Too many small changes ?

[hobbycat]

I’ve made quite a few small changes and got myself in a pickle ….

Starting point - 100mcg T4 and 15mcg T3.

I suddenly had an energy crash that lasted for days and a low T4 result hence my changes below :

21/04/22 - started 112.5mcg T4 + 15mcg T3

(2weeks)

04/05/22 - started 118.7mcg T4 + 15mcg T3

(3 days)

07/05/22 - started 125mcg T4 + 15mcg T3

(2weeks) feeling my low brain cognition still not shifting so ….

25/05/22 - started 125mcg T4 + 16.25mcg T3 (5 days)

30/05/22 - now I feel uncomfortably over medicated with shakes and internal agitation.

So, now I’m going to stop the extra 1.25mcg T3. I’m so surprised it’s been so impactful.

How long might that take to come out of my system?

I’m really anxious about feeling like this. I know I shouldn’t have made so many little changes, and that my patience needs taming.

My T4 overall increase of 25mcg was across 5 weeks and I thought that was a regular increment and had quite a long time to bed in and I had thought the T3 increase of 1.25mcg (a 5mcg tablet in quarters) was a tiny.

It wasn’t until I added the extra T3 in that my brain started working again, and before that I had to reduce my T3 because my heart didn’t like it. I’m so lost as to where the balance is.

Does anyone think a change of brand might make a difference?

(now my 15mcg T3 is Mercury Pharma and the 1.25mcg T3 is Mornington).

[SlowDragon Administrator]

Changing brand of levothyroxine or T3 can cause differences

How long since you started HRT …..is it tablets or topical on skin

What were most recent TSH, Ft4 and Ft3 results

Do you split your T3 as 2 or 3 smaller doses spread through the day

If your very sensitive to dose change in levothyroxine or T3 it’s best to go slowly …..just one increase in levothyroxine to 112.5mcg daily and wait 6-8 weeks before retesting

However you probably don’t want to get even more confused by reducing from 125mcg to 112.5mcg unless you have to

Is levothyroxine all the same brand

Have you considered also splitting your levothyroxine into 2 or 3 smaller doses, taking at same time as T3

Also when were vitamin levels last tested

[hobbycat in reply to SlowDragon]

I’ve now got two T4 brands and two T3 brands.

HRT is gel - and I change on 21/04 - same as my first increase of T4 this time around.

TSH 0.02 T4 12.5 T3 4.6 in March.

T3 10mcg at 7am and 5mcg at 2pm. I was adding additional 1.25mcg at 6pm.

I’m abroad for 5 days so can’t cut my tablets. I’m wondering if it’s best to do 100 / 125 alternative days ? Or I could take 100mcg at 7am and 25mcg at 2pm but I feel so over medicated and I feel awful 😞 so I wonder if I should reduce ?

[tattybogle in reply to SlowDragon]

Hobbycat.... Just noticed what seems to be an error in results from march~ here healthunlocked.com/thyroidu... they seem to be:TSH 0.02

FT4: 12.7 ( 9.01 - 19.05) 37%

FT3: 5.3 ( 2.63 - 5.7) 87%..... not 4.6 as you put in reply to slowdragon above .

[hobbycat in reply to tattybogle]

Oh my, you are more on it than me ! Yes, those are my numbers. Just a few weeks later and my energy went through the floor.

[Lalatoot]

No I don't think it is the brand. I think it is your tinkering. As you said yourself you've made too many changes. It is frustrating but you must only change 1 thing at a time and then wait for 8 weeks for the impact of that change to show.There is no quick fix otherwise you just get in a muddle.

[hobbycat in reply to Lalatoot]

Yes, it’s so hard though, when after weeks nothing seems to be changing … I hate this all so much … 🙈

[Lalatoot in reply to hobbycat]

It took me 2 years of small changes to get to results and doses that I was happy with longer-term. It's the only way unfortunately. I had to give up my job and was housebound because of it. Only now beginning to get any life back.

[Jewiemax15]

Your T4 looks low , perhaps speak with your endocrinologist?

[tattybogle in reply to Jewiemax15]

We don't actually know what the current fT4 level is. I think that fT4 '12' result was from March when hobbycat was taking 100mcg levo , and it looks like levo dose has been increased to 125mcg since then .

Also, we don't have the lab range for that fT4 test, but even though [12-22] ish is a common range , some fT4 tests use ranges of eg [7 -14]... and if this test was one of those, then a result of 12 isn't low.

[hobbycat in reply to Jewiemax15]

Hi. Thanks, I did. We agreed I would go up 12.5mcg T4 but my recovery was so slow and hence the changes above.