Lowering T3 dose

[lisan1]

Would it be on to lower dose by 10mcg in on go or shall I start with 5mcg?Feel what I think is overmedicated since stopping propranolol. Latest results on 87+20 is

Ft3 5.2(3.5-6.5)

Ft4 17 (12-23)

[SeasideSusie Remembering]

lisan1

T3 should be reduced by 5mcg at a time, not more. I think 5mcg might be enough anyway, you're not over range. Wait 6-8 weeks for levels to settle to retest and see how you feel.

[lisan1 in reply to SeasideSusie]

Do you think lowering T3 or T4 would be best option? Was thinking T3 since propranolol lowers T3 and the results were on propranolol so t3might have increased since stopping.

[SeasideSusie Remembering in reply to lisan1]

I would lower T3, your FT4 is only 45% through range yet your FT3 is 90% through range.

[Jaydee1507 Administrator in reply to SeasideSusie]

Free T4 (fT4) 17 pmol/L (12 - 23) 45.5%

Free T3 (fT3) 5.2 pmol/L (3.5 - 6.5) 56.7%

lisan1 mistyped results.

[Jaydee1507 Administrator]

What was the timing of your last dose of levo & T3 before this test? Recommended timings are 24hrs for levo & 8-12hrs for T3.

Free T4 (fT4) 17 pmol/L (12 - 23) 45.5%

Free T3 (fT3) 6.2 pmol/L (3.5 - 6.5) 90.0%

If you allowed the correct timing for T3 in particular then a 5mcg drop is what I would go for.

You may need to raise your FT4 in time. Some people do OK with a lowish FT4, others need it up at around 70% of its range.

How are you doing with vitamins? What are you taking and what were your latest results?

[lisan1 in reply to Jaydee1507]

I changed ft3 results to 5.2 I didn't realise that I miswrote.

[Jaydee1507 Administrator in reply to lisan1]

Free T4 (fT4) 17 pmol/L (12 - 23) 45.5%

Free T3 (fT3) 5.2 pmol/L (3.5 - 6.5) 56.7%

In that case you are under replaced and not over. Would recommend increasing levo.

The symptoms of under and over replacement can be very similar and quite confusing when you are experiencing them!

How are vitamin levels?

[lisan1 in reply to Jaydee1507]

Vitamin levels are ok.How would you proceed? When on propranolol I tried to increase levothyroxine to 100 but felt overmedicated.

[SeasideSusie Remembering in reply to lisan1]

In that case I agree with Jaydee, possibly undermedication is causing the palpitations and if you optimise your levels this may be the answer. However, we have to bear in mind that palps can be caused by other reasons.

[lisan1 in reply to SeasideSusie]

The main symtom I have since stopping propranolol is that I'm irritated. How would you proceed. When on propranolol I tried to increase levothyroxine to 100 but felt overmedicated.

[SeasideSusie Remembering in reply to lisan1]

I'm sorry, I have no experience of this to draw on. I take Bisoprolol and have no problems, I understand that it's Propranolol that interferes with thyroid and I've never taken that.

With combo meds it's a case of finding what levels suit you as an individual. With your results the FT4 would be fine for some people as long as FT3 is higher. Others would need them to be fairly well balanced, more or less as they are, but both higher in range. So it's very difficult to guide people who are on combo meds other than to say take your time to make small tweaks in the hormones (but never both at the same time) to find what suits you, and this can take a long time.

These can be signs of hypothyroidism:

Easily upset

Wanting to be solitary

Mood changes

Depression

Nervousness

Anxiety

Personality changes

and these can be signs of hyperthyroidism

Mood changes

Nervousness

Anxiety

so you can see how symptoms can overlap at times.

[SlowDragon Administrator]

Propranolol slows up using thyroid hormones

Because you have stopped propranolol your body is likely realising it needs MORE levothyroxine or T3 not less

How long since you stopped propranolol?

[lisan1 in reply to SlowDragon]

A month

[lisan1 in reply to SlowDragon]

I don't understand this I thought propanolol made ft3 lower than without?

[SlowDragon Administrator in reply to lisan1]

it slows up thyroid hormone being used (and also slows up converting Ft4 to Ft3)

So now you are using it up quicker and converting quicker