Update on Last post (Liothyronine rejected

[BluSurfer]

Good evening all, I hope you are ok.

To update you I had bloods this morning in the hospital and received this email in the afternoon. I responded back to ask if i could be on 100mg of levo all the time instead of 3-4 days and unfortunately an automated reply sent back to say they were out of office till 28th so I guess next week I will need to phone them. Does anybody have any thoughts on how much I can increase my current dosage or the nurses response in "bold"?

Current medication is 75 mg levo and 10mg lio (post below shows meds as higher dosage but that was made in error sorry for confusion)

"Hi so the FT4 is slightly under range at 11.6,

TSH normal at 0.72 and

FT3 normal at 4.0 

Do you want to try alternate day doses of Levothyroxine 75mch/100mcg- that is a slight increase. So 4 days  of the week 75mcg and 3 days 100mcg and have another test in 6 weeks? I will do a letter"

Assuming the ranges are as before =

T4 12 - 22

TSH 0.27-4.20

T3 3.1 - 6.8

On a different note I will look to get my vitamins checked etc asap as that was brought up before.

Thanks again for all your help, would really like to feel good over Christmas and ready for the new year🤞

Last post below:

Hi all, I hope you are all keeping ok!

My last bloods were in 14th Nov 2022 TSH as 0.70ml (range 0.27-4.4) 

Im on Levo Throxine 75 and Liothyronine 50mg I was put on Liothyronine as a request as I didn't feel Levo was doing anything.

I really struggle with fatigue and weight gain even though I eat clean and workout 3-4 a week and have an active life in general. When starting it, it made me feel amazing and i could see i was so much less puffy in the face and everywhere really! Plus I could wake up in the morning.

The past 6 weeks Ive been struggling again so, I reached out to NHS endo team to ask for an increase and they have come back with this:-

"Firstly when is your next blood test? The last TSH ( mid November) was nicely in the  lower half of the normal range and therefore I cannot recommend an increase in the Levothyroxine unless your thyroid function has changed. We do not increase the dose of Liothyronine- that is a standard dose. "

Does anyone have any recommendations for my response with regard to getting an increase in medication? obviously I will request another blood test and ask them to tell the GP to test for T3, T4 and TSH (because they only ever do TSH) But Im Really Struggling so any thoughts would be greatly appreciated...

Thanks In Advance.

[Regenallotment]

sorry I’m struggling to follow this 😵‍💫r read it about 5 times … I think I’ve understood - correct me if I’m wrong.

You were on T4 /T3 combination therapy which by those blood tests appears to have suppressed your TSH and FT4.

So the nurse writes to say stop T3 and suggests a slight increase in T4 medication instead.

Your symptoms are fatigue and weight gain and you work out 3-4 times a week.

How are your vitamin levels? Optimal vits help you absorb your T4/T3. We’re they tested at the same time?

I’ve listened to podcasts suggesting that we hypos can overdo it in the gym striving to boost the metabolism and ending up exacerbating the ‘metabolic syndrome’ effect of the body slowing down the metabolism further as if we are in some kind of ancestral famine /stress situation. Look up Eric Baclavage, he was talking about this. He doesn’t say give up or stop but he does say change your program completely, away from long cardio and onto resistance and weights and shorter sessions. We’re effectively creating physical stress and making ourselves more hypo. I can do this at the allotment, going all in for a couple of days and then I’m sofa bound for a week. I was in denial about this for some time but I’ve made peace with it now.

You won’t know if the T4 dose advice is right for you for about 8 weeks when you test again and compare symptoms. In the meantime you can optimise meds, read up on the latest fitness and hypo recommendations etc. wishing you well 🦋

[BluSurfer in reply to Regenallotment]

Regenallotment Thank you for your message, yes, sorry it is a bit all over the place, I think its because I copied the original message so people didn't have to go looking for it...(thinking that could be helpful)

I have heard of that but I haven't looked too much into it. I have always been a very active person so its a real battle as its always been the key to my mental health.. and being active is just me in general. I do try and listen to my body but since being on medication I do feel I am starting to get my life back.

I will be on the phone to the GP Monday to check my vitamin levels (hopefully) as the endo team in the hospital have said they dont do that.

Just to clarify I have been on T4/T3 medication from Aug this year and symptoms had reduced, however I have started to want to sleep a lot again and brain fog, fatigue and weight gain etc so I reached out to the Endo team after the recent bloods yesterday they want to do:

"Do you want to try alternate day doses of Levothyroxine 75mch/100mcg- that is a slight increase. So 4 days  of the week 75mcg and 3 days 100mcg and have another test in 6 weeks? I will do a letter"

I would like to increase all the time not 3 days of the week as I feel so bad. So i was wondering what everyones thoughts were. If I'm honest I think I could do with upping both but I understand its got to be done gradually and I get so frustrated when they are fixated on TSH.

Thanks again and I hope that clarifies the post

💟

[crimple]

Bluesurfer, I fear your Endocrinology team don't really know what they are doing in my opinion. Your T4 is below range and only testing TSH (which is NOT a thyroid hormone) is useless. They should have tested TSH, T4 and T3 before giving you T3. Adding in T3 usually reduces your T4 so definitely increase your levothyroxine as recommended. As for 10 mcgm T3 being a standard dose, that is nonsense. You need what you need. Your T3 is currently low and will need to be increased. They seem fixated on your TSH level.

My TSH is 0.005 so well below the range and has been like that since before I added in some T3. They will no doubt tell you that you will suffer from osteoporosis and heart issues. I told them I prefer a life to an existance. Regenallotment is correct that you can do too much exercise. Remember to allow 6-8 weeks after an increase in dose (T4 or T3) before testing bloods again. Only increase one at a time, levo or lio.

[BluSurfer in reply to crimple]

Yeah I do feel like Im banging my head against a brick wall most of the time! They are fixated on TSH and its so frustrating. Do you know what the optimum T4 and T3 levels should be?

Im hoping they will let me increase levo for 7days of the week and not 3 out of 7.

I do feel its very hard to get past the nurses too, so I always feel like I rarely get to speak to the doctor and I feel sometimes the nurses (probably not intensionally but) I feel they like to "hold the power".

[mistydog]

As soon as you add T3, your TSH and T4 will lower. And THAT'S FINE! STUPID PEOPLE don't know how it works. Keep pushing for the reinstatement of the T3, get information on T3 and how it works and give it to the medical "professionals".

[BluSurfer in reply to mistydog]

Thank you, it is really reassuring and Im very grateful for this group!