stopping medication : hi… me again. just a quick... - Thyroid UK

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stopping medication

Sppr profile image
Sppr
10 Replies

hi… me again.

just a quick recap.

was in 50 of levo for 3 months until July last year then increased to 75. In November the scooter added T3 (1 tablet a day)

Went for bloods on Thursday. He said stop taking all medication for 6 weeks then go back.

My results are below. Does this seem a normal thing to do?

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SeasideSusie profile image
SeasideSusieRemembering

Sppr

What amount of T3 in your tablet? They come in 5mcg, 10mcg, 20mcg and 25mcg.

When did you take your last doses before and the test? Last dose of Levo should be 24 hours before and last dose of T3 should be 8-12 hours before the test (splitting dose into 2 or 3 the day before).

What reason was given for stopping all thyroid meds?

Total T3 and Total T4 are outdated tests and not useful, the tests we need are Free T3 and Free T4, these measure the actual amount of free/unbound thyroid hormone available to the cells .

Sppr profile image
Sppr in reply to SeasideSusie

25 per day.

I took them at 6am and was tested at 4pm.

I questioned this and he said don’t believe everything you read.

I asked about vitamins etc, he said that’s just the latest ‘trend’.

I told him I was seeing no benefit of taking the T3 since nov.

My blood pressure was 139/99. That’s the highest it’s been in my life.

SlowDragon profile image
SlowDragonAdministrator in reply to Sppr

Change your endocrinologist ?

You need Free T3, Free T4, vitamin D, folate, ferritin and B12 levels tested

test early morning and last dose levothyroxine 24 hours before test

Last 1/4 tablet T3 8-12 hours before test

T3 result is a little high

Are you currently splitting the T3 as 2 or 3 smaller doses spread through the day

Suggest you cut tablets into 1/4’s

And reduce to 3 x 1/4 tablet per day

Taking at waking, afternoon and bedtime

Or 6am, noon and 6pm

Are you taking levothyroxine and T3 on empty stomach and then nothing apart from water for at least an hour after

Sppr profile image
Sppr in reply to SlowDragon

I take all tablets first thing in the morning. Empty tummy then wait an hour to eat. The T3 I take all at once.

How do you cut up those tablets? It’s so tiny.

So you think don’t stop taking?

SlowDragon profile image
SlowDragonAdministrator in reply to Sppr

cut up with sharp craft scalpel

Eg

amazon.co.uk/Modelcraft-Sca...

No one should ever stop replacement thyroid hormones suddenly

Expect endo panicked at low TSH

Suppressed TSH is common when adding even small doses T3

TSH is highest early morning

Lowest late afternoon

Get tested early morning

Sppr profile image
Sppr in reply to SlowDragon

my TSH was less than that when he started me on the T3.

I’m really lost now. His recommendation was sent in a email (once the blood tests had come back.) he simply said, as you’re seeing no benefit stop. So I asked stop what.. and he said all.

So confused.

SeasideSusie profile image
SeasideSusieRemembering in reply to Sppr

I questioned this and he said don’t believe everything you read.

I asked about vitamins etc, he said that’s just the latest ‘trend’.

Don't believe everything doctors tell you about hypothyroidism, especially endos (who are usually diabetes specialists), they know very little about treating it.

You should never have been started on a full tablet, you start on a quarter and gradually build up to the dose you need.

Run away from this one or any one who wants to stop your medication like that.

SlowDragon profile image
SlowDragonAdministrator

What were your thyroid levels BEFORE T3 was added in November?

As SeasideSusie said

Ridiculous to have told you to start on 25mcg T3

should ALWAYS add T3 very slowly

If got 20mcg or 25mcg tablets

Cut into 1/4’s……only cut one tablet at a time

Save spare 1/4’s in pill dispenser

This is how he should have told you to start

Take 1/4 tablet T3 waking

After week

add 2nd 1/4 tablet mid afternoon

in week or two ….add 3rd 1/4 tablet 

Wait 6-8 weeks and retest

Last dose T3 approx 8-12 hours before test

Last dose levothyroxine 24 hours before test

Timings at equal 8 hour intervals…..

eg 6am, 3pm and 10pm

If you find bedtime dose keeps you awake

Try 6am, noon and 6pm

But you’re where you are now

Suggest you get a scalpel

Cut tablets into 1/4’s

Reduce to 3 x 1/4 tablet per day

Experiment with timings as to what suits you

Sppr profile image
Sppr in reply to SlowDragon

these were November…

Results
SlowDragon profile image
SlowDragonAdministrator in reply to Sppr

Free T4 (fT4) 9.83 pmol/L (4.87 - 11.72) 72.4%

Free T3 (fT3) 1.07 pmol/L (.58 - 1.59) 48.5%

Not clear if these results are total T4 and Total T3

Or are Free T4 and Ft3

Assuming test was done as recommended …..early morning and last dose levothyroxine 24 hours before test

Results show poor conversion of Ft4 to Ft3

Next step should have been to check all four vitamins at optimal levels as this improves conversion rate

So come back with new post once you get vitamin results

Many people when adequately treated will have both Ft4 and Ft3 at approx 70% through range

So adding a SMALL dose of T3 was next step……just not a huge dose

You may only need 2 x 1/4 tablet eventually

Retest thyroid levels 6-8 weeks after starting splitting dose and reducing to 3 x 1/4 tablet per day

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