t3/t4 combo advice please

I am feeling very fed up, very low and like I can’t keep going with all this…

Saw endo last month and was advised to take 7.5 t3 and choice of whether I wanted to drop to 50 or 62.5mcg levo - down from 75.

I opted to stick with 62.5 levo as 50 had no symptom relief before! I started slow adding 2.5 t3 in morning for a week…no issue.

Then increased to 2.5 at 9am and 2.5 at 4pm for 2 weeks. Felt sort of okay but found that after 5 hours from last dose I would get super tired and struggle to stay awake in the evening. I’m also having a lot of near constant muscle twitching after taking the t3.

I stuck it out and then tried to increase to the 7.5 t3 - split 3 times a day and it was a disaster. Muscle twitching became much worse, I was debilitatingly tired and I felt really spaced out and had total inability to concentrate/focus. My heart rate shot up to 150 and I became incredibly grumpy and irritable (I am self employed so finding it impossible to manage these side effects/symptoms)

For now I have dropped back to 2.5mcg t3 twice daily but finding it hard to manage the evening fatigue.

Would it be silly to split the second 2.5 dose, 1.25 in afternoon, 1.25 in evening? Or maybe add 1.25mcg dose in the eve in addition to the 2.5 am and 2.5 afternoon?

Grateful for any thoughts or insights please!

For ref I am a smallish person at 5ft4 and around 53kg (used to be lighter pre meds!) so wondering if 7.5mcg is just overwhelming my system?

Recent bloods on 75mcg levo only:

TSH: 1.2 (0.270 - 4.2)

Ft4: 22.0 (12-22)

FT3: 4.7 (3.1-6.8)

VitD: 134 (50-250)

Total B12: 331 (145-569)

Ferritin 37 (30-400)

Folate serum: 15.4 (8.83-60.8)

have been working on supplementing and increasing vits and mins!

thank you for reading and for any advice/thoughts

[Jaydee1507 Administrator]

The main thing is to pick a dose and stick with it. You are pretty early days in your hypo treatment only having been diagnosed this year and arriving at the correct and optimal dose for yourself takes a lot of patience and time.

Changing dose will cause some relief of some symptoms but possibly also the emergence of new symptoms. Mostly these should get better the longer you are on that dose.

Your low vitamin levels will also add to symptoms and tolerance of T3 and will take quite a few months to rectify once you have a good supplement regime.

If it were me I'd stick with the 2x 5mcg dose but you could also experiment with splitting that dose.

[Hidden in reply to Jaydee1507]

thank you for replying! Ah okay I thought it would be best to do a low and slow intro to see how things go and allow my body a few weeks to get used to the t3.

Sorry I think I made a mistake in my post…do you mean 2.5mcg twice a day? I haven’t been taking 5mcg twice a day. 7.5 is proving way too much so not sure how I’d fair on 10!

I had a recent test and my ferritin is up 10% so things are defo moving in the right direction. Defo plan to keep up with my supplements!

[Jaydee1507 Administrator in reply to Hidden]

I think I got confused with all the different numbers and timings!

So take a total of 5mcgs a day and split it however you see fit and what suits.

Good to hear about your ferritin heading in the right direction.

What are you taking for B12 as that was quite lacking?

[Hidden in reply to Jaydee1507]

Haha yes it confuses me too! There’s so much to think about and remember!

I am taking the Pink tribe B complex and plan to retest in the new year. I was also taking a separate b12 sublingual with it but not sure if I should continue with both?

[Jaydee1507 Administrator]

You should continue with the separate B12 in addition to B complex until you are sure your level is good enough. Perhaps continue taking it until your next test.

[Hidden in reply to Jaydee1507]

Will do, thank you!

[Bearo in reply to Jaydee1507]

How far in advance of a blood test for B12 do you stop a b12 supplement?

I thought you should stop for a few months before testing but I may have misunderstood.

[Jaydee1507 Administrator in reply to Bearo]

It really depends what you want to know.

If you want to find out what your B12 (stand alone, not B complex) is doing for you then you can take it right up until the day before the test.

To find out if you have a deficiency then you would need to stop it for around 3 months.