I was started on t3 and t4 combo 5 and a half weeks ago.
After a week the IBS type symptoms started. Lots of bloating, gas, pain constipation interspersed with very loose bowels.
Other symptoms since then, nausea, dry itchy skin, thirst, hair loss, lack of energy, tinnitus and couple of dizzy spells and a feeling of being unstable when walking.
I had bloods take yesterday and they have been seen by the Endo but not given to me. He reports( via his secretary ) that my symptoms since starting the t3/4 combo are not related to my thyroid or the new medication. He has now written to my GP and asked her to investigate my new symptoms.
I have been taking 15mg Roma t3 and 75 mg Levo. Accord 50, Teva 25. Prior to that I was taking 1 3/4 to 2 Thyroid S. I had none of the above symptoms.
I am not due to see him for another 8 weeks.
Speechless.
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meme
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I believe it's very hard to accurately equate doses of NDT and T4/T3 combo therapy so it may well be you've taken a drop in hormone levels. I would also suspect the Teva and the only way to know would be to get a different brand prescribed. Try and get them to write on your prescription (NOT TEVA).
Thank you for the calculations, most helpful and illuminating .
I feel less nauseous without Teva.
Must admit that I have been taking aprox 12 mg extra of Levo every other day since I got the t4 result last week. (50 Accord cut in 4). The T3 are capsules, so cannot split. Does that sound reasonable or could I take more ?
I still feel rather unsteady at times and skin is still dry and tinnitus still a nusance. Bowels and associated pain much improved with extra 12mg every other day.
I do feel a little better with the extra.
I will write to Endo with your calculations and ask for a rise before I am tested again. I don’t want to get on his wrong side at this early stage in our relationship.
You should be able to do 12.5mcg levo extra a day. Previously your T4 was low due to low levels in NDT but on this combo you will be able to get it, and may need it a bit higher. I'm not sure if 25mcgs a day would be too much.
That is what I feel but he has the power to stop the T3 which he is prescribing.
If I add more Levo without telling him and do well, he will think his treatment plan was right all along. And may even reduce the T3 as my “all important” TSH will have risen .
I did hope to come off NDT due to the continuing price rises, supply and quality problems.
I have see my GP about my new symptoms. GP may offer a solution.
he's just trotting out the same old lazy 'status quo ' about TSH
and not bothering to use his own brain .
"unfortunately there is no data to suggest how soon after the intake of T3 levels should be measured" ....... bollocks
the is plenty of data showing what happens to fT3 levels in the blood following the ingestion of a dose of T3.
anyone can find a graph showing it if they are interested enough to look it up . So base on that data it is possible to deliberately check for the fT3 at it's 'peak' post dose .. or it's mid point . or it's lowest point , depending on what part you are interested in.
(just the same as it is possible to do for for testing fT4 after taking Levo)
" and because of the short acting nature of T3 we do not use T3 as routine replacement methodology" ...... so what ?
Just because T3 is not in 'routine use' that doesn't mean an endocrinologist should not be aware of how to use it / or measure it ..... that's just a cop out .
objectively ..... your new dose of T4 + T3 combo is giving you demonstrably lower level so fT4 and T3 than your previous dose of NDT.
objectively .... your TSH ( which he believes is infallible ) confirms this ,by being a bit higher.
objectively .... you have some symptoms you didn't have before this change.
so objectively...... it's apparent that he is not looking very skilfully at the information he's been presented with .
Humans are sensitive to even small changes in thyroid hormone levels ... if they were not, the human body would not have bothered evolving such a complex system of HPT axis & deiodinases to control them so minutely .. and we wouldn't need an (allegedy) skilled endo to prescribe and monitor them ,.... we could just go down the C0-0P and buy some with the Vitamin C tablets and Weetabix .
I hope you are not having to pay this bloke too much money to trot out this sort of tripe.
i'd rather not be in the same room with him if you dont mind . i suspect it might be detrimental to my mental health. mind you if you do ever decide to cut him loose and email him my response to his esteemed letter, i won't mind at all
Hi meme , sorry to hear that you are having problems, I really am not the best person to ask here ,as I am too suffering at the moment as have been diagnosed with a second autoimmune disease, so my t3/t4 also is in the process of being updated , but , I would agree with most of your replies, but I would say the best people to ask are slowdragon and grey goose, as they have helped me so much in the past . Take care , hope you get the help you're needing and feel much better real soon .
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Continue with t4/t3 or Levo only
Teva
stopping T3
Levo or NDT
Trying T3 only , 
