Liothyronine over or under.

[Hustler]

Is it possible that too much liothyronine may stall weight loss please. I have been on liothyronine only 60mcg daily for at least ten years it was 80 before that. I suffered two mini strokes in July and was given a blood thinner told to stay active and lose weight and despite strict low carb walking at least 3 miles daily and intermittent fasting I have only lost around 3 lbs in the last two months. I am around 11 stones and just wondering if I am taking too much liothyronine, although I feel ok on it but I think I read somewhere that you need less as you age and I'm 66 now. Any thoughts on this much appreciated.

[SlowDragon Administrator]

You need to test thyroid and vitamin levels

What vitamin supplements are you currently taking

Request GP test vitamin D, folate, ferritin and B12

Do you normally take T3 as single dose or split as 3 doses spread through the day

Day before test split T3 into 3 doses and last dose approx 8-12 hours before test

List of private testing options and money off codes

thyroiduk.org/getting-a-dia...

Medichecks Thyroid plus antibodies and vitamins

medichecks.com/products/adv...

Blue Horizon Thyroid Premium Gold includes antibodies, cortisol and vitamins

bluehorizonbloodtests.co.uk...

If you can get GP to test vitamins and antibodies then cheapest option for just TSH, FT4 and FT3

£29 (via NHS private service ) and 10% off down to £26.10 if go on thyroid uk for code

thyroiduk.org/getting-a-dia...

monitormyhealth.org.uk/

NHS easy postal kit vitamin D test £29 via

vitamindtest.org.uk

Only do private testing early Monday or Tuesday morning. Watch out for postal strikes, probably want to pay for guaranteed 24 hours delivery

[Hustler in reply to SlowDragon]

Thanks for this I think I will have to go on the private testing route as our practice only has one Dr and not managed to see him since before lockdown not even had annual blood checks either so It's really going to be up to me to sort. Unfortunately we are the worst place in the country for No GP's or dentists either. I am not on any vitamins or supplements except folic acid as I am on methotrexate weekly. I take two pills together in morning and one after tea because I kept forgetting lunchtime one when I was at work. Will look at private testing for the above, many thanks.

[SlowDragon Administrator in reply to Hustler]

Day before test…make sure last 1/3rd of daily dose T3 is at least 9pm……assuming test is 9am

medichecks.com/pages/clinic...

[Lilylui in reply to Hustler]

sounds like where I am ! It’s hard to get test done and private blood tests nearly 2 hrs away here in mid wales

[Jaydee1507 Administrator]

Being hypo, even on treatment, can cause low vitamin levels which in turn can mean your thyroid hormone doesn't work effectively. As SlowDragon says, you need to get certain levels tested: ferritin, folate, B12 and D3. Your GP will sometimes do this if they are nice, otherwise use the links given by SlowDragon.

You haven't shown us your latest blood results so noone can comment on how much you are currently taking.

[jimh111]

Too much liothyronine would not inhibit weight loss although it can have cardiac issues.

The issue about needing less hormone in later life is confusing. Average TSH tends to be higher in older people but I wonder if this is because their thyroids lose some vigour and so need more stimulation.

There is evidence that people with a higher normal TSH live longer than those with a lower normal TSH. Doctors tend therefore to suggest elderly patients have their levothyroxine reduced a little. However, if you look at the studies they show it is higher T4 levels that are linked to a shorter life and of course a higher fT4 usually comes with a lower TSH. There is evidence that high normal T4 causes cancer and cardiac problems. Ideally most patients would be given T3 / T4 combination therapy resulting in a low normal fT4 and an average fT3. The evidence suggests this is the healthiest option.

Of course some of us need a higher proportion of T3. This has risks but for many patients there is no choice. I would stay ob the lowest dose of liothyronine that makes you well. You may not lose much weight but the exercise will be doing you a lot of good.

[Hustler in reply to jimh111]

Not losing weight anyway lol, the difficult part is without help do I just drop amounts of T3 and for how long to expect to feel any different. My Dr was referring me pre pandemic to a consultant who was a diabetic specialist and clue less on thyroid just wanted to put me back on T4. Thanks for your reply.

[jimh111 in reply to Hustler]

If you alter your T3 dose you will feel the effects within a few days and can then make a judgement.

[Hustler in reply to jimh111]

Many thanks for this.

[FancyPants54 in reply to Hustler]

Reduce by a small amount only at one time and let that settle to see how you feel. So cut that 20mcg pill into 4 and even eights with a scalpel if you can and reduce by 1/8 or 1/4 at a time. Watch, wait and makes notes of what you observe.

[Hustler in reply to FancyPants54]

thanks for this, I might be doing this shortly. I am currently waiting for my results from medichecks from full thyroid panel including vits etc so will post on here and ask for advice.

[shaws Administrator]

I am not medically qualified but have P.A. which was diagnosed some years ago.

My mother also had this condition but her GP told her that blood test was fine that she needed no more injections.

The GPs advice caused my mother to develop stomach cancer and die.

I have monthly B12 injections instead of quartely and feel well.

I also have 3 other autoimmune conditions i.e. alopecia. vitiligo and hypothyroidism and the collective is named "Polyglandura Autoimmune Condition Type 3.

25mcg of liothyronine (T3) is approx equal to around 100mcg of levothyroxine (in its effect). I am prescribed 20mcg T3 for hypothyroidism.

I feel well - especially due to taking T3 instead of T4.

[Hustler in reply to shaws]

I am going to get some private testing done which hopefully may explain things a bit better, many thanks.

[Gilbo72]

I wondered the same thing when I first started on combo with lio added. It felt like I was actually putting on weight. I did read an article and a study (sorry can’t remember where or what) that T3 can actually cause blood glucose levels to rise. I have a history of PCOS which goes hand in hand with insulin resistance and then adding the T3 did seem to make it worse. I decided to change my way of eating, it was between going Keto (high fat low carb) or Whole-Food Plant-based ( high good carb, low fat unprocessed vegan) I chose the latter and haven’t looked back. My BP dropped over 20 pts, my fasting glucose and Hb1Ac is now perfect and I am finally losing weight slowly but steadily (0.5 to 1lb) a week.

I personally see myself as a hormone disaster, and with that in mind I take the approach of ‘a little and slowly’ as hormones are a balancing act. I do think we all hope that T3 will be the magic bullet, but it’s all a bit of a balancing act. Especially now I am entering perimenopause. I also echo Jimh11 above that take the smallest amount of T3 that can make you well. The Endo is happy with me on 20mcg of lio added to my levo, which brings my bloods to the ideal mid 70’s range, but I do think I prefer 15mcg which brings my bloods to just under mid range.

Well hope that is good for thought. We are all different.

[Hustler in reply to Gilbo72]

Thanks for that, plant based foods seems to have very good results.I was on levo only for 20 odd years but unfortunately it stopped converting thorough my liver so hence t3 only. Food for thought though.

[Fluffysheep]

Interesting question.

I was the opposite, was on levo and piled weight on. We follow a low carb diet which had always worked well, but didn't work at all when I was on levo. It was only when I started adding in some T3 medication that I started losing weight again.

[Hustler in reply to Fluffysheep]

I lost 3 stone in the pandemic on low carb and loads of walking but this last year has been extremely stressful with hubby operations and moving house etc and healthy eating of any sort flew off through the window and gained half back so two mini strokes later trying hard to get some sort of normality with food exercise but weight loss just not happening.

[terebol]

After being on levo for 15yrs, then becoming enlightened I moved over to NDT. I was on a steady dose for the lat 9yrs. As of last month, my NDT dose was raised. I will be 71 the end of this month. So I would not be living proof of a lower dose as I age! Also, FT3 is the biologically active thyroid hormone that will aide in making you feel better all over & help with weight. . Sounds like you might not be converting well enough for you. That is, of course, if all of your vitamin levels, etc. are optimal. As we age, D3 & B12 levels seem to fall off, regardless of the foods we eat. You have to find what works for you

[Hustler in reply to terebol]

Will get vits and and numbers checked. Many thanks

[shaws Administrator]

25mcg of T3 is approx equal to 100mcg of levothyroxine in it's action.

Your dose seems too high but it could be due to the fact that you are 'resistant' to thyroid hormones.

[Zazbag in reply to shaws]

How would you know you are resistant to thyroid hormones?

[Hustler in reply to Zazbag]

I know I was on levothyroxine because it has to convert through the liver and unfortunately mine had stopped doing this.The consultant said that is was probably an infection that had caused it from months before. The reason I knew something was wrong was extreme tiredness, weight gain, muddled thinking couldn't make a decision to save my life but worst of alldespite raising my T4 my joints (elbows and Knees especially ) were in agony. The consultant said that was because the T4 was pooling in all my joints as it had nowhere to go since the liver rejected it.

[shaws Administrator in reply to Zazbag]

''The following might be informative:-

yourhormones.info/endocrine...

[Zazbag in reply to shaws]

Thank you! Is thyroid hormone resistance recognised by the NHS?

[Hustler in reply to Zazbag]

I can only assume so that's why I was trialled with Liothyronine and built up to a fairly large dose of 80 mcg per day .