hello - so I have been fortunate in having a forward thinking endocrinologist (as per listing). He has enrolled me in a 3mth trial of liothyronine on the basis that >15 yrs on a very high dose of thyroxine (300mcg) may have desensitised my conversion to t3 after my t4 was halved after menopause 10 yrs ago. It’s now one third of that high dose.
It’s two doses of the lowest dose possible and I wasn’t sure whether I needed to have the second one an hr before/ two hours after food.
Is this 5mcg dose taken twice day?
Do you currently take levothyroxine waking or bedtime?
You can take first dose T3 waking on empty stomach (with levothyroxine)
Initially only add one 5mcg dose for first few days
Assuming all ok add 2nd 5mcg dose approx 10-12 hours after the first dose.
Yes ideally on reasonably empty stomach and nothing apart from water for at least 45mins (it’s absorbed faster than levothyroxine)
what were Ft4 and Ft3 results BEFORE starting on T3
has dose levothyroxine been reduced, if yes, by how much
Retest 6-8 weeks after being on 2 doses per day
Day before test, last dose levothyroxine 24 hours before test, last dose T3 approx 8-12 hours before test
when were vitamin D, folate, ferritin and B12 levels last tested
What vitamin supplements are you currently taking
hi slow dragon -many thanks re advice on timings etc. It’s two doses and i will defer second one for a few days as suggested. I was advised to discontinue if I get regular palpitations which is a possibility given my cardiac history. I don’t know what my blood results were from that NHS Trust. It’s two doses. I’m just about to do my bloods again but I was really quite bad with debilitating muscle & joint pain when taking vit D gels, vit k2, magnesium, and the b complex advised in this site. So I’ve stopped them all and restarted vit d spray which I got in special offer. Aches etc now almost back to baseline.
I smashed a cup of hot tea on the floor as wrist gave way hence the stopping of supplements.
I don’t know what my blood results were from that NHS Trust.
You are legally entitled to printed copies of your blood test results and ranges.
The best way to get access to current and historic blood test results is to register for online access to your medical record and blood test results
UK GP practices are supposed to offer everyone online access for blood test results. Ring and ask if this is available and apply to do so if possible, if it is you may need "enhanced access" to see blood results.
Link re access
healthunlocked.com/thyroidu...
In reality many GP surgeries do not have blood test results online yet
Alternatively ring receptionist and request printed copies of results. Allow couple of days and then go and pick up.
Important to see exactly what has been tested and equally important what hasn’t been tested yet
Bloods should be retested 6-8 weeks after each dose change or brand change in levothyroxine or before starting T3
For full Thyroid evaluation you need TSH, FT4 and FT3 tested
plus both TPO and TG thyroid antibodies tested.
Very important to test vitamin D, folate, ferritin and B12 as these need to be optimal on T3
Which brand of T3 is this
Which brand of levothyroxine are you currently taking
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 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
hello slow dragon,
T3 brand is Morningside.
T4 varies according to what pharmacist can access - Mercury, Accord, Aristo, northstar and teva.
I can easily access my GP blood results and my Christie data but haven’t yet got that access for the acute trust. They use a third party (nonNHS) data provider who have limited options re data storage.
The D3 spray has K2 in it which means it’s the B complex recommended on here that aggravated something.
would I need thyroid antibodies testing? I dont have Hashis - it’s a congenital chromosome disorder that causes my hypothyroidism and deafness.
Thank you for your time and patience
Which brand of levothyroxine do you prefer
Or is there one that upsets you
Many people find Levothyroxine brands are not interchangeable.
Many patients do NOT get on well with Teva brand of Levothyroxine.
Teva contains mannitol as a filler, which seems to be possible cause of problems. Teva is the only brand that makes 75mcg tablet. So if avoiding Teva for 75mcg dose ask for 25mcg to add to 50mcg or just extra 50mcg tablets to cut in half
But for some people (usually if lactose intolerant, Teva is by far the best option)
Aristo (100mcg only) are lactose free and mannitol free.
Most easily available (and often most easily tolerated) are Mercury Pharma or Accord
Mercury Pharma make 25mcg, 50mcg and 100mcg tablets
Accord only make 50mcg and 100mcg tablets
Accord is also boxed as Almus via Boots, and Northstar 50mcg and 100mcg via Lloyds ....but Accord doesn’t make 25mcg tablets
beware 25mcg Northstar is Teva
List of different brands available in U.K.
thyroiduk.org/if-you-are-hy...
Posts that mention Teva
healthunlocked.com/search/p...
Teva poll
healthunlocked.com/thyroidu...
Once you find a brand that suits you, best to make sure to only get that one at each prescription.
Watch out for brand change when dose is increased or at repeat prescription.
Government guidelines for GP if you find it difficult/impossible to change brands
gov.uk/drug-safety-update/l...
If a patient reports persistent symptoms when switching between different levothyroxine tablet formulations, consider consistently prescribing a specific product known to be well tolerated by the patient.
If symptoms or poor control of thyroid function persist (despite adhering to a specific product), consider prescribing levothyroxine in an oral solution formulation.
academic.oup.com/jcem/artic...
Physicians should: 1) alert patients that preparations may be switched at the pharmacy; 2) encourage patients to ask to remain on the same preparation at every pharmacy refill; and 3) make sure patients understand the need to have their TSH retested and the potential for dosing readjusted every time their LT4 preparation is switched (18).
if you want GP to specify specific brand it must be written in certain way on prescription
See here
Some people do react to niacin in vitamin B complex
Which make of vitamin B complex is it
You could try just adding separate B12 first
Eg
B12 drops
healthunlocked.com/thyroidu...
After 2-4 weeks assuming all ok, add a separate methyl folate. Eg Jarrow Methyl folate 400mcg
I will try the b12 drops. I had Thorne basic b complex
oh and my thyroxine is same dose as before (alternating 109/125 mcg)
Liothyronine by TEVA
Liothyronine t3
Thyroxine timing
Timing of levothyroxine dose
Liothyronine in water
