How long for T3 to work.

[Hookie01]

Just wondering how long T3 actually takes to work.It's just I slowly started to take it about a month ago, started off with 100 levo, 5 T3 in the morning, after a couple of weeks reduced levo to 75, increased T3 to 10 but suddenly I keep feeling like I'm really over active, have reduced to 50 levo but today I feel really bad. Have I increased too quickly do you think?

[SlowDragon Administrator]

more likely you reduced levothyroxine too much

What were Ft4 and Ft3 results BEFORE adding T3

Are vitamin D, folate, ferritin and B12 levels optimal

[Hookie01 in reply to SlowDragon]

T4 and t3 were quite low, the numbers are in my desk at work so not sure off the top of my head. Only one that won't be great is Vit D as i get tinnitus when I take it so I try and avoid it.I reduced levo because I felt rubbish and that I was on too much. Had sore eyes, felt I couldn't catch a breath and had headaches. Eyes and breath got better, still a bit of a headache today but really feeling anxious and over active.

[SlowDragon Administrator in reply to Hookie01]

well know phenomenon that initially if reduce dose levothyroxine you temporarily feel better….but as you become more hypothyroid, adrenals try to compensate for lack of thyroid hormones….tired and wired and extremely anxious

If Ft4 was low before adding T3, you likely needed dose increase in levothyroxine BEFORE considering adding T3

Approx how much do you weigh in kilo

What was TSH at last test

Which brand of levothyroxine are you currently taking

Do you always get same brand levothyroxine at each prescription

All four vitamins need to be at optimal levels

Improving low vitamin levels helps thyroid hormones work better …increased symptoms suggesting ready for next increase in levothyroxine

What vitamin supplements are you currently taking

Add results and ranges tomorrow when you find them

Air hunger - hypothyroid symptom

Tinnitus - low B vitamins and/or hypothyroid

[Hookie01 in reply to SlowDragon]

I'm on Aristo. I can't dose on weight, I'm very sensitive to meds. I'm 106 kilos, can't go past 125mcg without getting to the stage of clenching my teeth and getting anxious and now I get pain in shoulders, feet and elbows.I take b12 with folate. I am going to order some vit d but will still end up resisting taking it because of the Tinnitus and the feeling of a blocked ear, it sends me crazy, the tinnitus is so loud that I can't take it anymore. Only suffered this since having RAI. I believe it knocked out the balance of vitamins and minerals etc and I'm struggling to get the balance back, though I could be wrong.

[SlowDragon Administrator in reply to Hookie01]

have you tried splitting your levothyroxine

Literally cut 100mcg tablet in half. Take half dose waking and half at bedtime

Which brand vitamin D have you tried

Vitamin D mouth spray gives better absorption as avoids gut

Are you currently taking any magnesium supplement. You may need to take magnesium for week or two first before adding vitamin D

Are you on, or tried gluten free as well as dairy free

[Hookie01 in reply to SlowDragon]

I haven't spilt my levo, buy keep seeing it on here and was thinking of trying it, so I think I shall start.I've tried all vit D, tablets, sprays, drops, high dose, low dose even sitting in the sun does it! I usually buy the drops as I prefer them. I have recently brought magnesium though blood tests say my magnesium is high. I started taking them then stopped as wasn't sure if the breathing issues was that and the high anxiety. Wanted to hold off until I got the t3 sorted as not sure what was causing the issue.

I am dairy free and pretty much gluten free most of the time with the occasional slip when I'm busy etc.

[jrbarnes]

I did the same as well. Started with 112mcg T4/10mcg T3 and had to reduce and reduce that Levo. I only reduced once I felt poorly. Then waited until I felt ready to add a little T3. I got down to 50mcg T4/25-30mcg T3. This isn't enough hormone for me but trying to increase the T4 gives me insomnia, aggravation and neck pain. At this point I'll probably end up with a tiny bit of T4. Not sure the reason but a little T4 seems to keep my blood sugars feeling stable.

[Hookie01 in reply to jrbarnes]

I have been reducing when I started feeling rubbish, I had the neck pain too. God this is so complicated isn't it.

[jrbarnes in reply to Hookie01]

I've been at it for 2.5 years trying this and that to see what I like. It is so complicated! That neck pain is specific and really gets me. Even if you have to keep lowering the T4 to avoid those symptoms you can always raise it later if it ends up being too low. I can tolerate low T4 with a higher amount of added T3 added over High FT4 levels and low FT3 levels.

[Hookie01 in reply to jrbarnes]

It's strange because it was unbearable neck and head pain that sent me to the drs when I was first diagnosed as overactive thyroid. As well as shaking which I had earlier today. Makes me wonder if it was high T3 that caused it as don’t get it on T4. Who knows 🤷‍♀️ now I don't have a thyroid I guess I will never know! Back to trial and error I guess.

[jrbarnes in reply to Hookie01]

I only get that neck pain, insomnia, irritation, weakness, and jaw/teeth clenching when my FT4 levels are above say 60%.

[Hookie01 in reply to jrbarnes]

I get the clenching jaw when I'm too high on t4, not sure what percentage its at though

[Jeppy in reply to jrbarnes]

may I ask how we know how our sugars

Apologies to pop in May i pm

[jrbarnes in reply to Jeppy]

You can get the Blood Glucose tested through your physician or online testing if available.

[Jeppy in reply to jrbarnes]

tganks

[Lalatoot]

Hookie it is not an instant fix. It takes patience and careful adjustment of either levo or lio doses, 1 thing at a time then blood tests after 6 to 8 weeks It took me 2 years of careful adjustments to find doses and levels I wanted to stay on to see the longer term effects.

[Hookie01 in reply to Lalatoot]

I was just wondering if I was going too fast or if I suddenly felt like that cos the T3 had kicked in. I understand it will take time, just trying to get a bit of advise really. Trouble is, endo won't give me an appointment until my 3 month trial is up. He wanted me to go straight in with 50 levo and 10 T3 in the morning and 10 in the afternoon. I was on 100/125 levo alternate days, so he isn't any good for advise 😕 I point blank refused and said I need to do it slowly. He looked at me like I was stupid!!

[Lalatoot in reply to Hookie01]

My endo wasn't any better. They cut my levo by 50mcg and added in 20mcg. However my trial was for a year so I had time to go slowly even though the endo expected me to change overnight. I worked my way to my prescribed dose. With that dose my ft4 was 0% through range and ft3 72%. It was not right for me. Gradually I increased my levo back up and reduced my t3. I stopped dose changes on 100mcg levo and 7.5mcg t3. Nothing like the endos dose!

[Hookie01 in reply to Lalatoot]

I am thinking of going back to 100 levo and 5 t3 and starting again more slowly. T3 def helps with energy, its just my head I can never seem to get straight.

[SlowDragon Administrator]

Are you still splitting T3 as 2 x 5mcg doses

I realise you have capsules….so not easy …..but probably necessary to split as 2 doses initially …..at least for 3-6 months

[Hookie01 in reply to SlowDragon]

No, I was taking 10 in the morning. Only started at 5 in the morning and went up 10. Is it best to do 5 am and 5 pm first? I'll give that a go then. Thank you.

[SlowDragon Administrator in reply to Hookie01]

you might find my profile info helpful

I was on 125mcg 25 plus years

Before considering adding T3 I spent a year after endoscopy confirmed gluten intolerant……on absolutely strictly gluten free diet and worked hard on getting all four vitamins at optimal levels

Starting T3

Endocrinologist wanted to reduce levothyroxine by 25mcg and add 10mcg T3 as 2 x 5mcg

I started much slower …..reducing by 12.5mcg levothyroxine 4 days before adding 2.5mcg T3 (a noticeable whoosh) ……after 5-7 days that whoosh settled. After few more days …Added 2nd 2.5mcg dose T3 late afternoon

After 10-14 days …..reduced levothyroxine by another 12.5mcg (so 25mcg reduction in levothyroxine per day)…then waited 4-5 days before increased T3 to 5mcg in morning and still 2.5mcg still later afternoon.

After another week increased afternoon dose to 5mcg

Held at this about 8 weeks before testing…..initially felt better and worse in equal measure……very nearly chucked whole lot in the bin at this point. Only desperation made me hang on.

But very slowly things improved and able to return to normal life and increase activity levels

Few months later, like many, many members, I found levothyroxine had been reduced too much and Ft4 had dropped right to bottom of range.

Started to feel worse …..and experimented with slowly increasing levothyroxine.

Initially to 112.5mcg daily…..waiting 10-12 weeks….retest …..eventually back to 125mcg daily

That was 2017/2018

…..I am now finally settling on 3 x 5mcg T3 per day (waking, mid afternoon and bedtime….roughly equal 8 hour intervals)

Levothyroxine I find much better as 2 doses per day….Split in half…..waking and bedtime.

This summer gone dairy free ….as result absorption improved and found Ft4 was little high …..recently reduced levothyroxine from 125mcg 6 days and 112.5mcg 1 day week - down to 125mcg 4 days and 112.5mcg 3 days week…….ie very very tiny, tiny dose adjustments

This dosing regime gives Ft4 and Ft3 approx 70% through range….. (like many other members have found) this is what suits me

Your rapid dose changes are very likely too much and too rapid.

[mountainice in reply to SlowDragon]

Do you self-medicate (I used to till GP took over levo)? Just wondering, as I can't increase levo otherwise have to go through GP cos my prescription would be put of kilter.

[SlowDragon Administrator in reply to mountainice]

no I am prescribed levothyroxine and T3 on NHS

[mountainice in reply to SlowDragon]

How do you keep adjusting your dose then and still get the correct prescription? I only got mine after going to a private consultant and he wrote to the gp. I still get the T3 privately.

[SlowDragon Administrator in reply to mountainice]

I am prescribed 20mcg T3 and 125mcg levothyroxine

I have lost lot of weight over last year, (approx 8kilo) especially since going dairy free.

I went dairy free on advice of lipodema specialist Lipodema now significantly reduced/virtually gone

So as weight has dropped I have reduced dose levothyroxine and T3 incredibly slowly over last 6-8 months.

But I don’t necessarily need to share that information that I have reduced dose with GP 😉

[mountainice in reply to SlowDragon]

Great news your lipdema has virtually gone. That must be a relief. I too have lost about 12lb over the summer and I don't know why. I though perhaps it was after being on T3 for some time and therefore my weight perhaps going to what it should have been if I hadn't had hypothyroidism. In my 40's my weight went to 11stone 7lbs, then back to 8stone when I was ill and gradually settled at 10st 4 to 5. I was always trying to lose a few pounds but nothing worked, and if it did, it went back on again. Suddenly since the summer, I am now 9stone 7lbs (5ft 8). The only other thing I have done differently is we go for a walk every morning before eating, and so we have a fasting window of about 14 hours from the night before. I can see how it is a bit easier to reduce your gp dose as you will just end up with extra tablets, but if I want to increase anything it will throw it all out of course if I don't refer to the doctor. I have toyed with the idea of some changes since my last test, but I feel reasonable as long as I sleep so perhaps this is the best I can feel. I find it is hard to know how I should feel when I have spent many years not feeling right.

[SlowDragon Administrator in reply to mountainice]

I was originally around 10st (5’7” and size 12-14) before Hashimoto’s

Early stage Hashimoto’s hyper phase lost weight….too thin ….

Like so many members…..Hashimoto’s really kicked off after pregnancy

Over 25 years on just levothyroxine I eventually got to just over 15st …..adding T3 and strictly gluten free since 2017…..lost a couple of stone…..a few pounds crept back on in lockdown despite lots of gardening

Now lost another stone plus ….at least another stone to go …ideally two….

[KCFryer in reply to SlowDragon]

Hi SlowDragon when you said 'Like so many members…..Hashimoto’s really kicked off after pregnancy' I felt I have finally found the answers I've been looking for. I had a very symptomatic pregnancy with my levothyroxine being increased in 2020, on the other hand, at least it might have helped me to just put the right amount of weight on, which mostly was lost after birth. Then after my baby was around 3 months, I suddenly started putting weight on even though I was breastfeeding. The fat is mostly around my waist. Which strongly makes me think it's thyroid related, but no doctors seem to be able to help me. My endocrinologist in Brazil always measured my belly fat as well as doing a bio impedance examination, but I see that here this is not something that happens even privately. Is adding T3 the only solution to fix this? I'm about to get my blood results and will post for advice. Last time my T3 wasn't in a good range, but I'm terrified of self sourcing T3.

[SlowDragon Administrator in reply to KCFryer]

No not everyone needs additional T3

Essential to have optimal vitamin levels and fine tuning levothyroxine

Always same brand levothyroxine too

Things that might affect conversion rate/might need addition of T3

Gluten intolerance

Dairy intolerance

SIBO

thyroidpharmacist.com/artic...

H pylori

drhedberg.com/hashimotos-th...

Dio2 gene variation

thyroiduk.org/deiodinase-2-...

Graves’ disease - Post RAI

thyroidectomy

[KCFryer in reply to SlowDragon]

How did you know you gained weight after pregnancy due to Hashimoto's?

My conversion has been poor according to my last test, but I still want to try getting all my vitamins optimal before starting on T3.

I've been hypothyroid for 30 years now and have always been symptomatic with intervals of feeling ok. This is a strong reason for me to at least try for a trial on T3.

The guidance on prescribing liothyronine, recommends a combination trial in 'situations where patients experience continuing symptoms whilst on levothyroxine (that have a material impact upon normal day to day function), and other potential causes have been investigated and eliminated'.

I just wish it was simpler to get it...

[SlowDragon Administrator in reply to KCFryer]

How did you know you gained weight after pregnancy due to Hashimoto's?

I wasn’t diagnosed for another 4 years …by then had gained about 20 kilo

Both TPO and TG antibodies were sky high …..highest endocrinologist had ever seen….more on my profile

[KCFryer in reply to SlowDragon]

Thank you! I was on levo and still putting weight on after pregnancy. Metformin has helped me to keep insulin controlled and not gain any more weight.

[SlowDragon Administrator in reply to KCFryer]

Always essential to test Ft4 and Ft3 …..but especially if on Metaformin

Metaformin lowers TSH

cureus.com/articles/50564-e...

[KCFryer in reply to SlowDragon]

Thank you! My TSH has always been very suppressed even before I started metformin. Thank you for the articles, the one on SIBO is very interesting! This bit made me laugh as it describes me: “I woke up with a flat stomach and now I look pregnant syndrome.”

[mountainice in reply to SlowDragon]

I too believe I was hypothyroid from 3rd pregnancy. First two were at 23 and 25, third one 33. Not right since then. I was always 8 stone, or under, even after two children, but I was very thin, but that was my build. I tried gluten free for two years but didn't seem to do much so I gave it up. I am lactose free which has made me so much better but not dairy free.I hope you can continue with your weight loss.

[TiggerMe]

Keeping tabs on your resting heart rate and core temperature is useful I found, as too much T3 can put your BPM up too much same with your temperature, T3 increases metabolism which can feel really weird if you have been on a slow tick over

[Hookie01 in reply to TiggerMe]

Temperature is fine, resting hr is the same as it was. Hr not any faster than usual

[TiggerMe in reply to Hookie01]

That would mean you are not overdoing it and could add a little more T3, I've not seen your levels though?

[Lancew1321]

If I feel bad it's usually cause my levels are to low. Why did you lower t4 or levo.

[Hookie01]

Because I wasn't feeling good. Really tired, like I couldn't catch my breath, sore eyes.

[raine-wager in reply to Hookie01]

I was on liothyronine 5mg and levo lowered to 75 from 100 felt worse more tired back ache worse generally worse all round, tolerated for 2 months . Spoke to endo he has now taken me off liothyronine and upped my levo to 125mg. Feeling slightly better already still not good but will see how higher dose of levo works…

[bikebabe]

I’m right with you Hookie. Just going super slow with adding 5mcg T3 once a day. My heart feels a little bit unsettled but this might just be my body just getting used to more T3. Planning to do blood tests after 6 weeks then step up to the 2x5mcg. I also have to consider how the cancer cells are responding to the increased cell metabolism as I don’t want the cancer to start revving up. Hoping the two physiological mechanisms are separate.

[Portugal-2]

try 5 mcg in morning and 5 at night that’s what I do for T3 I also take 150 mcg Synthroid in morning.