On T3/T4 Combo, Suggestions Welcome

[Koola]

My last test results: TSH: 0.164 mU/l (Range 0.2 - 5) -0.75%

FT3: 3.77 pmol/l (Range 1.8 - 4.5) 72.96%

FT4: 15.8 pmol/l (Range 7 - 20) 67.69%

Should I take more or less levo or lio? (or titrate to more or less of both?)

I’ve been steady on both doses for many weeks and will do another test soon. Meanwhile, comments would be very appreciated to get an idea before the next results: I’ve only been feeling worse and if the next labs are similar or “better”, I’d first like to have some sort of direction, advice, before I start biting my nails... 🥺😬

Many thanks in advance 🙂

[Buddy195 Administrator]

what dosage of Levothyroxine and Liothyronine are you currently taking Koola & how long have you been on this dose?

[Koola in reply to Buddy195]

Currently : 81 T4 and 10 T3 though I have reduced to 5 every two days these last ten days due to tachycardia.

But before the test I was on 63 for 5 weeks and 71 alternating with 79 the next three weeks ; and 10 T3 all through.

[greygoose in reply to Koola]

You cannot alternate with T3. You need to be on the exactly the same dose every day if you want it to do what it's supposed to do. Alternating just won't work.

[Koola in reply to greygoose]

Okay. But until 10 days ago I was on 10 T3 for months.

[greygoose in reply to Koola]

OK, but you either need to continue on 10 every day, or reduce to 5 every day, or you will lose the benefits of the months you were on a steady dose.

[Koola in reply to greygoose]

That makes sense, only, I haven't and don't see any benefits at all. My lab results have gotten steadily better but I'm getting just as steadily worse !??

when first on Combo over a year ago I could feel T3 giving me energy for a couple of months but now I feel that it just adds to restlessness, tiredness, hyper like syndromes. Aside from those 2 first months, I was much better before the Combo.

Could it be that my body has gotten what it needed from t3, is converting better and I should fade it out?

[Buddy195 Administrator]

As greygoose says, you need to be on a consistent daily dose of T3 before considering a slight increase. Everyone has different ‘sweet spots’ where they feel best and for me it’s higher FT3 and FT4 just above mid range.

[Koola in reply to Buddy195]

I haven't found any sweet spots, whatever lab results I've had. My FT3 is high 72.96% and my Ft4 67.69%. best ever on paper. so why is" real feel" worsening by the week?

PS. I do check my vitamins , iron, ferritin regularly; when slightly low, never much, I supplement a little more.

[Buddy195 Administrator]

You still have room for an increase in dosage, but I would be extremely cautious when doing this due to your tachycardia. If you have a pill cutter, perhaps split a 5mcg Liothyronine tablet into quarters at first and add one quarter per day, so your body can slowly adjust to the increased dose. When you are on a stable dose for 6-8 weeks I would retest and share your results on the forum.

[Koola in reply to Buddy195]

that's an idea except that I have 20 mcg tablets and there's no way I can split a fourth of that into four.

Actually tachycardia is probably not the right word. My heart doesn't start beating super fast, just that I feel it thumping, which only happened back then being hyper, before RAI. But thanks for suggestion.