Advice/assistance regarding starting T3.

[Beads]

Most recent results, Monitor my health 24/7/2023

TSH 0.3 (0.27-4.2)

FT4 20 (12-22)

FT3 4.2 (3.1-6.8)

Vit D 117 - their ranges are just lines on a graph but it’s in the excess category.

VitB12/folate/ferritin- I have a replacement kit (which I forgot to do this morning) due to blood clotting so they couldn’t do the tests. Results from February were happily in the optimal range.

Blood removed forcibly (stab, stab, stab, ouch) from my body when I got up, so about 7am, last dose of levo was about 25hours beforehand. I take 125ug 4/7, 100ug 3/7. Levo only. At the moment.

Continuing symptoms include total lack of energy, everything is a massive effort, there’s brain fog (my memory is shot, I’m getting more and more forgetful), air hunger is back, nails are breaking again.

I have just got off the phone with a private endo, she agreed that I might feel better if I add a little T3 to my levo. She’s prescribed thybon henning, 20ug tablets, I’ve paid for them and shall be stalking the postie until they arrive. She said to start off with a quarter of a tablet (5ug) for a couple of weeks, if I don’t feel I’m getting much benefit then after a couple of weeks to increase to half a tablet. Do another blood test in 3 months, book another appointment with her to discuss.

So, background done, now to the advice.

How to start? I should reduce my T4 to 100 every day or a bit more? Previous blood tests when I was taking 100ug per day had T4 about 18.4 (12-22), so about 60%. Then when the T3 comes start on quarter of a tablet or go a bit slower? I have a pill cutter, can get a scalpel.

Right, here’s the important part. I’m off on holiday on 20th August. Do I start as soon as I get the pills and hope it all goes okay. Or wait until I get back, 27th August? At the moment I feel really lousy, worse than normal, I got a pack of Aristo brand levo that I was 3/4 of the way through when I realised I felt worse than normal, so ditched the rest of that pack and am back on Accord, have been for 4 days. Do I feel worse because of the brand or just because of the low T3? I won’t enjoy my time away if I feel like I did last week, so is it sensible to start before I go or not?

Current supplements include cod liver oil (which has a tiny amount of vit D), calcium, magnesium and zinc (again with a tiny dose of vit D), B complex, and plenty of sunshine.

Diagnosis: autoimmune thyroiditis, multinodule goitre, calcified thyroid cyst, many other thyroid cysts.

[Lalatoot]

Personally I would wait till I came back from holiday. When I started t3 at 5mcg per day I felt a bit sicky and headachy for 2 days Reduce your levo dose slightly if you wish but I would leave it where it was.

I would add 5 mcg for 1 or 2 weeks then if all ok add another 5mcg either as a separate dose or added to original dose

I would stop there and then do bloods after 6 or 8 weeks. Then if ft3 still low in your opinion add in another 5 mcg. I kept going and added in the full daily 20mcg dose then found I needed to backtrack as it was too much. I now take 7.5 mcg t3 daily.

[SlowDragon Administrator]

when were folate, ferritin and B12 last tested

I would let Accord brand settle back in and start T3 AFTER your holiday….it’s not always plain sailing

Starting on only 5mcg ….after week or so add 2nd 5mcg dose

When you Add 2nd dose T3 would suggest you add as separate dose Approx 10 hours after first dose

As to wether you reduce levothyroxine…..yes perhaps to 100mcg daily

[Beads in reply to SlowDragon]

Last tested February.

Ferritin was 129 (?15-450)

Active B12 104 (?37-210)

Folate 13.3 (?4-25)

Will be tested again next week, so long as I remember to take the test upstairs and take the sample. The ranges are as close as I can figure from MMH.

[SlowDragon Administrator in reply to Beads]

So all look good

[McPammy]

I’d reduce the T4 ever so slightly as you are very near to being over medicated as your TSH reflects. I’m a great believer in adequate thyroxine in the system not flooding it. Don’t overdo it as over medication often feels very similar to being under medicated. Take the 5mcg once a day to start with maybe as you get up. You might feel a dip in the evenings though. Then add a second 5mcg 8hrs apart once you feel confident and ready. My T3 doesn’t go above 5.6 ( 3.0-6.0) and that’s 2hrs after taking my 5mcg T3. If I haven’t taken T3 before the blood draw is usually around 4.5. I like to know how low and how high it gets. It can be quite subtle when you take it for some or a huge energy boost.

[Beads]

Thanks all, I’ll take the chance of feeling a bit worse and reduce to 100 7/7 when I top my weekly pot up on Sunday, then start the T3 when I get back. 2 weeks should be fine for the reduction before adding in T3?