decide that I was not going to take it anymore, but in 2019 I found Thyroid UK and if it wasn't for this Forum I wouldn't have the life that I have now.
Why do they think T3 is illegal? They have T3 flowing through their veins, as does every human on the planet. So does every vertebrate in the animal kingdom. I'm not sure about other classes of animal.
They do seem determined to make sure that people with thyroid disease don't have as much T3 as everyone else
I can't tell you why that GP thought that. I can tell you that he was a pratt, who kept decreasing my Levo because he told me that I was overmedicated on 200mcg. I didn't know any better than to let him decrease it then.
Once I joined Thyroid UK I began to learn how to treat myself. I decided to trial T3 in 2020. I asked him for a full thyroid test, as well as vitamins, which I got with no problem.
He had me down to 175mcg Levo and antidepressants, itchy ears, insomnia, I was self harming, etc etc
He rang me with the results and up it came, you are overmedicated and I want you to decrease your Levo dose. It was because my TSH was high and I refused to reduce anything. I told him about TSH being a Pituitary hormone which was calling for more Thyroxine etc etc etc. You don't need me to repeat all of that.
He never really said anything. I think he was just shocked that I could tell him about my thyroid treatment
But when I told him that I had asked for these tests because I wanted to trial T3 to see whether I might be able to feel better and would he assist me with the trial.
He just raised his voice a little higher and told me that T3 was an illegal drug and I was never to mention 'T3' to him again.
I did suggest he told the police about my illegal drug, because I would dearly like to know how illegal it was before I started my trial.
I suppose he just didn't bother, because no police arrived on my doorstep.
We didn't have too much contact after that. I did send him updates via email, but he never replied! LoL
I feel sorry for his hypothyroid patients now. He has bought out every other Practices in the area, there used to be six practices I believe, but he has bought them all out. God help them. I tried telling the Health Board about him, but they took no notice at all.
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) and see you have an Endoknob. Frighteningly common these days…
hypersensitive to T3
For anyone who is on T3 only... When did you realise you needed it? 
Adding T4 to T3?
When to take NAX?
