Need help

[Kapuna]

Has anyone on liothyronine and levothyroxine stopped the lio and increased the levo? I am on 100 mcg levo and 5 lio (2x a day) and have both hypo and hyperthyroid symptoms. My TSH continues to be <.02. I tried going to 10 lio twice a day and felt hyperthyroid (shaking hands and anxiety). Dropped back to 7.5 lio and the hyperthyroid symptoms went mostly away. I am wondering if it would be better to increase my levothyroxine to 118 and just drop the lio. Any thoughts?

[Hidden]

hey, without seeing your frees I would suggest that a negative reaction to adding t3 may indicate you need cortisol testing x

[SlowDragon Administrator]

You need full thyroid AND vitamin testing

When were vitamin D, folate, B12 and ferritin levels tested

What vitamin supplements are you currently taking

always test all thyroid bloods early morning, ideally just before 9am and last dose levothyroxine 24 hours before test 

Day before test, last 1/2 or 1/3rd of daily dose T3 Approx 8-12 hours before test

Please add recent results and ranges if you have any

[Buddy195 Administrator]

As SlowDragon has said, we really need to see your thyroid blood test results to offer better advice. We also need the ranges, as these can vary between laboratories.

TSH

FT3

FT4

In addition, have you recently tested key vitamins that support thyroid health (ferritin, folate, B12 and Vitamin D)?

If you are on combination treatment then it’s highly likely your TSH is suppressed (ie below range); this just happens when you take Liothyronine. As long as FT3 and FT4 are not over range, there is nothing to worry about.

I get heightened anxiety, tremor, palpitations etc if my FT3/ FT4 goes too high in the range for me. We all gave different ‘sweet spots’ where we feel best. Going slightly over range can give ‘hyper like’ symptoms but this is not hyperthyroidism. The symptoms will pass if medication is reduced and it often happens that (once settled) the reduced dose can be increased. We recommend testing levels prior to adjusting upwards or downwards.

I only adjust medication very slowly, as I’m extremely sensitive to change. For example, I adjust by 12.5mcg Levo alternate days at first (and find a pill cutter extremely useful for this). If I was adjusting Liothyronine, again I prefer increments of 2.5mcg, not 5mcg.

[cazlooks]

There is a theory that for some people the diet is very important. I don't mean people on a bad diet feel bad, I mean that some people can't process some foods to a satisfactory level. If you are one of these people and your diet is lacking in something then you will need lio. For example, my dd was able to stop lio altogether when stopped being vegan - and she was a good vegan with dietary training etc etc, but her body can't derive enough iron from a vegan diet. So, get all the bloods done, vitamins, liver function, cortisol, t3, t4, tsh etc etc and see what they show

[shaws Administrator]

Liothyronine is also called T3.

Levothyroxine is called T4 but has to convert to T3.

T3 is the 'active thyroid hormone needed in our millions of T3 receptor cells.

T4 is inactive and has to convert to T3.

[Kapuna in reply to shaws]

Thanks for the explanation, but I have done my research on T3 and T4 and am aware what they are. I also have a genetic defect that may reduce my ability to convert T4 to T3. What I need to know is if I can get the doctor to increase my T4 can I stop taking the T3? A followup blood test should reveal if I am converting the extra T4 to T3.

[Regenallotment in reply to Kapuna]

I have MTHFR gene too, my worry would be that you push your FT4 over range doing that, your T3 drops like a stone because you can't convert T4 to T3 and you'll feel rubbish. If the 7.5 Lio works, why meddle?

Things can change over time too, I've read posts where people suddenly need less of one or the other. Absorption can change etc.

[Kapuna in reply to Regenallotment]

The 7.5 didn’t work. I felt hyper and had stomach problems. Am back to 5 and feeling better. I’m wondering if I ended up resetting myself. Will be talking to my doctor in a couple of weeks about what’s going on. At 5 T3 and 100 T4 my TSH was <.02 but didn’t feel hyper.

[Regenallotment in reply to Kapuna]

sounds like that is your sweet spot as they call it. GP might think TSH an issue but if you take t3 then the TSH becomes meaningless in the sense of dosage. How you feel is a better guide along with an FT3 reading to be sure that’s in range. (It is likely to be in range as you can feel when you are on too much) 🤗