Advice on results following T3 trial please

[Hopetoheal22]

Hello, I hope everyone is well.

I’d be really grateful for any thoughts on my results following a 3 months trial of  T3. I built up slowly to a dose of 20mcg (10mcg in the morning and 10 in the afternoon and have been on full dose for the last month) alongside T4 of 100mcg, taken in the morning. Endo asked me to decrease T4 from 100 to alternate 50mcg one day and 75mcg the next, so I tried to lower a little but felt wiped out, so stayed on 100.

I’ve got hashimotos. Antibodies not tested (I did ask) 

Results (with ranges) after trial below:

T4   17.1   (12-22)

T3    6.6    (3.1-6.8)

TSH   Less than 0.014 mU/L 

They didn’t test ferritin (I did ask them to)

Vitamin D 137 (>50)

B12.     690 (197-771)

Results in Jan BEFORE starting T3: 

T4  14 (12-22) 

T3   2.5 (3.1-6.8)

TSH   0.38

Ferritin 46 (it’s often been in the 30s, doctors always say it’s fine as in range)

Vitamin D 131.8  (>50)

B12    758 (197-771) 

So T4 looking better now and T3 gone from off the bottom of the scale to nearly the top.

I am feeling generally better - a bit more energy, sleeping better and digestion much better - I have SIBO and the bloating has been loads better.

But still massive energy crash at 3pm and struggle in the afternoons. And feel wiped out the day after a lot of exercise (I’m always on the go) and often hungover in the mornings (I rarely drink alcohol)

 I am perimenopausal which doesn’t help symptoms! Also have two young kids, so life is very busy. Have brain fog and my mood is generally lower than it used to be.

I suspect endo won’t like my low TSH and high T3, and will want to reduce T3, I don’t mind halving it, but suspect I’m super sensitive to any reductions as I have been in the past. I don’t feel over medicated - some palpitations but I’ve always had those.

Would love your thoughts so I’m prepared for my review with the endo next week.

Thanks so much, I’m so grateful for your advice 

[SarahJane1471]

A good Endo will know that T3 reduces TSH significantly. If you feel pretty well on the dose you are on then ask to stay as you are for another three months. Explain you don’t feel overmedicated ( don’t tell him about the palpitations if you have always had them). A good Endo will listen to you.

[Hopetoheal22 in reply to SarahJane1471]

thank you SarahJane. Endo reduced my levothyroxine last time as TSH was v low and I totally crashed! So I hope they’ll understand not to do that this time, I’ll stand my ground 😊 thank you for your advice

[tattybogle]

If you'd only been on 20mcg T3 for 4/5 weeks before testing , then that's a bit too soon to decid how it feels / or to test .

your symptoms may still change over the next few weeks on 100/20. and so may your bloods .. so do bear that in mind .

It might be a good idea to stay on this dose for another month/ 6 weeks , and then repeat TSH / fT4 / fT3 , to see where you , and how you feel once the body has had enough time to properly acclimatise to 100/ 20 dose .

How many hours from last dose T3 to this test ?

fT3 is right at the top , and assuming you delayed taking evening dose so it was tested 8-12hrs as recommended , then that means that your fT3 is going quite a lot over range for a few hrs , twice a day. (which isn't necessarily a problem , but it's good to be aware that this is what will be happening).

If you do want to try a slight reduction at some point , then don't assume that just because you previously crashed when levo was reduced to 75, that you will still crash if you reduce levo now that you are taking T3.. you might not need so much levo now the T3 level is so much better

if you reduce either levo or T3 then:

a) reduce by a very small amount , eg 12.5mcg levo rather than 25mcg / or 5 mcg T3

b) always give a reduction at least 6 weeks for symptoms to settle ,.... don' t make your mind up during the first 5 weeks .. it is common to feel undermedicated for a few weeks after any dose reduction , but this doesn't mean it will stay feeling that way once the body has had time to adjust itself .

[Hopetoheal22 in reply to tattybogle]

thank you so much tattybogle, very good points -

I’ll request another blood test in six weeks and yes I must be going over range quite a lot as I took my last dose 10mcg of T3 13 hours before the blood test I think. Last dose of T4 was 26 hours before test.

I’ll reduce slowly if required, I’ll see what the next test says. Thanks again, really appreciate your advice and hope you’re well 😊

[KHSC]

Hello

I am also trialling T3.

My endo asked me to cut out sugar and carbohydrates (which I did with difficulty!) but it completely cured the 3pm crash.

Just a thought.

[Hopetoheal22 in reply to KHSC]

hi KHSC, thanks so much for that - that’s a really good idea. Amazing that you managed to cut carbs and sugar out! I’m v low sugar but feel extremely tired without carbs, I have tried to reduce and lost weight (not good as I’m underweight) I always eat them with protein. Would you mind sharing an example of what you eat for lunch and breakfast?

How else are you feeling on the trial? Hope it goes well and thanks again 😊

[KHSC in reply to Hopetoheal22]

Hi Hopetoheal22

I am 4 months into trial and feeling okay. It's been slow but starting to feel like myself again. I am about a stone lighter but now back to ideal weight.

I am trying the 16:8 so only eat in an 8 hour window (which I find easier than I though).

I don't eat breakfast but do have an early lunch. Lots of salads with cheese or egg, or an omelette is a normal lunch. It's not easy but is doable. I had cut down on sugar so cutting it out wasn't too bad but I do miss it occasionally!!

The endo has said it is a short term fix and once I start to feel better and the results improve and I reintroduce carbs and then sugar if I am missing them.

Good luck with your journey and I hope you start to experience some positive results soon 😊

[SlowDragon Administrator]

Suggest you try splitting as 3 doses T3 per day

10mcg waking, 5mcg 2-3pm and 5mcg at bedtime

Day before test make sure last 5mcg dose is 8-12 hours before test

You may need to reduce T3 to 3 x 5mcg in few months time

Are you gluten or dairy free

[Hopetoheal22 in reply to SlowDragon]

hi SlowDragon, hope you’re well. Thanks so much for your reply. I’m gluten free, don’t eat much dairy. My last T3 dose was 12 or 13 hours before the test. T4 26 hours before. Good idea to split the dose in 3, wonder if it might help my 3pm crash. Not sure if I can quarter the pills as halving just about works. I’ll try. Yes may need to reduce, I’ll ask to be tested again in six weeks as suggested by tattybogle.

Thanks so much, really appreciate your advice 😊

[SlowDragon Administrator in reply to Hopetoheal22]

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