How to add T4 back into T3 only

[Msmustang1981]

I followed up with my doctor this past Thursday regarding my ongoing problems I previously posted about. Definitely thinks the high liver enzymes are from the hydrocortisone and just wants to watch them since all liver scans and fancy liver tests were normal.

However, she thinks my ongoing abdominal pain, fatigue, nausea, no appetite, etc. is from my very below range free T4. She knows it is low due to the T3 monotherapy, but I can’t increase the T3 any faster than I currently am to compensate. I currently take 30mcg T3 only. She thinks I’m one of those people who need some T4 and I’ve read that some people do need to be back in range with that in order to feel good. Maybe I am one of those people!

I previously did very poorly on T4 only but she feels now with the HC, I need the T4 and T3. She suggested starting in at 125mcg which I feel is way too much for me. She also wanted to leave my T3 dose where it is which I think would be problematic too. I’d like a gentler approach. Do you think 50mcg of T4 would be a good starting point and maybe dropping my T3 to 15mcg down from 30mcg? Not sure how to add back in T4 but figured it was worth a try to feel better. Thank you!

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If your T3 is in range I would assume you can leave it where it is.

Going in at 50mcg levo seems sensible if you're sensitive to increases.

[Lalatoot]

To be gentle on the body t4 is increased in 25mcg. So I would add in 25mcg only at the start.To know if you should reduce your t3 dose first we would need to know your FT3 level. Decreases in T3 are done in 5mcg again to be gentle on the body.

If you were to decrease I would decrease by 5mcg then wait 4 or 5 days for it to leave the system and then add in 25mcg levo.

It is best to go slowly with small changes one thing at a time otherwise you haven't a clue what is causing symptoms or what to change. Slow small changes, methodical and patience wins the day.

[Alanna012]

I'm in the very same position it is so frustrating. I can't tolerate synthetic levo, but after a while on T3 only I get weak and undefined muscles and other symptoms. T3 alleviates depressive feelings, and other symptoms, but T4 confers me with real cognitive benefits like sustained concentration.

I feel like I'm on a seesaw with t3 on one side and T4 on the other and symptoms on both sides. (Although I caveat that T4 only is totally unbearable)

Am experimenting with adding one Bi-tiron tablet in the afternoon. So far it's ok but already I'm waking up with crampy carpel tunnelly hand feeling and I think I still need to increase it more. Just. Can't. Win.

I wouldn't reduce your T3 as if you struggle to tolerate T4 it will just make you feel worse. But I definitely think 125mcg levo is ridiculous to jump in with. You will feel awful doing that. I think 50 is probably ok since you likely have quite a big T4 deficit being on T3 only.

[beaubeau1121]

I added 37.5 levo ( splitting 75mcg compunded tabs)… to my T3 only of 45mcg( lowered from 50mcg only before adding t4)Unlike you, I was very happy on 50mcg T3 only…. & had gradually worked up to that dose over 6 months