stop liothyronine??

[Abirose97]

t3 5.0

t4 14.9

tsh >0.01

iron and vit d within range. didn't take any meds 24hours leading up to it.

second test in a row with these TSH results, t3 and t4 have remained stable both times. my only symptom is tiredness and hunger, no weight gain or heart palpitations. my doctor has told me to stop taking liothyronine but continue levothyroxine.

I'm going to try it as I don't know what else to do but would love some more insights. he has had a few patients that he did this with, with positive results.

[Abirose97]

I'm also trying a GF diet as recommended by someone on here. just in case that's anyone's suggestion. it is helping

[DippyDame]

Why does GP want you to stop T3?

How do you feel? Important question! Did GP ever bother to ask this?

It's not all about numbers...clinical evaluation is also important

Do you have impaired T4 to T3 conversion?

Is your FT3 result over range?

If not, there is little chance that you are overmedicated.

TSH is not an accurate guide when on T4/T3 combo

Essential that you have both FT4 and FT3 labs

Do you have reference ranges for the above results?

Was liothyronine prescribed by an endo

How much levo and lio are you currently taking and what dose of levo does he suggest you continue with.

Are you altering hormone doses too quickly....it takes 6-8 weeks for a new dose to settle into the system.

he has had a few patients that he did this with, with positive results.

Cutting back on T3 then!

Not a very convincing reason given that we are all different with different needs.

There is a tendency for medics to withdraw T3 ....to save money.

Did this GP consult your endo before overiding his/ her decision?

For full thyroid evaluation we need TSH, FT4, FT3, folate, ferritin vit D, vit B12 and antibodies TPO and Tg....to include ref ranges.

[Abirose97 in reply to DippyDame]

I used to live in england where I saw a private endo courtesy of my generous parents and he has been very happy with my TSH remaining at >0.01 but now I live in Canada and they are for some reason refusing to refer me to an endo

[DippyDame in reply to Abirose97]

Do you have any labs other than TSH?

[SeasideSusie Remembering]

Abirose97

We can't interpret your FT4 and FT3 without the reference ranges, can you add them please so that we can comment.

iron and vit d within range.

Just being "in range" doesn't mean that the levels are optimal. What are the results/reference ranges for these, and were B12 and folate tested?

didn't take any meds 24hours leading up to it.

Time gap for Levo - last dose 24 hours before test.

Time gap for Liothyronine - last dose 8-12 hours before test, splitting dose into 2 or 3 the day before and adjusting time if necessary.

So by leaving 24 hours between last dose of Liothyronine and test your FT3 result is a false low, your normal amount of circulating hormone will be higher if tested with recommended time gap.

my doctor has told me to stop taking liothyronine but continue levothyroxine.

What is your doctor's reason for this?

[1239]

I’m guessing they want to stop your T3 because your TSH is suppressed. It will be suppressed on T3. I already knew that but my endo in my last letter stated it as well. (Probably more for info for my gp than me!)

[DippyDame in reply to 1239]

I’m guessing they want to stop your T3 because your TSH is suppressed. Well that is a totally rediculous reason ....and science verifies this.

TSH reflects the hormone level in the blood but NOT the level of each hormone which is the important factor

Did they look at FT3?

That is the most important reading and if that is within range then there is little chance of overmedication

T3 is the active thyroid hormone and for good health is required by every cell in the body in a constant and adequate supply

Low T3 = poor health!

It will be suppressed on T3...

Only if the dose is big enough to cause suppression

This current obsession with TSH is causing huge problems for patients because they are often wrongly medicated as a result

thyroidpatients.ca/2021/07/...

bmcendocrdisord.biomedcentr...

[SlowDragon Administrator]

Who originally prescribed T3

GP should NOT be meddling

How much T3 are you currently taking

Day before test you should split T3 into 2 or 3 smaller doses spread through the day, taking last dose approx 8-12 hours before test

Ft3 is falsely low as last dose T3 was 24 hours before test

Please add range on Ft4 and Ft3 results

Ft4 looks like it might be too low.

You may need dose increase in levothyroxine

Please add actual vitamin results and ranges

What vitamin supplements are you currently taking

Do you have autoimmune thyroid disease, also called Hashimoto’s, diagnosed by high thyroid antibodies

[samaja]

Have you looked at Thyroid Patients Canada website? Tania Sona Smith is a great patient advocate and has written many articles about T3 (she's on it herself) educating both the public and doctors. She is a stickler for science as well so an excellent source of info for (often ignorant) medical professionals.

As to your results - when you are on T3 your TSH will be supressed as everyone said and it's really individual how much. Most people split taking T3 into at least two doses, often 3 and how much of a gap you need before your next blood draw is hugely individual but if you dont's want to frighten your doctor with you FT3 result you generally need from 12 (bare minimum when you are on a small dose) to 17-19 hours when on a decent replacement dose.

In practice, when you are on T3 you are mainly informed by your signs (vitals like temps, blood pressure and heart rate taken at least 3-4 times a day usually before and after your T3 doses) and symptoms not blood tests so I wouldn't get too attached to them 8-).

Your tiredness and hunger might be related to your cortisol more than T3. Have you had it checked, ideally both as morning blood cortisol and 4 point saliva test? NO thyroid medication works well without good cortisol so it should have been tested right at the start of both levo and T3.

If you really want to learn more about being on T3 you should read Paul Robinson's 'Thyroid Patient's Manual' and 'Recovering on T3' books.

All the best!

[notpink]

I think this is a fairly common response from GP re liothyronine. They seem to be obsessed with a suppressed TSH, but if you're on T3 it will be suppressed, yet GPs don't seem to have a clue about this. I see your T3 prescripition was recommended by a private endocrinologist. My T3 was started through this route also otherwise I wouldn't have been given it. My NHS endo. is also exhibiting a panic approach to suppressed TSH and dropped mine to 15 mcg from 20mcg via a letter at xmas. It must be a cost-related phobia they all seem to exhibit! It's so hard to be confident when in that position, but personally I would emphasise the private endocrinologists recommendations to your doctor and ask to keep the T3. It's hard enough coping with the various symptoms without feeling that you're not being understood. There's a lot of good advice on this forum though, so hopefully this will help you to be more informed and strong.