I've seen a new endo yesterday, and he finally listened to my symptoms. He thinks that I am not converting as well as I should (hallelujah!) and wants to add T3 to my levo dose.
He has prescribed me liothyronine 5mg per day and is dropping my levothyroxine dose from 125mcg to 100mcg daily. He said to take the liothyronine in the morning.
Any advice on taking liothyronine? I had switched the past few months to taking my levo at night, so I am wondering whether to switch this back to morning too. I would love some advice.
Is there anything to know about brands here? (e.g I take mercury Pharma of levo and find it better for me than TEVA)
What cost is normal? He recommended that I send the prescription to Roseway labs, and they have quoted me saying ‘Your prescription is for Liothyronine 5mcg SigmaPharm Labs and the total cost comes to £60.’ The prescription says on it 2/12 (which I assume means for 2 months) and says lactose free. Is this a normal cost? Also what’s the best way to post this to them to get the prescription fast? Any advice, I’m in London so not far from where they are.
I have read on here about people splitting doses when taking T3- but he said to me to take it all in one dose. Please let me know if you have any advice for me as I begin this new journey with adding T3 to my levo.
Lastly, does anyone have any opinions or advice on this: He said that along with my thyroid problem, he believes that from my symptoms and history I have post viral fatigue. From my understanding, there isn’t much I can do about that so let’s see how the T3 helps and how I feel after that. Has anyone been diagnosed with this? Any advice welcome.
Thanks in advance!
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thyroidqueen12
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To add: I mentioned to the endo that I'm starting a new job on Monday and that I was concerned about feeling worse by changing my medication. ( really can't afford to feel worse!) He said as I'm in need of T3, the only thing I might feel is 'as if i'm really caffeinated' in the beginning, so this shouldn't be a problem with new job.
(You have used the unit "mg" which is a milligram. Thyroid medicines are usually referred to in micrograms (mcg). It undermines you if you get it wrong when discussing with healthcare professionals. They'll assume you don't know what you are talking about - not that it is a simple typo.)
Congratualtions on getting T3 prescribed! 5 mcg is only a tiny dose, so it really wouldn’t be practical to split it. However, you take it whenever is best for you – lord knows why he said to take it in the morning! Perhaps because that’s when you’re sure to have an empty stomach, because T3 is best taken just like levo.
Was your FT4 very high? Because often endos reduce the levo when there’s really no need, and that can make the patient worse instead of better.
Did you find taking levo at night had any advantages? If so, continue to take it at night. No reason why you should switch back to taking it in the morning, if the night is better for you.
Don’t know anything about brands, but then they’re all the same to me. And I’ve taken most of them. And I don’t know anything about costs, either. As for the post viral fatigue, that sounds like a fob-off to me. Why would he ‘believe’ that? Have you had an infection recently? And, even if you do have post viral fatigue, that doesn’t mean you can’t also be fatigued due to low T3.
He said as I'm in need of T3, the only thing I might feel is 'as if i'm really caffeinated' in the beginning, so this shouldn't be a problem with new job.
What a silly thing to say. Has he ever taken it? And what does ‘really caffeinated’ feel like? I don’t think I’ve ever felt that even with caffeine! Lol
Thanks greygoose! He is starting me on a low 5mcg to trial how it affects my labs (I'm sure it's like with levo how they started me on 25mg!) He said he wants to lower my levothyroxine dose to avoid me going hyper by the addition of T3. Hoping this lowering of levothyroxine won't make me feel considerably worse though...
My latest results were this:
Tsh 0.93 mIU/L (0.27-4.2)
Free t3: 4.4 pmol/L (3.1-6.8)
Free thyroxine: 21.8 pmol/L (12-22)
Yes I'm doubtful about the 'post viral fatigue' but let's see how the T3 helps my symptoms...
He said he wants to lower my levothyroxine dose to avoid me going hyper by the addition of T3.
Oh, stupid! You can't 'go hyper' because you're hypo. It doesn't work like that. And, when adding T3 it lowers the FT4, anyway, so not much chance of you're being over-medicated. Besides, you're only over-medicated if your FT3 is well over-range, and that's not likely to happen on 5 mcg T3!
But, 5 mcg is a good place to start, as long as he's willing to increase it in the future.
Your endo shouldn't just think your conversion is poor he should find out and know!
High FT4 with low FT3 generally confirms poor conversion.
Did he also point out that to support thyroid function/ conversion you must have optimal vit D, vit B12, folate and ferritin.
These should be tested before adding T3.
Unfortunately medics knowledge of the importance of key nutrients is poor....or non existing!
Bottom line....when you rake your meds is a personal thing we all react differently so there is an element of trial and error involved.Initially it is not necessary to drop levo when adding T3.
Adding T3 will drop T4 a little anyway.
There's no reason why you cannot take your T3 at night with your levo...you will know in a week or two if it is settling well into your system
You may even find 5mcg at bedtime improves sleep
Time will tell...you may need to experiment
I need high dose T3-only and take it in a single dose at bedtime with no problems.
I cannot comment on cost because I buy my T3 from abroad.
Others will advise about ordering from Roseway labs but...
I imagine the endo has prescribed Liothyronine Sodium...just bad handwriting
This is the replacement form of T3 it is bio identical to the T3 (Triiodothyronine) made by the body....approx 20% from thyroid gland to bloodstream and approx 80% from T4 to T3 conversion
The cost of T3 has soared as a result medics have been reluctant to prescribe it on the NHS.
Don't expect a quick fix, it takes 6/8 weeks for a change of dose to settle into the system
Test again 6/8 weeks after altering dose and review levels of medication.
I'm saying this so that you don't decide after a few days ( weeks even) that the new protocol isn't working...it happens!
What your doctor is describing as post viral fatigue may be undermedication...low T3.
Have you had Covid....that can cause thyroid levels to drop?
Just a few thoughts...
and I'm not convinced that your endo is totally thyroid savey!
I see you have now deleted the "caffeinated" comment which supported that.
Hope you feel better soon and good luck for the new job.
I've been posting on here regularly with my blood results, and have been told my percentage through range is showing poor conversion with every blood test I've posted. The endo went through all my results since September 2021 with me.
My latest results were this:
Tsh 0.93 mIU/L (0.27-4.2)
Free t3: 4.4 pmol/L (3.1-6.8)
Free thyroxine: 21.8 pmol/L (12-22)
Folate serum: 4.2 ug/L (>2.9)
Vitamin b12 active: 105 pmol/L (25.1-165)
Vitamin d: 139 nmol/L (50-200)
He also recommended that I take supplements for Folate and B12. I tried to take the Thorne B complex (recommended on here) but it made me extremely itchy within 2 weeks of taking it. As soon as I stopped taking, the itching sensation stopped. Endo recommended that I supplement but taking the folate and b12 separately to try avoid this.
If you have any advice on supplementing for these, I’d love to hear it. I can’t remember everything he told me (i have terrible memory at the moment) but I asked him to detail everything in the doctors letter. So I’m hoping this will give some more specifics on which supplements to start on.
He told me to drop my levothyroxine dose from 125mcg to 100mcg as he is worried that I might go hyper if not dropping the dose when adding T3. He said that this was standard for introducing T3? I am worried now that I will feel bad side effects from dropping my levo dose, and this is going to be a big problem when starting a new job!.But am also keen to try what the doctor recommends (to give this new endo a shot!) before tweaking things...
Thanks for all the tips. I'm going to get the T3 from the roseway labs he recommended for now. If T3 works for me, I will look at other options of where to source it cheaper for a longer term solution.
On post viral fatigue: yes I had covid in December which made me feel worse again, but I also had a severe reaction to my first dose of AstraZeneca,
which he thinks could have kickstarted the post-viral fatigue. He said that some of my symptoms overlap with thyroid and should improve with T3 treatment, whereas others sound like post-viral fatigue. So we’re tackling the thyroid first, and then seeing if the other symptoms remain. A bit sceptical about post viral fatigue, but let's see. Fingers crossed the T3 journey will solve my probelms.
I absolutely agree with greygoose ( above)Medics are fearful of T3 and seem to think the very mention of it will kick off hypo... which is complete rubbish.
So long as FT3 is in range, hypo is not a problem.
Your FT3 ( above) is only 36.14% through the ref range so you are not even close to overmedication.
I need 100mcg T3-only daily because I have a form of thyroid hormone resistance (rare!)...my GP was convinced I would drop dead. I have to self medicate to function so I'm not restricted. Medics now see I'm still here after several years on T3!
5mcg is a tiny dose...I suspect after further testing this will have to be increased
Only you can decide what you wish to do, I can understand that you want to keep this endo on-side...he has prescribed T3!!
...but in your shoes I'd make a plea to avoid cutting levo dose.
Covid may have caused transient problems too
One study suggested, "...the higher the severity level of COVID-19, the higher the probability of decreases in the FT3, FT4, TSH levels"
However Covid may have had little impact on your levels..
Suggest you keep a diary/ spreadsheet of all changes and symptoms, including resting heart rate.
I'd suggest you are just going to need more T3 and hope your endo understands this.
He has prescribed me liothyronine 5mg per day and is dropping my levothyroxine dose from 125mcg to 100mcg daily.
With that FT4 level then I agree that reducing Levo was the right thing to do at this stage.Later in your T3 journey you will learn to understand where you need your FT4 and FT3 levels to feel your best, this takes a lot of time, patience and gradual tweaking (something that doctors aren't necessarily aware of). Some people are fine with low FT4 as long as FT3 is in the upper part of it's range, others are better when both FT4 and FT3 are over half way, it's all a case of trial and error and finding what suits you.
He said to take the liothyronine in the morning.
I had switched the past few months to taking my levo at night, so I am wondering whether to switch this back to morning too. I would love some advice.
I have read on here about people splitting doses when taking T3- but he said to me to take it all in one dose.
As for when to take either of your hormones, that's up to you so experiment and see how you feel although I'd treat the T3 the same as Levo with regard to taking it away from food/drink/supplements etc, just in case anything affects it's absorption.
If you want to keep Levo at night then maybe take half your T3 dose in the morning and the other half in the afternoon or evening or even with your Levo. If you want to move Levo to the morning then take half your T3 with your Levo and the other half in the afternoon or evening or even at bedtime.
Is there anything to know about brands here? (e.g I take mercury Pharma of levo and find it better for me than TEVA)
No, not really, not like the mannitol in Teva Levothyroxine causing problems. Some people have preferred brands of T3 just like some have preferred brands of Levo, again it's a case of try it and see.
I don't know anything about the cost of T3 other than if you can get your prescription written for Thybon Henning 20mcg in multiples of 100 then that is about the cheapest at around £50-£60 for 100 tablets, but Thybon Henning must be stated on the private prescription. Roseway, Chemist4U and Smartway I believe charge this price.
thyroid queen. Start by reducing your levo as advised and wait a week so that the levo has time to get out of your system. Then start taking your 5mcg T3. Take it with your levo if you want or in the morning.I am on 100mcg levo and 7.5mcg T3. I have been on as much as 20mcg T3 but by trial and error found that 7.5mcg was all I needed at the mo.
Take 50mcg lev and 5mcg T3 first thing and 50mcg levo and 2.5mcg T3 at bedtime.
When I was on higher doses of T3 I tried taking an afternoon dose but found no difference so I stick with morning and night as this leaves the day free for supplements if necessary.
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