stopping T3

[Reneey2k]

I’ve been on a t3/t4 combo for 7 years and was recently diagnosed with hypertension. I’d been missing my doses and my t4 was 10.0 (range 11.0 - 20.2) my t3 was 3.7 (range 3.2-6.8 ) I repeated 3 months later regularly taking and T4 was 19.0 but they didn’t test T3.

The GP put me on beta blockers but I started getting really thumping palpitations so went to see him again after 2 weeks thinking the palpitations were side effect of the beta blockers. My anxiety had also increased cause I was scared I was having a heart attack. He said it was probably anxiety causing the palpitations but what I did notice was I didn’t get them that day and hadn’t taken my thyroid medication. So it made me think it’s the T3. I’ve kept taking the T4 and it’s been 4 days now without the T3 and palpitations haven’t returned and heart rate is lowered too. I’m not sure what to do as I started T3 cause felt crap on T4 alone but I’m guessing your body can change and want different things or I’ll start to feel bad within the next few days.

Anyone had this with T3?

[SlowDragon Administrator]

Which beta blocker

Are you still taking the beta blocker

Obviously levothyroxine and especially T3 need to be taken regularly

When you were missing doses, likely to have caused drop in vitamin levels

Request GP test vitamin D, folate, ferritin and B12

How much levothyroxine are you currently taking

Do you always get same brand levothyroxine at each prescription

How much T3 were you taking

[Reneey2k in reply to SlowDragon]

Bisoprolol. 200mg Levothyroxine and 20mg T3. I’ve been taking the T4 regularly but stopped the T3 due to the palpitations. I was also sweating a lot which has also stopped since stopping the T3

[SlowDragon Administrator in reply to Reneey2k]

normally you would reduce T3 very slowly…..by 5mcg and wait 6-8 weeks …retest ….then reduce further if necessary

[Serendipity__ in reply to Reneey2k]

Hi! That’s a lot of T3 for one dose actually. As an idea, have you tried to split them into two - 100 and 10 in the early morning and the rest - somewhere between 1-3 pm. I personally do this and feel amazing (if that levo batch works well, of course). But mostly I even split my huge Levo dose to three times a day (T3 - two max).

[Litatamon]

I listened to a very informative video on why t3 and also high NDT dose can cause an increase in blood pressure for some people. And other changes with the heart.

The suggestion was to spilt dose to offset the larger hit of it. Have you tried to do that before you give up your t3?

Also beet juice works well for hypertension. Other members have mentioned berberine as well.

[Reneey2k in reply to Litatamon]

but what could cause the change after 7 years? Or is it that the beta blockers was slowing my heart and T3 speeding it up so they were clashing?

I haven’t tried splitting it cause I have capsules not tablets. I haven’t felt any worse since stopping so I wonder was I over medicated

[Litatamon in reply to Reneey2k]

Sorry I am not more help. ,So many on here talk about sudden changes after years.

I am simply worried about you giving up your t3, before experimenting with lowering the dose a bit and/or split dosing.

[SlowDragon Administrator in reply to Litatamon]

How long since you changed to Roma capsules

Perhaps you need dose reduction

We often need less as we get older

200mcg levothyroxine and 20mcg T3 is quite high dose

How much do you weigh in kilo?

Have you lost weight recently

Suggest you ask for change in prescription to

10mcg and 5mcg capsules

Or more flexible…..

3 x 5mcg capsules per day

Which brand of levothyroxine are you currently taking

Are you on dairy free diet?

Or gluten free

[Reneey2k in reply to SlowDragon]

82kg currently but weight has fluctuated between 75kg-87kg over the 7 years. Gluten free as coeliac

[SlowDragon Administrator in reply to Reneey2k]

As coeliac it’s especially essential to regularly retest vitamin D, folate, B12, ferritin

What vitamin supplements are you currently taking

What are your most recent vitamin results and ranges

[Reneey2k in reply to SlowDragon]

not had my vitamins done in a while but taking magnesium, zinc, vit D, b12

I’ll ask for 5mg capsules. It’s happened to some degree maybe 2-3 times a week

[SlowDragon Administrator in reply to Reneey2k]

Request GP test vitamin levels now including folate

Rather than just taking B12 you probably need vitamin B complex

But test first before starting

[Reneey2k in reply to SlowDragon]

got vitamin results and low in

ferritin, 19ug/L (30-300)

vit D 50nmol/L (50-200)

folate 1.5ug/L (4-26)

T3 4.7pmol/L (3.2-6.8)

T4 19.1pmol/L (11.2-20.2)

Tsh 0.01

Dr wanted to reduce my T4 as Tsh still suppressed. How long before it becomes unsuppressed?

[SlowDragon Administrator in reply to Reneey2k]

well you need all four vitamins at OPTIMAL levels

Ferritin severely deficient

Ferritin at least over 70, and nearer 100 better

Vitamin D at least over 80nmol and between 100-125nmol might be better

Folate is severely deficient

At least over 20

No B12?

[Reneey2k in reply to SlowDragon]

Sorry. I get b12 injections. 980ng/L (180-770). They’re not supposed to test that but did

[SlowDragon Administrator in reply to Reneey2k]

presumably GP has prescribed folic acid for folate deficiency?

Essential to know how low B12 is BEFORE starting on folic acid

Taking folate if B12 is low can lead to severe neurological problems.

en.wikipedia.org/wiki/Subac...

It is vital if you intend to supplement both B12 and folate that B12 supplements is started a week before the folate. Or if getting B12 injections, first injection is 48 hours before starting folic acid

[SlowDragon Administrator in reply to Reneey2k]

GP needs to do FULL iron panel test for anaemia

Presumably you been prescribed iron supplements?

How many per day

cks.nice.org.uk/topics/anae...

In all people, a serum ferritin level of less than 30 micrograms/L confirms the diagnosis of iron deficiency

Also See page 7 on here 

rcn.org.uk/-/media/royal-co...

Look at increasing iron rich foods in diet 

Eating iron rich foods like liver or liver pate once a week plus other red meat, pumpkin seeds and dark chocolate, plus daily orange juice or other vitamin C rich drink can help improve iron absorption

List of iron rich foods

dailyiron.net

Links about iron and ferritin

An article that explains why Low ferritin and low thyroid levels are often linked 

preventmiscarriage.com/iron...

irondisorders.org/too-littl...

davidg170.sg-host.com/wp-co...

Great in-depth article on low ferritin 

oatext.com/iron-deficiency-...

drhedberg.com/ferritin-hypo...

This is interesting because I have noticed that many patients with Hashimoto’s disease and hypothyroidism, start to feel worse when their ferritin drops below 80 and usually there is hair loss when it drops below 50.

Thyroid disease is as much about optimising vitamins as thyroid hormones

healthunlocked.com/thyroidu...

restartmed.com/hypothyroidi...

Post discussing just how long it can take to raise low ferritin 

healthunlocked.com/thyroidu...

Never supplement iron without doing full iron panel test for anaemia first and retest 3-4 times a year if self supplementing. It’s possible to have low ferritin but high iron 

Medichecks iron panel test 

medichecks.com/products/iro...

Iron and thyroid link

healthunlocked.com/thyroidu...

Excellent article on iron and thyroid 

cambridge.org/core/journals...

Posts discussing why important to do full iron panel test

healthunlocked.com/thyroidu...

healthunlocked.com/thyroidu...

Chicken livers if iron is good, but ferritin low

healthunlocked.com/thyroidu...

Shellfish and Mussels are excellent source of iron 

healthline.com/nutrition/he...

Heme iron v non heme

hsph.harvard.edu/nutritions...

Ferritin over 100 to alleviate symptoms 

healthunlocked.com/thyroidu...

Low Iron implicated in hypothyroidism 

healthunlocked.com/thyroidu...

Ferritin range on Medichecks 

healthunlocked.com/thyroidu...

healthunlocked.com/thyroidu...

We have received further information the lab about ferritin reference ranges. They confirm that they are sex dependent up to the age of 60, then beyond the age of 60 the reference range is the same for both sexes: 

Males 16-60: 30-400 ug/L

Female's: 16-60: 30-150

Both >60: 30-650 

The lower limit of 30 ug/L is in accordance with the updated NICE guidance and the upper limits are in accordance with guidance from the Association of Clinical Biochemists. ‘

[SlowDragon Administrator in reply to Reneey2k]

Low vitamin levels are direct result of stopping T3 /skipping levothyroxine doses

[Reneey2k in reply to SlowDragon]

he prescribed Folate 5mg once a day. Didn’t prescribe iron or vit D. Just told me to get it over the counter

[SlowDragon Administrator in reply to Reneey2k]

Email /contact GP and request full iron panel test

Ferritin is deficient

[SlowDragon Administrator in reply to Reneey2k]

vitamin D

Yes self supplement

GP will very often only prescribe to bring vitamin D levels to 50nmol.

Some areas will prescribe to bring levels to 75nmol or even 80nmol

leedsformulary.nhs.uk/docs/...

GP has correctly advised on self supplementing if over 50nmol, but under 75nmol (but they rarely do)

mm.wirral.nhs.uk/document_u...

But improving to around 80nmol or 100nmol by self supplementing may be better

pubmed.ncbi.nlm.nih.gov/218...

vitamindsociety.org/pdf/Vit...

Once you Improve level, very likely you will need on going maintenance dose to keep it there.

Test twice yearly via NHS private testing service when supplementing 

vitamindtest.org.uk

Vitamin D mouth spray by Better You is very effective as it avoids poor gut function.

There’s a version made that also contains vitamin K2 Mk7. 

One spray = 1000iu

amazon.co.uk/BetterYou-Dlux...

Another member recommended this one recently

Vitamin D with k2

amazon.co.uk/Strength-Subli...

It’s trial and error what dose we need, with thyroid issues we frequently need higher dose than average

Vitamin D and thyroid disease 

grassrootshealth.net/blog/t...

Vitamin D may prevent Autoimmune disease 

newscientist.com/article/23...

Web links about taking important cofactors - magnesium and Vit K2-MK7

Magnesium best taken in the afternoon or evening, but must be four hours away from levothyroxine

betterbones.com/bone-nutrit...

medicalnewstoday.com/articl...

livescience.com/61866-magne...

sciencedaily.com/releases/2...

Interesting article by Dr Malcolm Kendrick on magnesium 

drmalcolmkendrick.org/categ...

Vitamin K2 mk7

betterbones.com/bone-nutrit...

healthline.com/nutrition/vi...

[Reneey2k in reply to SlowDragon]

Is my t4 too high? I was thinking if it’s lower 175mg maybe then I could go back on the T3. I asked about 10mg capsules so can split the dose if need be. I can only try and see if the palpitations return. I’ve not felt any side effects since stopping other then feeling cold but that could be just cause it’s flipping cold right now . Before I could go out in a T-shirt in this weather and would still sweat so maybe my dosage was too high

[Litatamon in reply to Reneey2k]

I don't know why the change in seven years, but when you calculate the T3 in - as it is calculate differently - that dose is way over what you weigh.

The weight calculation and dosing is not written in stone of course, but I think it is a good place simply to cut back a small amount of the t3 just to see if it makes a difference.

(Or try the split dosing)

Is the missing the doses very recent or has it happened to some degree all along?

[Batty1 in reply to Reneey2k]

I always ask this very same question Ive been taking this medication for years without issue and now I have issues …. It could simply be something in the medicine has changed or its just your body chemistry changing things up …. Hard to say really.

[SlowDragon Administrator in reply to Reneey2k]

ask to go back to T3 tablets

20mcg T3 is cheaper than capsules and then easy to split into 5mcg doses

Current prices

healthunlocked.com/thyroidu...

[Reneey2k]

the pharmacist said capsules are a lot cheaper then the tablets