t3 only treatment need advice

[charley123]

When i got hypo i figured out fast that t4 only only worsend everything. My doc added 10 t3 it was better but not optimal. She put me on 4 Grain NDT and i did well for 2 years. Then got one symptom and we played with NDT dosages lower, higher, brands and a combo with NDT plus 10 T3...

I transitioned to 75 T3 (3x 25 every 5 hours) and loose my symptom. I did well for 2,5 years and then my life crashed..tierdness lack of motivation no intresed in nothing housebound depression..I took antidepressant after antidepressant, dopamine, candida diet, probiotics but it did nothing for me. Ok antidepressant help me to be not suicidal and sad but no impact on motivation, drive, sleep, tierdness...

Bent back onNDT again 3,5, 3, 2,5 Grain like the years before T3 nothing. T4 only 150-200mcg, T3 only with 55, 60. Nothing. I had with every dosage switch/increasement/lowering every time the same effect. Improvement for 1-2 weeks then bad crashing after 4 weeks. Doesnt matter if ft3 is high in range , slight over range , middle or low. ..improvement then worsening.

My thyroid is shrunk from 8,4ml volume to 4,1 ml volume in 7 years.

This year I figured out that i have a very high revese t3 on levo 150 ft4 - 1,56 ft3 - 4,2 rt3 - 319,4 pg/ml (90-215). A 4 point cortisol test showed only low morning cortisol but the other 3 where on top of the range.

So I did the following:

I was 10 weeks on 3 Grain blood test show: ft3 - 4,3 (range 2,5-4.4) ft4 1,02 (range 0.89-1.76) . I took prednisolone 5mg. Took my last day 3 Grain then the next day 60 T3 total. 3x 20 every 4 hours. After 4 days i tracked puls and vitals. My high heart what was on the all NDT, T4, T3 dosages 90-115. But now went down between 70-80 for a complee day. While 3 weeks on 60 T3 my optimal heart reate fluctuates. Sometimes was only low for 4 hours after getting up. In the 3 week the low heart rate dissapeard.

Week 4 I Increased to 70 T3 ( 3x20 1x 10) the fluctuated heart rate with 70-80 come back for a few days then dissapeard depression comes trough my antidepressant

Week 5 i increased to 80. Low Heart rate dont come back depression still there. So up to 85. Depression dissapeard luckily heart rate not anymore.

I increased prenisolone from 5mg once daily to 3,75 morning 4 hours later 2,5 total 6,75 Nothing

Now i am on 100 splitted in 4x 25 every 4 hours..nothing....no low heart rate..no symptom relief..

As i had low heart beat the 114 t4 ot the 3 Grain was 100 % in the system together with 60 t3.

100 t4 is replaced in t3 only therapy with 25-35 t4. 35+60 = 95 T3.

But the 100 T3 did nothing...

What could be the next step? Maby an other splitting?

[Jaydee1507 Administrator]

So far you haven't mentioned your vitamin levels or what you take to supplement them.

What we have found in this group is that unless all of your key vitamin levels are at OPTIMAL then whatever thyroid hormone you take be that Levo, T3 or NDT will not work well.

You posted some years ago that your B12 was quite low. Are you now supplementing that, if so what with and have you rechecked your level lately?

healthunlocked.com/thyroidu...

[DippyDame]

My first thought is that you have made too many changes too quickly

I'm sorry but I'm finding it difficult to track your dosing protocol

High reverseT3 indicates too high an FT4 level....often the result of impaired T4 to T3 conversion. rT3 is transient and unlikely to cause the symptoms you mention but the cause of the high rT3 is likely to be your dose. I'd suggest your T4 to T3 conversion is poor and causing high FT4

I'm looking at your comment...

I transitioned to 75 T3 (3x 25 every 5 hours) and loose my symptom. I did well for 2,5 years.

Have you considered taking that 75mcg in a single dose?

I followed the late Dr John Lowe a thyroid expert who took high dose T3-only in a single dose in the early hours of the morning...I take mine at bedtime. The bigger single dose can provide a force that pushes the T3 into the cells overcoming a form of resistance that prevents adequate T3 entering the cells and so reaching the nuclei and attaching to T3 receptors.

I'd suggest you need to decide on a dose that you think appropriate ( based on previous experience....maybe 75mcg) then stick with that single dose on a daily basis, and taken at the same time of day, for 6 weeks. It takes this time for a new dose to settle into the system. You will then have a baseline to work from.

Monitor your symptoms along the way, checking your resting heart rate, intolerance to heat, loose bowels and evidence of hand tremors. All indicate overmedication.

Resting heart rate is 60 -100 bpm. Mine is 65bpm.

Bear in mind the rate will rise in relation to activity

If , after a week or so this dose appears too high, based on above signs and symptoms then reduce dose by 5mcg and continue as before

There is no quick fix....it's not like taking paracetamol for a headache.

Did your doctor prescribe prednisolone? How long have you been taking it. Some of your symptoms could be side effects. I wouldn't be happy taking it.

Have you optimised vit D, vit B12, folate and ferritin?

Have you had thyroid antibodies TPO and Tg tested for Hashimoto's disease?

Just a few thoughts to consider....these are based on my own experience I'm not medically qualified.

Good luck

[charley123 in reply to DippyDame]

When i quit 3 grain of one day to another and took 60t3 (3x20) my high heart rate decreased in 3 days from 115 to 70 for a whole day! Then the 70 bpm came back. Sometimes for 4 hours after getting up. Sometimes at the end of the day... This effect dissapeard after 3 weeks. (Because the t4 level decreased)After 3 weeks i took 1 week 70t3 ,

2 weeks 80 , and raised to 100t3 and it didnt bring back the effect on my pulse not anymore...

I dont know whats wrong..

[Alanna012]

Hreat advice above from DippyDame and Jaydee.

I don't know why but sometimes something changes - sometimes you don't even have a clue what it is - and the thing you were taking before suddenly seems to have less impact, as if the body has adapted to it. In that case it's worth trying a bigger dose or changing the brand to a different one. If you've been using the same brand T3 perhaps switch it to another.

[charley123]

Now I'm on 140 T3 (40-40-40-20) and nothing changed...

[charley123]

Now on 200 T3 and nothing changed...