T3 Not Working ?

[starbuck10]

Hi i have been taking T3 10mcg for two weeks now without major improvements although i am a little less brain foggy still very stiff joints no side effects is this a high dose? Am taking 100mcg levo for some time also for my hashimoto's .

[FancyPants54]

You can barely take less! This is a low dose. But you still need to keep on the same dose for 6-8 weeks to let it bed in and then retest. Do you take the 10mcg all at the same time or split it into 2 doses of 5mcg during the day?

Be sure to arrange your next blood test in the right way. You need to split your medication of T3 the day before the test so that your last Levo is 24hours before the test and the last half of your t3 dose is 8-12 hours before your test. Take your medication for the day after the blood test is finished. Arrange the first appointment you can, between 8am and 9am on the day.

[starbuck10 in reply to FancyPants54]

I take it in the morning with my levo i still find it hard to concentrate or motivate myself very fatigued energy levels go up and down i usually crash early evening i hope my consultant will up the dose at some point then as its a low dose .

[FancyPants54 in reply to starbuck10]

It took a long time to get sick. You can't expect a replacement low dose hormone to fix everything in 3 weeks. It takes months to get the dose right. But it's worth going slowly, holding each dose change 6-8 weeks and then retesting following the protocol I outlined in my first reply. The day before the test, you split your dose.

[starbuck10 in reply to FancyPants54]

Many thanks for the prompt reply i will do that .

[buggles84 in reply to FancyPants54]

Why would you manipulate the test by delaying and splitting dose? You're not going to get a true result.

[arTistapple in reply to buggles84]

Dosage is very poorly researched. This has a knock on effect to testing. Dosage is only ever discussed in detail on this site. Have you tried discussing dosage with your doctor? Contrary to your idea of ‘manipulation’ this is considered to give a much more accurate result - through trial and experience of forumites. It’s non-existent in medical circles. Similar with the ‘all important’ TSH itself. It’s just not accurate for comparison unless you take it at almost exactly the same time every test. Medics do not acknowledge this. However they are happy to change dosage on this basis of haphazard testing. Very worrying. Hormones are both delicate and powerful. Taking the tests this way is far more accurate.

[buggles84 in reply to arTistapple]

It's not accurate in the slightest......because it's not how you would medicate on a normal day.The reason people do this, is to purposely raise TSH and lower T3, to prevent the doctor from lowering doses when they see

Such numbers.

[arTistapple in reply to buggles84]

Apologies on one part of what I said. The patient themselves said they normally take the dose all at once. It became a little different when it was someone else who suggested the T3 be split. This I picked up wrongly on my reading.

It is my understanding that under the patient’s own circumstances the daily meds i.e. those taken in the morning as the patient appears to do - should be held back until after the test. Obviously if the test should happen late in the day even this might need further attention. I am no expert on this subject it just so happens that I have been doing as much research as I can into dosage amount, as opposed to timing, which has its own importance. If I have still got this wrong I hope someone more knowledgable will answer your query.

[FancyPants54 in reply to buggles84]

You want your test results to give you a level that you spend the mid part of your T3 half-life at. If you test within 4 hours of taking the T3 you will get a high score, but you don't spend much of your day like that. If you take all your T3 in one go in the morning and so it's 24hrs before the test you will get a low that you don't normally live with for very long. By splitting the dose and taking it at the midway point in the cycle of the hormone, you get a middle of the road level, which is easier to work with.

This is standard practice for many patients here. They neither want to know or care about the highs and lows because most of the working day they are in a mid ground between them.

[SlowDragon Administrator]

Try splitting the T3 everyday

5mcg waking and 5mcg 10-12 hours later

What were your thyroid results BEFORE adding T3

What were most recent vitamin D, folate, ferritin and B12 results

[SlowDragon Administrator]

Looking at previous post

tsh 0.2below ref range

serum t4 14 pmol/L

serum t3 5.6pmol/L 

What was range on Ft4 and Ft3 results

Ft4 looks low

ALWAYS test thyroid levels early morning and last dose levothyroxine 24 hours before test

Presumably you have autoimmune thyroid disease, also called Hashimoto’s, usually diagnosed by high thyroid antibodies

Have you seen improvements in symptoms being gluten free?

and dairy free ?

[Marz]

It's very important to create a good environment in your body so the thyroid hormones you are taking are well received and work optimally.

You posted 17 days ago and were asked about your levels of B12 - Folate - Ferritin - VitD. Again in this post. Optimal levels will enhance your thyroid treatment but LOW levels could well be the cause of foggy fatigue. So please post your most recent results so members are able to guide you through the maze. Are you taking any supplements ?

[Jaydee1507 Administrator]

You mentioned in your last post about issues with your bowels. If your gut is not happy then this can result in more brain fog, fatigue and generally feeling awful.

I'd recommend doing a low FODMAP elimination diet, adding in some live yoghurt, dairy free also available. If you haven't tried dairy free then do. Fermented foods can also help repopulate the gut microbiome.

monashfodmap.com/ibs-centra...

T3 doesn't perform miracles overnight. You may not yet be on enough and you definitely need to give it a lot more time.

[starbuck10 in reply to Jaydee1507]

Yes my bowels are terrible i have been gluten free for two years avoid dairy also lactose free milk as well i tend to get a tight cramp like feeling in my stomach then when it eases it feels tender uncomfortable do plenty of walking which helps . I have looked at live yogurt but they all seem to contain dairy also there are so many live bacteria its hard to know which one would suit me .

[starbuck10 in reply to Jaydee1507]

Oh also am vegetarian not sure which foods would be fermented . Would acidic drinks i never seem hungry my stomach feels as though its not producing enough acid .

[Jaydee1507 Administrator in reply to starbuck10]

You can use apple cider vinegar (has to contain part of the Mother, see label), 1 teaspoon in a glass of water before main meal to help acidify your gut.

Finding the dairy free section in any supermarket can be a challenge. Ask staff if you can find one. There are a number of dairy free alternatives or live yoghurt, check the label.

Cocos do quite a nice coconut kefir available in some supermarkets.

Coconut Collaborative do a nice range of dairy free yoghurts, some aimed at improving gut health. Check local supermarkets for stock. coconutco.co.uk/collections...

This link shows a number of ways to improve gut health. Also check out the low FODMAP diet which would be worth doing. Onions & garlic are often the cause of gut issues whilst hypo. joinzoe.com/learn/how-to-im...

[SlowDragon Administrator in reply to starbuck10]

As vegetarian it’s even more essential to test and maintain OPTIMAL vitamin levels

Extremely difficult to maintain good iron/ferritin levels on vegetarian diet

Please add most recent vitamin D, folate, ferritin and B12 results

what vitamin supplements are you taking

[Noree88]

I tried t4 by itself, combo, NDT by itself and combo. None of it worked. If t4 meds drive your natural t3 down and you add t3 to try to supplement, the t3 and t4 fight eachother. Whenever I added them together, both t3 and t4 levels dropped. I’m on only t3 now and although it’s not perfect, it’s far better trying with some form of T4. If you can convert t4 then great but if you don’t then I don’t see why anyone would continue to take it. If it turns down your t3 levels it’s essentially poison.