T3 what amount per day do you take

[Lilylui]

I am on T3 15 mcg x2 a day.

my tsh is going up again I got it down from 108 to 20 it is now going up to 30.

My weight is increasing I had managed to lose 1.5 stones and got bmi into normal levels 24.2 that has increased to 25 today.

I feel I need to increase my T3 liothyroine a bit more, I was due to see endro in March but due to strikes etc that is now put back to July, my GP can’t help either he says.

I thought of increasing slowly by 5mcg up to 40mg will this be too much?

I do have P-AF possibly caused by the thyroid.

[Mollyfan]

Could you ask the GP to contact endo and ask for advice. It is not right for you to be left with a TSH of 30 for 3 months.

[Lilylui in reply to Mollyfan]

endro doesn’t want me on it but gp knows he thought I was seeing him in March as well

[Buddy195 Administrator]

Lilylui, can you share your most recent thyroid blood test results and ranges for TSH, FT3 and FT4? TSH should be under 2, with most members noting they feel best with levels under 1. Have you previously been on a higher Liothyronine dose? Have you tested key thyroid vitamins recently (ferritin, folate, B12 & Vit D)? Having these optimal improves thyroid health.

[Lilylui in reply to Buddy195]

my mot recent blood test was tsh 30 they did not check for anything else! Previously my ranges were all out when my tsh was 108 I had put them on a previous post a while ag9 but can’t find them now

[Buddy195 Administrator in reply to Lilylui]

 You could look to test FT3 and FT4 privately, as many forum members do, for a better picture of your thyroid health: thyroiduk.org/help-and-supp...

Have you tried Levothyroxine in the past or combination treatment (Levo plus Lio)?

[Lilylui in reply to Buddy195]

I wanted to do that via medicheck but live in rural mid wales and can’t find anyone to draw blood at all ! I even asked at the doctors surgery, tried a radius of 20 miles, the ones where you prick your finger and draw blood I can never get enough blood out, so not sure what to do as would like to know what my reverse T3 is

[SeasideSusie Remembering in reply to Lilylui]

Lilylui

so not sure what to do as would like to know what my reverse T3 is

Check out Medichecks and Blue Horizon, they both offer home nurse visits for blood draw but of course it increases the cost of the test.

It's a waste of money testing rT3, it cant tell you anything more than what looking at FT4 and FT3 can tell you. There are a many reasons why rT3 can be raised, only one of them is to do with the thyroid and that is when there is an excess of unconverted T4. You take T3 only so your T4 will be very low so it wont be possible to have excess unconverted T4. Save your money.

[SlowDragon Administrator]

What are actual Ft3 and Ft4 results

Last dose T3 should be 8-12 hours before test

Also important to test vitamin D, folate, ferritin and B12

what vitamin supplements are you taking

Suggest you increase T3 by 5mcg

Perhaps try taking T3 as 3 doses per day

15mcg waking, 10mcg mid afternoon and 10mcg towards bedtime

Do you always get same brand T3 at each prescription

[Lilylui in reply to SlowDragon]

yes same brand it is Roma

I thought of getting it up to 40 mcg as I buy Teva ones so had some left

[SlowDragon Administrator in reply to Lilylui]

only increase by 5mcg at any one time

Then wait 6-8 weeks to retest

[radd]

Lilylui,

If you are medicating T3-only the usual daily dose is between 50 - 75mcg (as quoted by Antonio Bianco during his recent interview). A raising TSH evidences you are under medicated. Healthy heart function relies on adequate amounts of thyroid hormone.

[Lilylui in reply to radd]

that’s what I thought but was worried it would start AF off, endro isn’t great either he disagrees with T 3 but I saw him private first then on nhs so pushed him to let me have it. He says it causes AF but too be honest he is a diabetic specialist not thyroid

[radd in reply to Lilylui]

Lililui,

Both high cholesterol and homocysteine results from too little thyroid hormone and contribute towards cardiac issues. The heart also needs adequate thyroid hormone to function properly as in contracting and pumping blood. Other common causes of Afib are low iron and/or cortisol.

Others have suggested doing TFT's to ascertain what your levels are.

This is from the GP Online website -

Endocrinology - The thyroid and the heart. .. gponline.com/endocrinology-...

[Lilylui in reply to radd]

where will I find this interview please?

[radd in reply to Lilylui]

youtube.com/watch?v=PGlYO_H...(Not working as expected?)

[radd in reply to radd]

Lilylui,

The reference to taking T3-only in 50 - 75mcg is in the Q & A at the end, probably about the fourth or fifth question.

Although I recommend you to listen to the whole talk because it is very informative, and only about 1 hour.

[Aurealis]

your TSH is going up and you feel that you need to increase liothyronine… what further info do you need?

I don’t find weight a reliable guide - my appetite increases and so, so does my weight if T3 dose is too high.

[Lilylui in reply to Aurealis]

just starting to feel like I did before T3, extreme tiredness, aching, just don’t have energy for anything also getting breathless as more weight going on.

[Aurealis in reply to Lilylui]

so you’re confident an increase in dose is needed…

[Lilylui in reply to Aurealis]

yes think so just really wanted to know what amount others take

[Aurealis]

high doses of Levo over time have been shown to cause AF. Like you, I have AF and I wouldn’t make a big increase in T3 dose as it can cause palpitations and you could end up in A&E

[Lilylui in reply to Aurealis]

I can’t take Levo at all he put me into a@e although Aug/Sept/oct 2021 then in hospital for 5 days.

I have started a 50mg dose every 14 days now again, I used to take 250mcg a day for 10 yrs and a lower dose before that without problems but can’t anymore

[AKatieD]

Good news is T3 acts quickly so you will know within a few days what the effects of increasing the dose is. Steady state is achieved in days.

You can test after a week so no need to wait several which is much better than T4 which takes ages to know the impact of dose change. It also means, if you are worried about AF, that if you have a problems after an increase in dose you can go back down again and the effect will stop quickly.

As the others said, if you cant do the finger prick yourself then Medichecks etc offer other ways of getting a sample done.

I found some tricks that really helped though if you want to try again. That was, to have a warm bath and not rush the test in the morning. Drink plenty. Then one firm supplies a small elastic band to go at the top of your finger, tight but not very tight. Pop that on and the blood seemed to drip freely from that finger, when without I did have trouble getting any out.

Best of luck

[tattybogle in reply to AKatieD]

i would say there is still a need to wait 6-8 weeks to test reliably ,even when only changing the T3 dose .. T3 is short acting, true ,so a stable blood level from a new dose is reached sooner than it is for T4 dose change (a change to T4 dose would take about 3/4 weeks for fT4 level to be stable).......... BUT the changes the new dose brings about in the body are not limited to just that initial increase / decrease in T3 ( or T4) level .

A change in T3 (or T4) level will have effects on the deiodinases, which will take considerably longer than few days to show up and stabilise,...eg. speeding up or slowing down the rate of clearance of T3 to T2 .. speeding up or slowing down the rate of conversion from T4 to T3 and affecting amount of T4 converted to Reverse T3 instead of T3.

Also the TSH has a small effect on deiodinaes too .. and since it takes TSH a few weeks to respond to a new level of thyroid hormone .. the fT3 and fT4 results you get at 1/2 weeks may well be significantly different at 6-8 weeks .

[AKatieD]

Thanks Tattybogle. While I understand where you are coming from, I don't agree entirely.

If you want to know the impact of a change of T3 dose on your T3 levels, then an early test is very useful. STTM say you can test after a week and I certainly have found it very helpful to have a quick indication of how far through the range the new dose has taken me compared to the old.

Not all of us convert T4 to T3 well, so the diodinase impact may be less important for many of us on here.

With regard to TSH, many of us also have negligable TSH following suitable treatment and so any change in that would also be negligable.

That is not to say a later test after several weeks is not useful too. But the early indication (with later follow up) is a very valuable initial indication rather than leaving you wondering or feeling rough for weeks.

[tattybogle in reply to AKatieD]

i agree , having an early peek at results is useful/ interesting... and waiting longer is probably less likely to have as much impact on bloods when taking T3 if TSH is low anyway , than it does when we change levo dose and TSH is higher .. i was mainly clarifying that another test at 6-8 weeks could be different from week 1/2 results and to always bear that in mind , and more importantly that symptom response to a new dose of T3 may well change after a week or two . cos there's a lot going on behind the scenes when we change dose .. more than just the initial change in blood levels.

Regardless of how well we convert T4>>T3 the effect of the deiodinases is still relevant and will presumably take it's effect over a longer time than a week in response to different level of T3 .. eg they control speed of converting active T3 to inactive T2 for example.. and T4 to Reverse T3.