T4/T3 combo v T3 monotherapy

[CapnM]

Hello, can someone fast track me towards content to considerations of T4/T3 combo versus T3 monotherapy. I am trawling Dr Google and found many references but nothing specific.

Context. Good news after 4+ years struggling on Levo and a steady downward spiral in 2023 I took the plunge and self trialled 10mcg T3/Lio. Results after one week were profound (really really profound) rather proving that I was trapped on too lower dose (GP: your tests are in range). I may also struggle with Levo as the two times I did persuade somone to raise it I got horrid side effects. Maybe I should have pushed for more or stayed the course but I just could not continue with the symtoms/side effects. I have enough T3/Lio now for next 6 months but wondering if I really should try re-introducing Levo a little.

What are the considerations and risks? Any direction to holiday reading I can do?

thanks

p.s. Happy Christmas everyone and big thanks to the admins who run this site.

[greygoose]

As with most things thyroid, it's very individual. Some people need quite high levels of FT4 as well as the right levels of FT3. Others only need a little. And, some, like me, are better off with no T4 at all. And, no-one can tell you in advance what you're going to end up needing. You can only find that by trial and error.

What are the considerations and risks? Any direction to holiday reading I can do?

None whatsoever - to both those questions - as far as I can tell. I've been on T3 mono-therapy for many years, now. And whilst I have good days and bad days, if I try to reintroduce T4, I have only bad days! So, I've decided not to do that anymore.

The only possible drawback, as far as I can see, is if - for whatever reason - it is no-longer possible for you to obtain/take your T3 and you have no T4 to fall back on for conversion to T3. Happened to me once, for reasons I won't go into here, but I survived pretty well for six months without it. And it was only a bit of weight-gain at the end of that time, that drove me to the doctor's for blood tests. That was 10 years ago, and I'm still here to tell the tail.

But, that's just me. And things might not work out the same for other people. So, we just have to listen to our bodies and what they're telling us. Does it want T4 or doesn't it? We have to find that out for ouselves.

[CapnM in reply to greygoose]

Thanks. Very useful.

[greygoose in reply to CapnM]

You're welcome.

[Forestgarden]

There's a lot of interesting pieces on this site, links to papers etc:

thyroidpatients.ca/2019/09/...