Trying to balancing T3 and T4

[hobbycat]

Sad and disappointed to be here asking for help yet again. Yes, I have been chopping and changing my doses desperately trying to find my sweet spot, not knowing who or what to believe.

My latest results are :

June 23 (0n 118mcg T4 and 17.5mcg T3) (bloods taken 9am before morning meds)

TSH 0.01 T3 5.3 (87%) and T4 13.6 (46%) (feeling exhausted still)

Aug 23 (0n 125mcg T4 and 17.5mcg T3)(bloods taken 9am before morning meds)

TSH 0.01 T3 5.2 (81%) and T4 15.6 (65%) (feeling exhausted still)

Nov 23 (0n 125mcg T4 and 17.5mcg T3) (bloods taken 3pm after morning T4 and T3 and lunchtime T3 meds)

TSH 0.01 T3 6.0 (109%) and T4 15.7 (66%) (feeling exhausted still & overmed)

Prior to the last test I had tried to reduce my T3 by 2.5mcg and 1.25mcg but quickly my cognition and memory declined and it was clear to me that I need this T3, so I put it up and I feel better cognitively for it.

But now, two weeks into taking 125mcg T4 and 17.5mcg T3 and I am feeling over medicated and my tests reflect this too. I know everyone says to stick with changes for 6-8 weeks but does this even mean when you are testing and feeling overmedicated ?

I have an Endo call on 20 November which feels like ages away when I feel like I do - and previously when I've emailed questions about dosing advice I am ignored for weeks - so I am here again.

I thought that reducing my T4 slightly to alternate 125 & 118 would be a good next step.

Can anyone give me their thoughts ?

Just to note too I have had a huge number of blood tests that have come back 'normal' with B12 at 645 (187-883) and Vit D in Jan23 was 73 (50-150).

[Easylover]

UK Paul Robinson. He has his own website. He wrote Recovering with T3. He's the expert.

[hobbycat in reply to Easylover]

Thanks for your post, that’s interesting, please could you say a little more about why you said that?

[Easylover in reply to hobbycat]

Hi, just like you, doing my best. I keep studying and learning. I've changed some things like my dosing and timing. I take NDT. Natural Desiccated Thyroid. I now set my alarm which I didn't used to do but take medication at the same time every day. I used to take it all at once , now I split my doses into three. The reply by Petgirl2 is good because she's already went to Paul Robinson Website. Take care! Blessings.

[Petgirl2 in reply to Easylover]

Was reading his page on T3 , cortisol connection. Very interesting.

[Easylover in reply to Petgirl2]

I just love all of you on this site! Thank you for writing. The cortisol thing is dangerous and tricky. It has to be only done with a 5 point or 4 saliva test and I forgot what time the blood test. Anyway, I think the guy is definitely onto something. I just want to feel amazing again. God bless every one!

[WitchingHour2point0]

I get tired when my T4 is too low. (As well as my T3) but your T3 is over range now.

If they were my results, I'd be inclined to increase my T4 to 150mcg and reduce T3.

[McPammy]

From looking at your results and my own experiences I’d say you need to lower your T3. Do you split your doses throughout the day? I feel tired and heavy if I go over ranges. It’s important to know if you are over your levels and your TSH reflects this also. I’ve tried to ensure my levels and TSH reflect that of a healthy persons thyroid results. So I aim for TSH around 1.00. I recently got my T3 and T4 checked after taking my meds. My T3 was 5.6(3.9-6.0) and my T4 was 11 1 (7.8-14.4). My TSH was 0.93 (0.35-5.50). I’m just within range. I only feel well and very energised when all is in range and TSH not suppressed. I split my doses of T3 5mcg twice a day 8hrs apart and I also split my levo dose twice a day. I find this helps me.

I’d try and slightly lower your T3. I think you’ll need at least 10 days of doing so as the half life will be hanging around for a few days and your body needs a bit of time to adjust.

It’s good you checked with and without taking your meds. The evidence shows T3 is slightly too high. I also feel that I need to use up that T3 energy with some sort of exercise. I go on brisk walks to burn it up. It does make me feel pretty good.

These are just my experiences but I wanted to share with you just in case you can take anything from them.

[hobbycat in reply to McPammy]

It’s interesting to hear that you feel tired and heavy if you go over range. From all the little changes I’ve made over the last few months the T3 is key for my cognition which was one of the main wins when I first started it in 2017.

I dream about having excess energy to use 😂.

[Lalatoot]

You should ignore the last set of results as they were not done following the same protocol as your previous sets. You can't look for trends in results when you don't follow the same protocol each blood draw.T3 peaks in the blood 2 to 4 hours after a dose. By having a t3 dose at lunch and a blood draw at 3pm you have measured your peak level. But all your other tests were done before medication though you don't say how big a gap you left between meds and draw. Knowing how many hours between meds and draw allows us to know if you are measuring the peak, the average or the lowest levels of hormones.

[greygoose in reply to Lalatoot]

Exactly what I was going to say.

[hobbycat in reply to Lalatoot]

My last test I needed to get in before my Endo call and there were no early morning appointments so I knew it was not ideal. My meds times are 6am for all my T4 (125) and T3(10) and 2pm for my T3 (7.5). Usually my blood draw is at 9am before my morning meds.

Is there anything else you might add knowing this info?

[SlowDragon Administrator]

Do you normally split your T3 as 2 or 3 doses

Even if you don’t normally….day before test always split T3 as 2 or 3 smaller doses spread through the day with last dose 8-12 hours before test

when you say you feel over medicated….what exactly?

Vitamin D is a bit low

Can you add Folate and ferritin results

What vitamin supplements are you taking

As you have Hashimoto’s are you on gluten free and dairy free diet

[hobbycat in reply to SlowDragon]

My T3 is split at 6am and 2pm. I was taking a third split at 6pm but when I dropped that I felt no different. I like the advice re splitting for tests.

Overmedicated is unwellness with nausea, heart awareness increases as does heart rate, and some agitation and anxiety.

Ferritin 80 (20-204).

Folate 8.9 (3.1-20.5)

Vitamin supplements 5000 x Vit D spray and B12 sublingual (can’t recall how much) and I’ve started drops of folate.

Am I Hashis when my antibodies are now negligible?

Yes, gluten-free since Feb23.

Does that data help?

[SlowDragon Administrator in reply to hobbycat]

If you had high thyroid antibodies in past, even if now in range you still have Hashimoto’s

Perhaps try increasing levothyroxine to 137mcg either daily or 4 days week and 125mcg 3 days

And reduce T3 to 12.5mcg…..as 1/4 waking, and 1/4 tablet 10 hours later

[hobbycat in reply to SlowDragon]

The issue I have is that as soon as I reduce my T3 my cognition falls off big time.

[KarmaMaya]

Just my experience- it takes time to adjust - at least a week no matter what dose or thyroid medication you change. Your cognitive clarity my decrease initially when you lower your T3, but then rebalance after a week to 10 days.