T3/T4 combo issues: Not sure what to say except I... - Thyroid UK

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T3/T4 combo issues

Joant24 profile image
24 Replies

Not sure what to say except I’m really fed up. It seems as if 15 mcg T3 spread through the day and 75 mcg of thyroxine at night takes its toll on my bowels making them very loose and uncomfortable not to mention embarrassing. Also the extra 5 mcg of T3 gives me palpitations, headache and spaced out feelings. This is not due to over medication as my levels had actually dropped on this dose.

I dropped the mid day T3 and felt much better for a while then I felt under medicated! I decided rightly or wrongly to reinstate the midday dose and here I am on the loo for the 4th time and it’s not even 10:00 am!!

I’m beginning to think that taking Liothyronine is not helping me and wondering if I should go on to just Thyroxine.

I’m going to make an appointment with my Thyroid Dr to see what she thinks but I was wondering if anyone else was having similar issues. I’ve never felt right since on medication and knew it would take time but I feel worse now than when I started.

I would say that due to the many many UTIs I’ve suffered I’ve been on an immense amount of antibiotics over the years and my gut is probably a little delicate and I’ve been referred to a gastroenterologist but heaven knows how long that will take.

I’m sorry to go on and obviously I did have things to say 😂but jokes aside I’m not sure what to do for the best. I think I may have just wanted to say it sort of out loud to people who will understand. My very dear friend recently told me that I have too much time to think about myself and need to just get on with living which caught me off guard to be honest. She said it from love as they say but it still stung and makes you wonder if there’s a grain of truth even though I knew things weren’t right.

sorry again for the moan 🥰

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24 Replies
Bollieforme profile image
Bollieforme

I’m exactly the same! T3 & T4 only difference intake my T4 in the morning. I take a few additional supplements which I think contribute to toilet visits! All about healing the gut maybe? Do you take any supplements?

Joant24 profile image
Joant24 in reply to Bollieforme

Only Vit D, probiotic and folate. I did think about doing the Zoe thing but have heard it’s not for everyone and being over £200 it needs careful consideration. Thanks for replying 🥰

greygoose profile image
greygoose

Does your friend have a thyroid problem? If not, then she doesn't really know what she's talking about. Being hypo and unable to find the right dose is all consuming, and there isn't much of a life to get on with! Right now, you're having to learn to listen to your body and find out what it's telling you it wants. And to learn that you have to listen very hard.

So, give us some more information, so that we can get inside the problem:

- labs before starting T3

- labs since starting T3

- timing of doses

- nutrient status - you need optimal nutrients for T3 to do what you need it to do

- have you ever measured your stomach acid level?

Think that's enough to be getting on with. :)

Joant24 profile image
Joant24 in reply to greygoose

Nope not tested stomach acid, is that the one with bicarbonate? I’m not at home tonight so I’ll get my dates in order tomorrow and get back to you. Appreciate the reply and didn’t want you to think I’m ignoring you 🥰

greygoose profile image
greygoose in reply to Joant24

Yes, the one with bicarb. Hypos often have low stomach acid which makes it difficult to digest food and absorb nutrients. And low nutrients can cause a lot of problems. :)

Moan all you like. I’d advise too that you steer clear of so called ‘friends’ who have such a warped perception of love.

waveylines profile image
waveylines

I think your friend meant well but clearly has never had a chronic health condition, or one that's not been easy to treat!! It's said out of ignorance. Please ignore her or give her a straight talk back!

Re T3. Have you tried halving one of your 5mcg tablets in half? Or are they split already? If split you could try alternate days of 10mcg/15mcg of liothyonine.

JGBH profile image
JGBH

Hi, sorry you’re having a tough time…. Can’t really offer a solution as such but I wonder why you feel the need to split your Liothyronine and why do you take your levothyroxine at night? I take 75 mcg of Levothyroxine and 20 mcg Liothyronine together at 6.30 am and have breakfast at 8.30 or even later on at times. This might not help you… but perhaps it’s worth a try. I am sure someone will be able to resolve this problem. I must admit it’s never totally alright…. but manageable. I had a thyroidectomy in 1980 so once your thyroid has been removed it’s difficult to feel really well. I was only taking Levothyroxine then Liothyronine was added only a few years ago because life had become very difficult. I had to fight very hard and long for Liothyronine to be prescribed. Good luck.

Joant24 profile image
Joant24 in reply to JGBH

I find taking T3 and T4 at bedtime works better for my tummy, if I take it in the morning and then have breakfast I have problems. 🥰

JGBH profile image
JGBH in reply to Joant24

Indeed we all react differently to medication. However we can never obtain perfection with drugs…. It is often a trade off… Most frustrating.

Hennerton profile image
Hennerton

Your cry for help reminded me of myself when I first started T3. It is not easy and must be done very slowly, while your body adjusts to this new amazing thing that has hit it. The lovely Dr Skinner told me to cut the daily dose into tiny pieces and take them at intervals through the day. Gradually my body adjusted but you also need to observe and try to let your body tell you what it wants. Gradually you can take bigger pieces until you reach the point when you can take it at regular times such as twice a day. Even now after many years, I never take a whole tablet in one hit, perhaps because I am very thin and just don’t need large doses. It is all trial and error…. Oh and ignore the friend’s nasty little remarks. She probably means well but nobody, unless they also have a thyroid problem, can understand what you are going through.

Joant24 profile image
Joant24 in reply to Hennerton

Thanks for reply, I’ve been on T3 combo for nearly a year I think and started really slowly as recommended which is why I’m so fed up. I’m not at home tonight but will reply to Greygoose with timings etc tomorrow when I’m home. 🥰

Hennerton profile image
Hennerton

p.s I just looked back on my notes at that time and I was only taking 5 mcg a day for a week and then added another little crumb the second week and built up slowly. This should help your bowels adjust

SlowDragon profile image
SlowDragonAdministrator

Looking at previous post with full results 3 months ago

healthunlocked.com/thyroidu...

High thyroid antibodies

Are you on gluten free or dairy free diet

Which brand of levothyroxine and which brand of T3

What are your more recent thyroid results?

Brightness14 profile image
Brightness14

I have absolutely no Gut problems at all but after starting on T3 I had exactly the same problem as you have. Now my body has adjusted to it after nearly one year. I cannot take more than 6.25 i.e. one quarter at a time. I did start with eights such a pain.

I do take 25T3 a day but split into four takes.

I am now going back onto NDT which suited me for years.

Joant24 profile image
Joant24 in reply to Brightness14

I tried NDT first but couldn’t get with it at all. I think my T3 has been consistently at the bottom of range for so long that it’s maybe a shock to the system to be somewhere more sensible. 🥰

Brightness14 profile image
Brightness14 in reply to Joant24

I take Thyroid s which I had been on for over seven years and feeling very well.

I have started back on just 1/4 grain at 6am and another 1/4 grain at around 1.30 pm

I will increase by just 1/4 grains in the AM in around 10 days time.

I am topping up with some 6.25 of T3 in between. I have only just started but feel better already, Levo doesn't suit me.

What NDT did you try and how did you start. The Armour is very like T3 fast acting but the Thyroid s has a coating so much slower release.

My FT3 has to be above 6 for me to feel well.

shaws profile image
shawsAdministrator

I now take 30mcg of T3 daily (when I awake along with a glass of water and wait an hour before eat I eat)

I have no symptoms and feel I have normal health.

25mcg of T3 is approx equal to 100mcg of levo.

I cannot take levo as it gave me awful palpitations and I feel very unwell on it..

Joant24 profile image
Joant24 in reply to shaws

I think I might spend the day locked in the bathroom if I did that! 😂. Brilliant to know you’ve got it all sorted now, gives me hope.

Brightness14 profile image
Brightness14 in reply to shaws

I think that the Levo has increased my Heart Rate.

DippyDame profile image
DippyDame

Your "very dear friend" clearly has never suffered thyroid or bladder problems....you need help not trite advice.

Your last labs show FT3 right at top of range.

It's within range but that doesn't mean you are not taking over the dose you need!

We aim to take the lowest effective dose not the highest dose we can tolerate....there is a difference.

I'd suggest the following ...

1 Reduce T3 dose by 5mcg...symptoms suggest overmedication

2 Wait at least 2 weeks then increase levo by 25mcg...you have room to increase and your system may tolerate it better than T3. It should convert to a little extra T3.

3 Follow a gluten free diet - high antibodies/ Hashi's

4. Try taking the hormones at new times of day

5. Optimise. vit D, vit B12, folate and ferritin - esential to support thyroid function

Test again after at least 6 weeks on a steady T4/T3dose

By then you will be able to judge how you feel in relation to the new dose and results should point the way forward.

I have had Chronic UTIs for years and I need high dose T3-only to function so I understand your challenge

cutic.co.uk/what-is-chronic...

The abx can cause havoc with the gut...adding Vit C can help but it must be good quality. I started with a cheap effervescent one 1000mg ( Prescribing nurse suggested it) My innards rebelled....now using Solgar capsules which are fine

Have you tried Hiprex + vit C instead of abx.

Vit C acidifies the urine to help absorption.

Also, re vit C....

People who are hypothyroid and especially those with Hashimoto's are likely to have low stomach acid levels. The science also shows us that hypothyroidism can actually lower this stomach acid level.

Your antibodies are high/ Hashi's

It's vital that we learn to listen to our body....an old medic friend told me that many years ago. Said it's like a car engine, it will tell you when something is wrong!!

I've been in many awkward and embarrassing situations with both the CUTI and IBS ....have learned how to cope a little better now!! I'm convinced, that in my case, both are the result of decades of low cellular T3...andof listening to my body.

Good luck!

Joant24 profile image
Joant24 in reply to DippyDame

I think you are right in saying I possibly don’t need a high T3 result and that years of being low in range has taken its toll. I’ve stopped my lunchtime dose of T3 I couldn’t go through another episode of symptoms again. However I do feel the under active symptoms come back without it hence the recent UTI. So maybe upping Thyroxine to 100 mcg might be the answer.

Already on Hiprex but not with Vit C! I haven’t got round to buying Vit C but will give it a go toot sweet.

Thanks for reply 🥰

locky8 profile image
locky8

For the uni's try taking cranberry tablets. Solgar are my brand of choice as high strength so one a day.They put a lining on the bladder to stop bacteria taking hold.For the T3 I'm on 20mg taken 10mg twice a day and don't seem to have any problems but I do take marshmallow root capsules as I had gastritis and a haitus hernia and they line the digestive tract. I also take Gaviscon.

The other thing I thought is maybe you have intolerance to the fillers and wondered if you've tried different brands as they often have different fillers. 🤔 I take Morningside brand but I have taken others.

Hope you find a solution.

underact15 profile image
underact15

Following with interest and hoping you're ok! I've been battling increasingly horrible symptoms for 3.5 years now (on levo only - various doses - first diagnosed post childbirth in 2015) and I've finally been prescribed T3 thanks to the DIO2 gene test (which I learnt about on here) - phew! I'm now concerned that it's not going to make me feel better and I'll be back to square one but at least I will be trying it I suppose! The joys of thyroid disease hey....and as for your friend, I've actually been trying out the whole "get on with it" mindset for years and it doesn't make a difference - my symptoms are very much still there and they very much still affect my day to day life, it's rubbish! I do think I'd potentially feel worse if I gave up completely though, we've got to have hope haven't we!? Really hope you're ok and here's to finding the magical dose very soon! x

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