How much T3 to increase by?

[GlowCoach]

So I tested too early at 4 weeks after my last dose change and have now left it 11 weeks due to being away for a while. There's been quite a shift in the results, so good job I retested later, although now wishing I had added another 5mcg back at the time. Anyway, on 125mcg Levo taken at night and 10mcgs T3 split in two, my FT4 is at 74% and FT3 dropped right down to 32.4%( was at 52% previous test same dose!). I have a touch more go in me but only just! Currently having lots of problems with incredibly dry skin.

How much should I up T3 by? I was wondering about adding 10mcgs in 2 steps of 5mcgs a few weeks apart?

Bloods taken at 9.15am, fasting, no biotin for 5 days. Vitamins optimal, still supplementing B complex, folate, D3, B12 injections and magnesium. Last dose Levo 24hrs, T3 10hrs.

TSH 0.5 mIU/L (.27 - 4.2) 5.9%

Free T4 (fT4) 19.4 pmol/L (12 - 22) 74.0%

Free T3 (fT3) 4.3 pmol/L (3.1 - 6.8) 32.4%

[FancyPants54]

How many hours did you leave between last doses of Levo and T3 and the test?

[GlowCoach Administrator in reply to FancyPants54]

Oh was 24hrs for Levo and 10 hrs for T3. I'll edit my post.

[FancyPants54 in reply to GlowCoach]

Someone was going to ask.

[GlowCoach Administrator in reply to FancyPants54]

My brain is so fogged (and no wonder) I was desperately wracking it to try and recall all the points to make in the post. 😆

[FancyPants54]

To me it looks like poor conversion there. Have you considered reducing your Levo by 25mcg and then, after a couple of days, adding in another 5mcg T3? It’s what I would try next. My bloods were showing higher T4 and stubbornly low T3. I reduced Levo and it helped bring my T3 up.

[GlowCoach Administrator in reply to FancyPants54]

I wasn't actually looking to drop my Levo at all. I understand that people feel well when both their FT4 & FT3 are around 70% of their range. Seeing as adding more T3 will drop my FT4 anyway then there's no point dropping that.

[FancyPants54 in reply to GlowCoach]

Well that is exactly what I used to think. And exactly what I did and it backfired for me spectacularly. I was taking 60mcg T3 and 125 Levo at one point and feeling like death warmed up and sat down. So then I reversed the levo and T3 until I was almost T3 only and not such a high dose, just on 25mcg Levo. But I started to feel worse again so I'm bringing my T4 up very slowly. Currently on 87.5, or at least the equivalent because I've switched to NDT to try and am on the equivalent to the Levo I was on and slightly less T3.

All that dose experimenting took over a year, well over in fact. And I'm now starting to feel that I might be closer to an appropriate dose. My FT4 doesn't want to go over 50% of range. It's slightly under still. If it goes over and I'm taking T3 then my body sees the hormone and reacts by up regulating the D3 enzyme that converts the thyroid hormone to T2 and lets it get excreted. Basically having my FT4 over 50% (give or take a few percent) leads to a lowering of my FT3 and worsening of symptoms.

It sounds about-face to reduce a T4 dose. But some of us don't need our FT4 very high at all and having it high can reduce T3 conversion and retention. In this game anything is worth a try.

[GlowCoach Administrator in reply to FancyPants54]

Interesting. I really wasn't expecting the 20% drop in FT3 but then again maybe its getting to places it wasn't before when on Levo alone? I have recently concidered walking the odd small flight of stairs rather than taking the lift which wouldn't have happened pre T3. For sure there's chunks of me that haven't seen a decent dose of thyroid hormone in decades!

I'll try the 5mcg increase and see where that takes me but bare in mind what you have experienced.

[TiggerMe Ambassador in reply to GlowCoach]

Certainly sounds like you have successfully re-awakened many snoozing cell receptors and have good cellular uptake, linking to the lowering of T3 in the blood and the inclination to take the stairs 👏

I'm just at a similar point, having added back in a small T3 increase and now making a small reduction in T4... we shall see

[JAmanda in reply to FancyPants54]

I’m kind of finding the opposite. I was on 100/25 for a long time but my t4 level was never over 30% in range and my t3 kept gradually going down (ftom 85% to 45%). Over time I’ve been increasing my t4 to 120 a day and my t3 to 15 and feel all the better for it. Sleeping great. Got a retest on 23/1/23.

[GlowCoach Administrator in reply to JAmanda]

My sleep has long been an issue, I have 3 sleep conditions. Mostly I sleep too much bu its of very poor quality so I'm still tired. Looking forward to benefitting from a night time T3 dose!

[JAmanda in reply to GlowCoach]

I have in the past felt a nighttime dose of t3 worked well but nowadays I find I need to take it all at once first thing in the morning or I can’t get to sleep. But I think the increase in t4 is really helping me.

[SlowDragon Administrator]

Suggest adding 3rd 5mcg dose…..so 3 doses per day at roughly equal 8 hour intervals

[GlowCoach Administrator in reply to SlowDragon]

5mcgs just seems like a very small amount when my FT3 is at 32%? Hence concidering adding another 5mcgs after a few weeks.

[SlowDragon Administrator in reply to GlowCoach]

I wouldn’t

Wait 6-8 weeks and retest

[Lalatoot in reply to GlowCoach]

I agree with SlowDragon add 5mcg then wait and then test. A little can make a big difference. 7 5mcg t3 lifted my ft3 from 17% to 72%.

[GlowCoach Administrator in reply to Lalatoot]

It's so hard to know really. I've been getting weaker and weaker and more unwell for so many years now. Seems strange that adding 10mcgs T3 has effectively dropped my FT3 level. I di feel the benefit of it - a bit - no idea how I got through the summer on 125mcg Levo alone. I shudder to think!

Maybe the major drop has now happened and it will now go in an upward and forward direction. So I'll just do the 5mcgs but it does feel like a drop in the ocean.

[lh22]

It might be worth getting some other biomarkers tested eg iron, Vitamin D, B12, full blood count to see if you have any nutritional deficiencies which could also be affecting T4 to T3 conversion, and also making you feel tired and weak.

[GlowCoach Administrator in reply to lh22]

Thanks. Had them all retested a few months back and they are all optimal. Still staying on top of them with supplements.

[arTistapple]

I wonder too about where the T3 may be going. If you have been hypothyroid for a long time it may be your T3 receptors are just soaking it up at the moment. If you have had any sort of balance for any length of time (not necessarily a health balance but a meds balance) I would tackle the T3 as per @SlowDragon suggests very slowly. I have just had a recent experience of how the absolute tiniest amount of T3 can easily tip into over medicated. I would say don’t risk it!! It could be unpleasant and will set you back.

[TiggerMe Ambassador]

I would also suggest keeping track of your resting heart rate and temperature when you first wake up as these are a great guide to how your body is reacting to the dose change 🤗