Just found this , July's guidelines BTA

[Polo22]

Haven't ad time to read and process it all, just thought others might be in terested

british-thyroid-association...

[Polo22]

Not so impressed with BTF

FT3

This is usually only used in testing for hyperthyroidism or assessing its severity.

[greygoose in reply to Polo22]

As one doctor said to me 'T3? Oh, that's something to do with hyperthyroidism, isn't it?' They haven't got a clue!

[Polo22 in reply to greygoose]

It would be hysterically funny if it wasn't so bloody important

[greygoose in reply to Polo22]

Exactly.

[tattybogle]

i'm going to add this quote to my list of references advising GP's to keep TSH lower in patients on levothyroxine

" In those with established overt hypothyroidism, levothyroxine doses should be

optimised aiming for a TSH in the 0.3–2.0 mU/L range for 3 to 6 months before a

therapeutic response can be assessed. In some patients, it may be acceptable to have

serum TSH below reference range (e.g. 0.1–0.3 mU/L), but not fully suppressed in

the long term."

the rest of the consensus statement is disappointing regarding liothyronine , but the 0.1 -0.3 bit is particularly useful for levo patients struggling to get GP's to allow a 'low but not supressed' TSH.

healthunlocked.com/thyroidu.... my-list-of-references-recommending-gps-keep-tsh-lower-in-range-

[tattybogle in reply to tattybogle]

The dosing guide for adding T3 is a bit of an improvement over the usual 'reduce levo by 50mcg in everybody'.

they now have " Substitute T3 at 1:17 of current Levo dose , reduce levo by 3 x T3 dose" ,

eg:

100mcg Levo ~ replace with 5mcg T3 + 85mcg levo

125mcg Levo ~ replace with 7.5mcg T3 + 100mcg levo

[Polo22 in reply to tattybogle]

I was going to ask about this, it's easier to understand they way you have written it. I am having a bit of a stressful time at the moment, and clarity of thought is somewhat lacking. So Thank You. Hoping my repeat HbA-1c comes back improved /lower and then going to try and get a GP appointment to come clean about self medicating T3.

[SarahJane1471]

Having just got back from my Fatigue Management course I wasn’t sure I had the energy to read these guidelines. But I did and although they trot out the usual guff it also seems a little more positive re trials of T3. Or is that just my addled brain not reading it right 🥴. As tattybogle says there is the useful table AND acknowledgment of some people needing T3…… oh AND that Overt Hypothyroidism is not just a TSH over 10 but can also be under range FT4 ( which was my case).

Looking forward to other people’s views