Hello there,
I was on 100mcg T4 daily.
I was started on a trial of 5mcg T3 alongside 75mcg T4 four weeks ago due to being highly symptomatic and having a poor conversion rate. My TSH was 0.87 and now it’s 3.6.
Do I keep the T3 at 5mcg and increase my T4 to 100mcg. Or as I’m feeling better on the T3 do I increase my t3 to 2x 5mcg doses throughout the day and stay on 75mcg T4.
Thankyou for any advice, I can’t get hold of my GP.
Sam x
Do you have blood results with ranges to share? We can really only go by those.
Get tested after you have been on a stable dose for 6-8 weeks, longer is better. Be sure to test with the recommended protocol.
Recommended blood test protocol: Test at 9am (or as close as possible), fasting, last levo dose 24hrs before the blood draw, last T3 dose 8-12 hours before blood draw & no biotin containing supplements for 3-7 days (Biotin can interfere with thyroid blood results as it is used in the testing process)? Testing like this gives consistency in your results and will show stable blood levels of hormone and highest TSH which varies throughout the day. Taking Levo/T3 just prior to blood draw can show a falsly elevated result and your GP/Endo might change your dose incorrectly as a result.
What supplements are you taking?
5mcgs T3 is a pretty small amount so its likely that will need to be increased.
supplements I take are vitamin D, magnesium, iron. Blood tests are taken between half 8 and half 9. Last dose of T4 taken 24hrs before.
Please find latest labs with range…
TSH 3.39 0.27- 4.0 mu/l
T4 16.2 11.30 - 21.6 pmol/l
x
You said you have been on T3 for 4 weeks. It takes 6-8 weeks for blood levels to stabilise, so you need to retest in 2 weeks at the earliest for an accurate result.
Now that you are on T3 you have to get an FT3 result as TSH becomes irrelevant of dosing correctly. Taking T3 often suppresses TSH.
Follow protocol advised by SlowDragon for the blood test.
just testing TSH is completely inadequate
Day before test split T3 in half….take half waking and half 8-12 hours before test
Last dose levothyroxine 24 hours before test
Do you always get same brand levothyroxine at each prescription
What were Ft4 and Ft3 BEFORE adding T3
When were vitamin D, folate, ferritin and B12 last tested
What vitamin supplements are you currently taking
List of private testing options and money off codes
thyroiduk.org/getting-a-dia...
Medichecks Thyroid plus antibodies and vitamins
medichecks.com/products/adv...
Blue Horizon Thyroid Premium Gold includes antibodies, cortisol and vitamins
bluehorizonbloodtests.co.uk...
Monitor My Health also now offer thyroid and vitamin testing, plus cholesterol and HBA1C for £65
(Doesn’t include thyroid antibodies)
monitormyhealth.org.uk/full...
10% off code here
thyroiduk.org/getting-a-dia...
Only do private testing early Monday or Tuesday morning.
Link about thyroid blood tests
thyroiduk.org/getting-a-dia...
Tips on how to do DIY finger prick test
healthunlocked.com/thyroidu...
Medichecks and BH also offer private blood draw at clinic near you, or private nurse to your own home…..for an extra fee
obviously the questions and replies from others are things you need to sort, but my remark is - you might find 25mcg too large a reduction for just 5mcg of T3 added.
See how everything goes, but you might need to take 5mcg T3 twice a day or add a little levo back (100, 75 on alternate days).
Not saying this is correct for you, but it’s what I needed. Am well aware that we are all different though.
Making sure all vits and minerals are good as recommended is very important.
Didn’t realise this was your first post
So a belated “welcome to the forum “
Next step is to test full thyroid and vitamins
As you know you have Hashimoto’s you could use MMH
Monitor My Health also now offer thyroid and vitamin testing, plus cholesterol and HBA1C for £65
(Doesn’t include thyroid antibodies)
monitormyhealth.org.uk/full...
10% off code here
thyroiduk.org/getting-a-dia...
When were folate, B12 , vitamin D and full iron panel last tested
How much vitamin D are you currently taking
Many (most?) Hashimoto’s patients need to supplement vitamin D, magnesium, vitamin B complex daily
Some need separate B12 initially (or ongoing if vegetarian or vegan)
If supplementing iron test full iron panel 3-4 times a year (via Medichecks if GP unhelpful)
As you have Hashimoto’s
A) have you had coeliac blood test
B) are you now on strictly gluten free/dairy free diet
Which brand levothyroxine are you currently taking
Is this same as when on 100mcg dose
Important to know what Ft4 and Ft3 were before starting T3 and before Levothyroxine was reduced
I think I am missing something. Since her T4 was close not even close to the top of the range, why would it be reduced? Wouldn't it make more sense to keep the T4 the same and just add a little T3 and go from there? It seems like this will add to the confusion of what works and what doesn't work.
HeartWoman ,
we don't know what fT4 was before it was reduced, it may have been at top of range then .. but even if it wasn't , Endo will just be following the guidelines they are given for starting combination therapy . nearly all guidelines say "reduce levo by 'x'....and replace with 'x' T3... with very little consideration given to where fT4 is in range.
Their main interest is keeping TSH in range, so they reduce Levo as a matter of course because they know adding T3 will lower TSH.
If they were using their own brains , then yes , they wouldn't necessarily need to reduce Levo unless T4 was high in range.... but they are not encouraged to use their own brains.
Yes I was reduced to 50mcg levo as I added in more T3 which made me feel super unwell :/ Iv popped a new post up with all recent reports and what my levels where before t4 supplementation x
Help with not tolerating T3 Liothyronine 
Need advice on titrating Cytomel!
starting T3 - advice welcome 
