Good morning all. My first question here. I've just (after 12 years of absolute hell) been prescribed T3 by private Endo recommended & referred by my GP. I've always felt terrible and had several adverse effects on Levo but been ignored by 3 different endo's so far, one of them (female) even told me to leave my job (of 33 years) because shifts don't help and if I won't help myself how can I expect her to help me?! Never mind the mortgage and other bills and all the rest that comes with having a life! Anyway, I now have T3 and took my first 5mcg early this morning. Do I really have to take the Levo along with it, or will the Liothyronine be enough? Just a general question on the physiology of it, I can post blood results if anyone thinks they're relevant. Thanks in advance for any help and/or information.
Do I need both T4 & T3?: Good morning all. My... - Thyroid UK
Do I need both T4 & T3?
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Ozziemum
Do I really have to take the Levo along with it, or will the Liothyronine be enough?
That depends. We are all different. Some members do take T3 only, some of us take Levo plus T3. Some of us need decent levels of both FT4 and FT3 (upper range) but some are fine with low FT4 as long as FT3 is upper range. It really is a case of you experiment to find what you need.
I've always felt terrible and had several adverse effects on Levo
Have you tried different brands?
Have you looked at the fillers, is there a common one which could be causing your adverse effects if you have tried different brands.
If you've only tried one brand, what's in that which might be affecting you? Teva is one brand that many people don't get on with because it contains mannitol instead of lactose and it's the mannitol that causes them problems.
If you've tried all the different brands of tablets, have you tried liquid Levo which some people are fine with when they don't get on with tablets.
Lots to look into.
Thanks for that, I've probably had every brand there is over the years and all of them are the same with the side effects (palpitations and VERY bad facial acne.) I was given Atenolol for the palpitations which has helped a lot but I'd really rather not have bad skin as it affected my confidence so much when I was a paramedic - overweight with acne going into peoples houses and telling them what to do about their health. Masks were great for me! There's nothing I found that seemed to help my skin although I'm having some success with Boots tea tree & witch hazel products.
I've got the Teva T3 and only taken one dose so far but I was kind of hoping to get rid of the T4. One of my experiments when I was trying to get the endos to listen to me was to stop taking it completely for 3 months and not tell them, to see if my bloods would be any different. They weren't, and I was on 300mcg daily. The endo who was particularly unhelpful wasn't interested in that experiment and actually reduced the t4 to 275 instead of trialling T3. I should stop harping on about her but she had such a terrible effect on my mental health at a very precarious time for me that it still grips me 5 years later. My TSH has always been around 5.6 on the 300mcg and I just keep getting told 'that's fine'.
We really need to see your labs before we can understand what is going onPlease can you post any you have...including ref ranges.
It took me decades to discover what was wrong with me...it's all in my bio if you're interested
I did eventually find the answer and I'm sure there will be one for you too...so stay positive meantime.
I need high dose T3-only...but that is rare
T4/T3 combo is more usual
But, we are all different
Shocking response from that endo!
Come back with more details and members will advise
Good luck.
Thank you! I'll post my bloods soon but I've only ever had the basics, even from the consultant clinics! The private endo did a more comprehensive panel - but the lab didn't (NHS) I'll get back with more details after work. Thank you😊
Hello Ozziemum hope things improve for you. I’ve recently started T3 only. My experience was the transition from T4 to T3 only has been a slow step by step process based on tracking how I’m doing and reviewing as the T4 slowly leaves my body. If you are thinking of making that change you might want to carefully plan and use the good advice on this site and from your new endo. The T4 can take up to eight weeks to leave your system and over that time you may have ups and downs and may need to adjust the T3. So if it was me I would not stop T4 until I had given my body time to settle after adjusting to the first small dose of T3 and then I’d consider next steps from there. Just for info my endo had me slowly drop T4 from 135mcg to 50mcg then 25mcg, then 0mcg while slowly increasing T3. So no sudden removal until I was getting good improvements on the T3.
Have you ever tried liquid levo? 300mcg and TSH of over 5 still suggests perhaps an absorption issue.
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There’s approx 2 million people in U.K. on levothyroxine
Roughly 10-20% of those patients need the addition of SMALL Doses of T3 prescribed alongside levothyroxine
A much smaller number (perhaps 10% of that number that need addition of T3 )… do better on just T3
But it’s a common mistake to want to ditch the levothyroxine, for majority of patients on T3, they will also need levothyroxine
Typical doses of levothyroxine plus T3
Is somewhere between 75mcg - 150mcg levothyroxine plus between 10mcg - 30mcg T3
On ONLY T3 many members would usually be on much higher dose T3
Which ever mix you end up on …..starting out on T3 is ALWAYS the same
Essential to start SLOWLY…..adding 5mcg T3
After a week or two….add 2nd 5mcg dose approx 10-12 hours after first dose
Assuming that’s ok…..in 2-3 more weeks….add 3rd 5mcg dose T3 and take doses at roughly equal 8 hour intervals
WAIT 6-8 weeks at this dose (plus levothyroxine) and then retest
Always test thyroid levels early morning, ideally before 9am and last dose levothyroxine 24 hours before test
Last 5mcg dose T3 approx 8-12 hours before test
How much levothyroxine are you currently taking
Has endocrinologist suggested you reduce levothyroxine before adding T3….if yes….by how much
Please add most recent thyroid results and ranges
ALWAYS get same brand levothyroxine at each prescription
Work out which brand suits you best, and insist on same brand levothyroxine at each prescription
When were vitamin D, folate, ferritin and B12 levels last tested
What vitamin supplements are you currently taking
Do you have autoimmune thyroid disease, also called Hashimoto’s usually diagnosed by high thyroid antibodies
Assuming yes, have you had coeliac blood test done
Are you on strictly gluten free diet
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Acne often suggests B12 problem
Essential to test vitamin levels at least once a year
That frequently means testing privately
Medichecks or Blue horizon most popular option
Only do private testing early Monday or Tuesday morning, before 9am…..and not in heatwave
Ozziemum,
Welcome to our forum. Over weight with acne is reminiscent of PCOS where higher levels of androgens are produced. Have you a dysfunctional cycle? Have you had LH/FSH tested?
I'm menopausal if that makes any difference? I suppose I've overdramatised the 'acne' really, it's not that bad but when combined with the inability to lose any weight, the ease of gaining and the horrible experience I had with the previous endo I was feeling pretty rubbish when she also called it acne. People with acne would be annoyed with me jumping on their problem. I think she really did do a lot of damage and I'm still getting rid of her out of my thinking - if I'm getting reasonable results just with tea tree & witch hazel it can't be that bad and I don't think it suggests a hormonal problem. Although I'm having bloods done for my hormone levels at the end of the month so I will mention it and see what they come back as. Thanks for your suggestion!
When I was in my late 40s (I'm 51 now) I suddenly got horrible acne. I didn't even have bad acne when I was a teenager so this was out of the blue I went to the dermatologist and she prescribed Aczone. It was like a miracle. Acne went away in a matter of days and it's never come back. I'm in the US but maybe there is something similar there!