following referral to endo he’s suggesting trial t3 as I’m possibly not converting t4-3
Meds are arriving tomorrow between 9-1 ! I normally take Levo around 6am . Would I be ok starting tomorrow taking the t3 med a couple of hours after Levo ?
I am just so eager to start as I’ve felt so bad for months !
It’s only been the advice/support from here that I finally managed to get GP to listen !
TIA
Nutty because your for is near the top of the range at 92%, I would suggest that you reduce your levo first by 25mcg then wait a week for your level to go down .The following week add in 5mcg or quarter tablet t3. Wait a week.
If all is ok. Then add in another 5mcg either to the first dose or as a separate dose .
I would then wait 8 weeks and do bloods. However you can continue adding 5mcg every fortnight until you reach 20mcg. Then wait 8 weeks and do bloods .
My endo prescribed a daily dose for me of 20mcg but I only actually need 7.5mcg so it is a trial and error thing to find what's right for you. Best to add it slowly.
Thanks Lalatoot endo has advised me to reduce Levo to 75/50 ? He has told me 10mg (split dose ) for 2 weeks and then 15mg . I have to get bloods done and speaking to him in 6 weeks 🥴🥴🥴
The standard protocol for endos seems to be reduce levo by 50mcg and add in 20mcg lio.Yours is much in the same vein. And they expect it to be done overnight!
Some folks do that and get away with it; others need to slowly build up to the new dosages.
My endo reduced me by 50mcg and added in 20mcg lio but having read up on this site, I did it over a period of 9 weeks. It wasn't the correct dosages for me and I spent the next 2 years slowly adding back in 50 mcg levo and reducing my lio to 7.5mcg till I found what suited me.
As I had been unwell on levo for so long I was lucky to be given a year's trial of T3 by the endo so i had time to take it slowly.
I find it all so daunting he’s already booked 6 week appointment! I’ll reduce Levo first and then just start 5 mg lio . Thanks again
He is likely to say to get your bloods done 2 to 4 hours after your lio dose. Don't! 2-4 hours after a dose will measure the peak ft3 in your blood. We don't spend the day with peak levels and we want a more realistic picture so it is suggested on here that we get bloods done 8 - 12 hours after a dose to measure a lower ft3.If you choose to do this and your endo asks if you got bloods done 2 - 4 hours after dose, you answer "That's what I have been told to do". You can add, "I always follow the same protocol so I can compare results like for like." (but never say what the protocol is!
Sorry to butt in here but may I ask what level of ft3 you’re at to be comfortable? I only ask because I’m on 10mcg which I expect has taken me to around 5 or just under (could be wrong) and I’m so hot. I mean I know it is hot but it’s different. This happened last time I tried t3 too. Thanks x.
I take 2x50mcg levo and 5mcg and 2.5mcg lio. this takes my ft4 to 50% through range and my ft3 to 72%. I am not symptom free but as my body had many many years of rewiring itself and adapting to survive, I expect it will take many years of recovery to re-adapt to having decent thyroid hormone levels. i settled on this dose as I felt I needed to stop juggling dosages to give the body time to heal and that these were good levels for me. I have been on these doses for 1 year this month.
Thank you Lalatoot. Very informative and useful info.
I find the thought of all this juggling doses really scary ? Do you adjust by blood results or how you are feeling. I am now thinking my T3 has prob been low for sometime so many symptoms overlap it’s hard to pinpoint the cause !
Nutty you use blood results and how you are feeling. It took me 2 years to settle on doses. You only change 1 thing at a time, wait 8 weeks and do blood results. As the symptoms of under medication and overmedication are so similar you need to look at where your results are to guide you as well.It isn't as daunting as you think! We are here to help too so if you post blood test results we can offer opinions as to the next steps. If I can do it, you can. Just be methodical and patient.
Thanks again Lalatoot can I just ask do you use the finger prick for blood test ? I initially had nurse come out but thinking this would be bit expensive if doing it regularly
I don't know about Lala, but I use Monitor My Health finger prick tests for all my testing. I just need to know my FT3 level really as I'm fading Levo out altogether as an experiment so my TSH and FT4 are irrelevant. Monitor my Health is done at an NHS lab in Exeter and costs around £26 if you use the code available on Thyroid UK web site.
Thanks I will give them a go
Nutty I have been lucky to get mine on the NHS and have been doubly lucky to be able to talk the endo team into keeping me on their books for the 2 years I was juggling doses. My argument was that they couldn't discharge me to the GP when I was not stable. Because of this I was getting 4/5 monthly blood tests. It was just a sheer luck situation!!! Oh and my persuasive charm 😆
Excellent advice ! Except for in Emergency situations , tapering one drug then slowly increasing the new one is always the way to go to prevent the worst side effects on your body to a medication change , with all types of drugs and conditions , not just Thyroid problems.
How much levothyroxine are you currently taking
Do you always get same brand levothyroxine at each prescription
As Lalatoot says ……Reduce levothyroxine dose by 25mcg
Wait 4-6 days …………….and then add 5mcg T3 with your dose levothyroxine in the morning
Which brand is T3 and what dose is T3 endocrinologist has prescribed
You will need tablets, not capsules.
You can’t split capsules
After about a week on 5mcg in morning…..assuming all ok….add 2nd 5mcg dose approx 10 hours after first dose
Personally I would hold at that and retest again in 6-8 weeks
Test thyroid levels early morning, before 9am and last dose levothyroxine 24 hours before test
Last 5mcg dose T3 approx 8-12 hours before test
Thanks SlowDragon currently on 100one day then 75 next day , always get same brand
I’m not sure of the T3 brand he didn’t say but told me 10mg for 2 weeks then 15 mg for 2 weeks ?
Well you can’t test until 6-8 weeks after being on constant dose
Starting on more than 5mcg is frequently too much for many people
Personally I started on 2.5mcg waking and 2.5mcg about 5pm
After 5-7 days assuming it’s all ok …add next 5mcg dose
Then play it by ear …..you might feel it’s too soon to add 3rd dose
If you do add 3rd dose ……split at roughly 8 hour intervals through the day
Thanks again yep I’ll do it gradually!
Hi SlowDragon I’m going to follow your suggestion of splitting the 5mcg into 2x2.5 . Think 5 overloading me struggling to walk legs like weights /dizzyI’ve initially cut 20mcg into quarters and now halved quarter ! Will that be ok ? Presuming I take all the little bits should work out correct dose x
Yes…..use damp finger to mop up all the crumbs
Thank you !
I kept my T4 Levothyroxine at same dose and took 5mcg twice a day 8hrs apart. Subsequently I lowered my Levo by only 10% down from 75 a day to 68 a day. I’m on liquid Levothyroxine so it’s easy reducing or increasing. This regimen has kept my T4 and T3 levels in the middle of their blood ranges. And my TSH is around 1.00 which are all checked every 3 months. For myself I do better not letting my levels of T4 or T3 go over half way. I never take my meds prior to a blood test this was also advised by my private only Endocrinologist. I’m full of energy and life and lost 4st+ without even trying. Once you start your T3 remember to keep busy if you can and exercise if you can. You may find that 5mcg twice a day is sufficient for you. It is for me. But we are all different. Keep an eye on your vitamins too.
Thanks McPammy there is so much to take in !
Once you get your own regimen sorted you should feel more confident about it all. I’d follow your Endo’s advise. Most important thing is to feel better and stay that way. And to recognise if you feel your going over medicated and to rectify that if it’s required at all. 👍😀. Don’t worry. ThyBon Henning is one of the best brands I believe.
I agree with most people that starting with 10 mcg T3 may be too much. My nurse accidentally started me on 20 mcg (or 25 mcg) - can't remember, and I definitely lost about 10 kilos in weight rapidly.
That being said, generally speaking I am happy I switched immediately. I am in the States, so I think the advice here is often very different (and closely related to your insurance). I barely responded to T4. However, if I would have tapered off my T4 at that point in time, I am sure I would have been sick in bed with muscle pain all over.
I can't find your labs in this post, but someone seems to say that you are 92% through range of ft4. So, if you are really on a large doses of T4 then it makes sense to taper off first. I probably didn't have that. Either way, a week is just a guideline (one that makes sense) - but I would also see how you feel and play it by ear.
So, - as many people mentioned; listen to your body. T3 is a very fast-acting hormone, and some symptoms can be scary (heart palpitations) and suddenly come on, and be gone an hour later. It is important to take note of these symptoms.
I see a lot of people saying to take the next doses ten hours later. I feel that is very, very long. You clearly do get up early in the morning, so that can help. I am very bad with my morning dosage. However, I always take my second and third dosage at the same time every day. That seems to do the trick. At most I will shift it by an hour if I woke up very late.
Just wanted to say that I - ideally - take 7.5 mcg T3 between 7-8 am, with my 75 mcg Levo. I then take 5 mcg at 1 pm, and 2.5 mcg 7 pm and that makes me fall asleep sometime before midnight. I like my morning dosage to be higher than the other dosages, but without the 5 at 1pm I would not be able to finish my work in the afternoon. If I take 10 mcg in the morning I may experience a racing heart/shaky fingers during a peak bioavailability moment. If I wait more than the max 6 hours, I experience a huge dip in energy which I may not get over fast enough to finish my day.
However, it took me about 4 years to figure out this schedule - I think it was based on a schedule by STTM which I sort of 'panic-changed' to last Fall. It seems to work for me.
Good luck!
- G
Thanks G for you feedback as you say wer all different and listen to my body ?
It’s good to be aware of symptoms people have experienced so as not to be totally freaked out if they happen 😳
I’m just desperate to give it a try it’s the fatigue and constant achy muscles I’m hoping it will help with ?
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