Should I reduce T4 before adding T3

[Eton]

My T4 is 84% through range and T3 is 5.4% through range. I am going to add 6.25mcg of T3. My question is whether I should lower Levo first? I take 75mcg T4 on Friday and 87mcg the remaining 6 days of the week.

Thank you

[Lotika]

personally, I would knock back the T4 a bit, if the you are only 5.4% through range v 84% on T4 only. My conversion is also horrific and I recently came to the conclusion that my body has little use for T4.

[jrbarnes]

I'd add on the T3 without lowering your T4. I currently take 112mcg with 10mcg of T3. I had to increase my T4 dose when I added T3. I would say keep your T4 the same. Add the 6.25mcg and then wait. If you still feel hypo then add the other 6.25mcg. You may even have to increase your Levo like I did or you could have to lower it. I was alternating on 112mcg 3 or 4 days per week and the rest on 100mcg then added 5 mcg of T3 and then up to 10 mcg after a few weeks. That left my FT4 levels around 60%. Then I went up to 112mcg daily and that's when I started to feel the most improvement. Previously when I tried to increase my Levo to 112 mcg I felt terrible. I got horrible neck pain and tension, brain fog, achy muscles but when I got up to 10mcg of T3 then I was finally able to increase up to 112mcg daily. I can tolerate high T4 and T3 together but I cannot tolerate high T4 and lowish T3. If I could go back in time to 2 years ago when I was having all sorts of debilitating hypo pain and my FT4 levels were around 80% I would have just added the 10mcg of T3 onto it instead of lowering my T4 first. From my experience recently I think starting off with a lower amount of T3 like up 13mcg and keeping your T4 over 60% in range is a good place to start. Hey good luck! Also, want to add I always had really low FT3 levels despite high T4 because the hypo caused a severely low appetite which had me eating less than 1000 calories per day and going several hours between meals. To maximize T4/T3 conversion make sure you eat enough calories and carbs and don't fast daily. Correct an iron deficiency if you have one. This is what made the most significant change in my conversion.

[Eton in reply to jrbarnes]

Many thanks for your advice. Like you I have a poor appetite as I have gastritis which causes nausea.

[jrbarnes in reply to Eton]

The poor appetite makes it so much worse. After the partial removal of my thyroid I lost my appetite and never gained it back after going on on Levo. I can imagine the gastritis complicates things as well.

[Eton in reply to jrbarnes]

Yes the gastritis is very unpleasant. I try to control it with a bland diet so that I can avoid the medication I have been prescribed as much as possible as it would probably reduce my absorption of levo. I am kinda hoping that a better t3 level might help with the gastritis, but I’m not really too optimistic.

[jrbarnes in reply to Eton]

Low thyroid hormone affects so many bodily functions including the intestines and digestion so I wouldn't be surprised if you experienced some improvement.

[Eton in reply to jrbarnes]

I hope you are right!

[greygoose]

Personally, with FT4 only 84% through the range, I wouldn't reduce the levo at this point. Taking T3 will lower your FT4, anyway. And, if you feel it's still too high at a later date, you can always reduce it then. If it were me, I would want to start on the T3 as soon as possible, and worry about the levo afterwards.

[Eton in reply to greygoose]

Thanks greygoose. I will take your advice.

[greygoose in reply to Eton]

You're welcome.

[limonene7]

When I started taking T3 last October, my T4 was near top of range and I didn’t lower it. It barely budged from its range position for about 5 months, at which point I decided to lower my levo from 125mcg to 100mcg. Remarkably, my T4 dropped like a stone to the lower end of the range. I was not expecting this. After seeing the results, I increased levo back up to 125mcg and  it looks like my FT4  has now settled out at 50% through range. My FT3 barely moved throughout this time staying at just under mid range but since my T4 has dropped in range, my FT3 has also come down and I believe I am now hypo. Really peculiar interplay between these hormones I think. None of it makes any sense to me.

[Eton in reply to limonene7]

many thanks for your reply. Yes I agree…it is so difficult to get the balance right. Do you feel better having added the T3 or is there not much difference?

[limonene7 in reply to Eton]

I did for a while but my FT3 is currently about where it was when I was on levo only and is less than 23% through range. At the same time, my levo is also quite a lot lower than it was when I was levo only. I believe I am currently hypo again and have been having symptoms for quite a while. I have just started another 1/4 tablet of T3 so hopefully will start feeling better. All the best on your journey to find optimisation!🙂

[FancyPants54]

Having gone down the route of not lowering T4 and starting T3 and then steadily increasing T3 as my T4 fell on it's own, I would not do that again. I would lower T4 by 25mcg before starting the T3.

I think keeping the T4 up caused some sort of reaction and I could not feel any benefit of the T3. In fact the more T3 I took the more exhausted and hypo I felt. I got as far as 60mcg T3 a day and could barely move.

I then had to go through the pain of reversing things and am now on 25mcg T3 a day trying to bring the Levo back up slowly to a sensible point. I'm hoping I might be able to reduce the T3 further as the Levo comes back.

My conclusion is that I rushed it all and felt that I didn't need to lower my T4 because it wasn't top of range, but I really should have done so.

[buddy99]

I would reduce the T4. I went by this chart. restartmed.com/thyroid-medi... It worked quite well for me so far. I did have to do a bit of math to figure out how to split my 100mcg T4 pill, but I think it's worth the try. I've been on that for 3 weeks, so I cannot definitively vouch for success, but I feel the best I have in decades.