blood results : hi all what’s your thoughts on my... - Thyroid UK

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Thyroid36 profile image
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hi all what’s your thoughts on my blood results, my endo has started me on t3 today 🙌🏻 , I was originally only 100mcg of levo 1 x time, he has now said to take:

T3 to be taken 10mcg twice daily – one with Levothyroxine 75mcg in the morning and the second dose around 4 PM.

Although most is in range things do look a little low.

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Thyroid36 profile image
Thyroid36

I hope the t3 makes me feel human again combining with t4, I’m full thyroidectomy patient

Lalatoot profile image
Lalatoot

Thyroid36 To be gentle on your body I would advise:

Week 1 reduce your levo so that your level drops.

Week 2 introduce 5mcg T3 liothyronine.

Week 3 If all ok then introduce another 5mcg T3 lio. Either added to first dose or as separate dose.

There is no guarantee that you will need the full dose the endo says as there is no way of predicting what an individual needs on combo. I only need 7.5mcg T3 daily added to my 100mcg levo. So you can stop if you feel that it is right for you or:

Continue to increase T3 dose by 5mcg every 2 weeks until you reach a total daily dose of 20mcg.

Wait 6 - 8 weeks and do bloods.

Being slow, patient, methodical and adjusting only 1 thing at a time id the best way to find the combination of doses that suit you.

It is trial and error. You can also try different timings of doses. some take it all in one go. I have taken both levo and lio in 2 doses and 2 doses. I now take them first thing and bedtime which leaves the rest of the day free for supplements.

Thyroid36 profile image
Thyroid36 in reply to Lalatoot

oh really ok, so you don’t recommend I start the t3, u think it’s best to reduce my Levo to 75mg as he has said and then next week start the t3 but only adding in 5mg .

SeasideSusie profile image
SeasideSusieRemembering

Thyroid36

T3 to be taken 10mcg twice daily – one with Levothyroxine 75mcg in the morning and the second dose around 4 PM.

You shouldn't start T3 at such a high dose, it's a powerful hormone and starting on 20mcg daily is too much of a shock to the system. You should start on 5mcg for the first couple of weeks, if all is OK then add in a second dose of 5mcg then leave at 10mcg daily for a few weeks. If necessary you then increase by only 5mcg at a time and leave a few weeks for things to settle to see if you need more. I would retest at this stage and check levels as well as assessing how you feel.

As your FT4 is at the top of the range then reducing Levo from 100mcg to 75mcg daily is the right thing to do as you're adding T3.

B12 is low at 273pg/ml. Many people with B12 in the 300s have been found to need B12 injections.

Do you have any signs of B12 deficiency – check here:

b12deficiency.info/signs-an...

b12d.org/submit/document?id=46

If you do then list them to discuss with your doctor and ask for testing for B12 deficiency and Pernicious Anaemia. Do not take any B12 supplements or folic acid/folate/B Complex supplements before further testing of B12 as this will mask signs of B12 deficiency and skew results and if you have B12 deficiency is not detected and treated then this could affect your nervous system. B12 deficiency should be treated before starting folic acid because folic acid can sometimes improve your symptoms so much that is masks B12 deficiency.

Ifyou don't it would be OK to supplement with a sublingual B12 1,000mcg daily along with a good quality B Complex containing methylfolate and methylcobalamin to keep all B vitamins balanced.

When taking a B Complex we should leave this off for 3-7 days before any blood test as it gives false results.

Folate is low so eating folate rich foods may help, also the B Complex will help.

Ferritin could be a bit higher, it's recommended to be half way through range (about 82 with that range) although some experts say the optimal level for thyroid function is 90-110ug/L. Eating iron rich foods will help, eg liver, liver pate, black pudding, red meat.

Vit D is low at 76nmol/L. You might want to check out a recent post that I wrote about Vit D and supplementing:

healthunlocked.com/thyroidu...

and you can check out the link to how to work out the dose you need to increase your current level to the recommended level.

Your current level is 30.4ng/ml and I would treat that as being in the 20-30 category and you'll see that 3,700iu D3 daily is suggested. As it's winter and we can't make Vit D naturally from the sun I'd suggest you take 4,000iu and retest at the end of March.

Magnesium and Vit K2-MK7 are important cofactors of D3 so you will need those too.

Thyroid36 profile image
Thyroid36 in reply to SeasideSusie

thank you for the article for the vitamin d and I’m going to start with some b12 shots my sister administers them so I’m going to get her to give me some. As my gp just takes to long to discuss it and isn’t concerned when I mentioned it last time 🙈

SeasideSusie profile image
SeasideSusieRemembering in reply to Thyroid36

If you're having B12 in any form you need to also take a B Complex to balance all the B vitamins.

Thyroid36 profile image
Thyroid36

amazing thank you so much so reduce to 75mcg and add 5mcg then a couple of weeks later add another 5mcg. Does his recommend dosage seem about right if I add it gradually and see how I feel like you said. What side effects should I be looking out for ? Thanks

SeasideSusie profile image
SeasideSusieRemembering in reply to Thyroid36

amazing thank you so much so reduce to 75mcg and add 5mcg then a couple of weeks later add another 5mcg.

Yes.

Does his recommend dosage seem about right if I add it gradually and see how I feel like you said.

Nobody knows what dose you will end up with, you just have to start it then gradually increase and see what you need. I'm still tweaking and I've been adding T3 since 2015. It's not a quick and easy fix, finding the right balance of Levo and T3 takes patience and a lot of time.

What side effects should I be looking out for ?

Don't anticipate any, if you are looking out for side effects you'll start thinking that everything from a headache to a sore toe is a side effect. The only effect to look forward to is improving you thyroid levels and symptoms.

SlowDragon profile image
SlowDragonAdministrator

What vitamin supplements were you taking before these results

Ideally we always recommend getting all four vitamins at OPTIMAL levels before starting T3 because optimal vitamin levels frequently improves conversion rate of Ft4 to Ft3

B12 and folate far too low

Ferritin and vitamin D reasonable

Don’t assume that you will need the full 20mcg T3

What dose tablets are you getting

Cut into 5mcg dose maximum

Starting on just 5mcg in morning, 4-7 days after reducing levothyroxine

Go slowly, don’t rush to increase

You might only need 3 x 5mcg T3

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