T3 and Migraine

[jpar]

Hi. I am taking 75mcg of T4 Levoxyl and doing well on it but I am still undermedicated. Instead of raising the T4, my doctor is starting me on T3 5mg. Because I am so sensitive to medication I've started with 2.5 of T3 for about a week and a half now. I've started to get migraines again and some dizziness and wondering if its the new addition of T3. Do you think T3 is the culprit? Is it a sign that I can't tolerate it or something that my body will adjust to? Thank you!

[greygoose]

More likely to be due to under-medication. Did your doctor reduce your levo when he started you on T3? If so, and given the fact that the FT4 drops somewhat when starting T3, 2.5 mcg is likely not enough to replace the T3 you were making from your T4, so you've ended up under-medicated.

[jpar in reply to greygoose]

So, you say that the T3 will drop the T4 somewhat? Is that permanent or temporary? I am very much out of range right now. My tsh is at 8 and my free T4 and T3 are in range. Right after I had covid my tsh went from 5-12. I am at 75mcg right now and thought maybe I can add T3 instead of raising T4. My doctor said that she wanted me to go to T3 5mcg and also raise to 88mcg. But I am super sensitive and need to raise slowly and one at a time and that's why I started with 2.5mcg instead of 5mcg. I just really don't know if it's the T3 or if I just need to raise T4 only. So do you think the migraine is from the T3 dropping to much?

[greygoose in reply to jpar]

Yes, when you add in T3, the FT4 drops in range. And the more T3 you add, the more it will drop. And it's permanent. That's what T3 does.

You are very, very under-medicated to have a TSH over 8. But what are the exact numbers for the FT4 and FT3 - results and ranges? Just saying they are 'in range' is meaningless. It's where they fall within the range that is important. And, yours must be pretty low to have a TSH over 8. And, as migrains are a hypo symptoms, and you are pretty hypo, it's more than likely that it is under-medication that is causing them, not the T3 per se.

I can't tell you if raising T4 only would give you optimal numbers, without seeing the numbers as they are right now. Maybe, maybe not. But, you probably do need to raise your dose of levo at some point, even with T3. However, it's best not to change both at the same time. If I were you, I would go up to 5 mcg T3 now, and see if that helps the migraines. I certainly don't think it's the T3 itself causing them, it's more like lack of T3.

[radd]

jpar,

Many members have experienced headaches (& an inner heat) after introducing T3 & each dose raise, which usually subsides after a few days. If you think your migraine is associated with introducing T3, then you need to be mindful. 

I would say you risk remaining under medicated on 75mcg Levo but adding T3 isn’t always the way to optimisation. Your need for T3 meds must be established by failing to convert sufficient T3 after Levothyroxine has been optimised.

If your doctor is jumping the gun, I would stop T3 meds & ask for Levo to be increased initially, hold for six weeks and then test TSH, FT4 & FT3 to see what’s going on. Your previous posts indicate difficulties in raising meds. Have you looked into supporting the adrenal glands? Are your ferritin (& nutrient) levels optimal? Deficiencies can impair how we utilise our thyroid hormone meds and even encourage intolerance of them.