Hi everyone, its me again. A bit of an update first. My GP called me in August to say my TSH had now gone below range & was 0.18 (0.27-4.2) she said to lower my Thyroxine dose to 125mcgs one day then 100mcgs the following day & admitted she was out of her depth & sent a new referral to Endocrine & I was seen in October. He was a senior registrar but seemed quite knowledgeable & agreed on a trial of T3 for 2 months based on new blood test results that day. These were
TSH 0.7 (0.27-4.2) T3 3.3 (3.1-6.8) T4 20 (11-22).
I received a phone call from him a few weeks later to say he would issue a prescription for T3 but it would be for 6 months as 2 months was not long enough. I asked how I got the prescription but as he was new he wasn't sure so said to leave it to him. Well I have waited daily for a letter for 5 weeks & nothing so last week I called the Endocrinology department who said he still hadn't dictated a letter & was now on annual leave! I said my appointment had been in October! Anyway yesterday I received a call from an Endocrine Nurse who arranged the prescription for me to collect from the hospital today. She said I presume the Dr gave you instructions on how to take it. Er NO! So this was her response. She said to reduce my Thyroxine to 50mcgs daily then to add in 10mgs of T3 twice a day 8 hours apart. She said she would post out some blood forms & make a follow up for 6 months time with the Dr & she would call me in a month. I really feel I need your advice here as it seems a huge drop in Thyroxine & a large starting dose of T3. Am I right or should I do as she says? Any suggestion ? Help Please. Thanks in advance.
Written by
Otto11
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Your FT4 is at 83% at the moment and will drop slightly when you start T3.
Most NHS Endo's seem to advise dropping Levo by 50mcgs which is heavy handed and really you don't need to drop any with your level where it is, or only a very small amount.
Its suggested to start T3 with 5mcgs for a few weeks and if all is well add in another 5mcgs a few weeks later. Retest after 6-8 weeks.
She said to reduce my Thyroxine to 50mcgs daily then to add in 10mgs of T3 twice a day 8 hours apart.
That’s much too heavy handed
What brand levothyroxine is your 100mcg
Have you got any other dose tablets and which brand
Initially reduce dose levothyroxine a little …..perhaps 75mcg and 100mcg on alternate days
Cutting 100mcg into 1/2 and 1/4 if necessary to get 75mcg
Use a sharp craft scalpel to cut and save spare 1/4 for next 75mcg dose
After 5 days on reduced dose…..
Add just 5mcg T3
Or even 2.5mcg waking and 2.5mcg mid afternoon
(If you only have 20mcg tablets difficult to cut smaller than 5mcg)
After a week consider reducing levothyroxine to 75mcg daily
And 5-6 days later add 2nd 5mcg dose T3 mid afternoon
Perhaps hold at that and retest in 6-8 weeks before considering if need to add any more T3 or not
Recommended that all thyroid blood tests early morning, ideally just before 9am, only drink water between waking and test and last dose levothyroxine 24 hours before test
This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip)
On T3 - day before test split T3 as 2 or 3 smaller doses spread through the day with last dose 8-12 hours before test
Private tests are available as NHS currently rarely tests Ft3 or all relevant vitamins
Testing options and includes money off codes for private testing
Thank you so much for your detailed response its very much appreciated.
I did say to the nurse that I thought 50mcgs Thyroxine was rather low so she said I could do 75mcgs/50mcgs alternated days. I asked for it to be altered to 75mcgs which I felt more comfortable with & she agreed & the pharmacy has given me 3 boxes of 25mcgs tablets. They are Mercury. I also have 100mcg tablets which are Accord. The pharmacy gave me Roma T3 10mcg capsules which would be difficult to split but it does say it can be dissolved in water. I have spent the afternoon reading other posts & found several suggesting splitting the doses which seems much more sensible to me than the nurses regime. I will follow your advice. I asked my GP to check my vitamin levels in November (telling her a little white lie that I would need them for my Endo appointment) These are B12 755 I have also had a B12 injection since then ( I have them every 6 months prescribed by previous retired Endo) Ferritin 77, Vit D 89 & Folate 8.8 I have bought some Methylfolate drops which I'm currently taking. My Folate has been low for a long time unfortunately (no idea why) & Ferritin has been better in the past too. Work in progress I guess. Thanks again for all your wonderful advice.
Igennus B complex popular option too. Nice small tablets. Most people only find they need one per day. But a few people find it’s not high enough dose
IMPORTANT......If you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 7 days before ALL BLOOD TESTS , as biotin can falsely affect test results
In week before blood test, when you stop vitamin B complex, you might want to consider taking a separate folate supplement (eg Jarrow methyl folate 400mcg)
Post discussing how biotin can affect test results
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