T4+T3 dosing help!

[Tansin22]

I have central hypothyroidism. I have tried T4 only (failed) , T3 only ( better but too difficult to follow multiple doses) and also tried t4 +t3 ( 50:50 mcg as well as 50:10 mcg ) . I felt my best on 50:50 mcg dose of t4+t3 but still not 100%. So I tried 100 mcg t3 with 12.5 mcg t4. This is what i feel best on but only question I have is that I haven't found single person following a high t3:t4 protocol and hence I call upon the fellow members if it is safe to adhere to such protocol in long run !

Thanks you

[TiggerMe Ambassador]

Your dosing is high but not unheard of, we each need what we need and perhaps you just don't absorb well... have you any results with ranges to share?

I shall call up DippyDame as our high T3 guru 🤗

[Tansin22 in reply to TiggerMe]

I plan to draw blood after 4 weeks but I am expecting my T3 would be up in the sky anyway. Also , due to central hypothyroidism, I can't rely on my TSH.But my journey throughout has made me rely more on stmptoms rather than lab value, so was just concerned about long term effects.

I also had a question to community about proximity temperature. So my toe fingers and knees are often colder than other body parts esp at night . Should I be patient with the process or just up my dose ?

[TiggerMe Ambassador in reply to Tansin22]

We are with you on often ignoring TSH, I'm not sure that any one thinks having long term above range fT3 or 4 is going to do anyone any good... what were your last results like?

Cold fingers and toes could be Raynard's Syndrome? Have you ever check your thyroid antibody levels could it also be under autoimmune attack?

[Tansin22 in reply to TiggerMe]

Yes I have been a lurker on this forum for quite a bit so I have taken due cognizance to check on the basics . Tested for all autoimmunity parameters and negative

The reason why ask about long term consequences of high T3 is because most people will have palpitations at that dose but mine is just 85 bpm. Also I feel undermedicated due to the fact that my bp is still high (150/90) and I have muscle weakness (but that can be sign of overmedicated as well) . Super confused It's definitely not raynaud's as my colour of toe fingers doesn't change . Also my cortisol is normal, so pretty sure it's not raynaud's .

[TiggerMe Ambassador in reply to Tansin22]

Would be good if you filled in your Bio as we don't have much to go on, 85bpm is a reasonably quick tick over compared to many of us, before adding T3 I was low 50's and now low 60's but BP remains low.

Muscle weakness could be low Vit D, folate, B12, iron, potassium, magnesium, calcium.... sex hormones? How are they all looking? You'll know we work on results with ranges

Ah ha, I now see you are a 33 year old, tall, slim chap.... so 85bpm seems fast unless you just aren't very fit?

[SlowDragon Administrator]

Which brand levothyroxine and which brand T3

What about vitamin D, folate, B12 and ferritin levels

What vitamin supplements are you taking

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

[Tansin22 in reply to SlowDragon]

Very good experience to share regarding levothyroxine brand .When I was on T4 solo, I started with GSK eltroxin. This improved my energy but not joint pain. After few months, due to supply issues, I switched to Euthyrox and it made my life hell. Whatever improvement I made, was gone . At that time I didn't know that levothyroxine preparations can vary with brands .

I am 6ft tall 95 kg male( 33)

Vit D high normal

Iron studies normal

B12 folate and other parameters also normal.

[SlowDragon Administrator in reply to Tansin22]

Please add actual results and ranges on vitamins

And add age and gender on profile

Have you tested testosterone and cholesterol levels

[Tansin22 in reply to SlowDragon]

I will definitely update on lab results but they are normal to be assured of . Free Testosterone is mid normal

Shbg in 40s

Cholesterol mid normal.