Too much T3? One time. Does it make a difference?

[DandyButch]

Because of a change of dosage of liothyronine from 10 mcg 2 x daily plus 10mcg 1 x daily Mon, Wed, and Fri, To 20mcg 1 x daily and 10mcg 1 x daily, I was given a completely different brand. Originally given Roma capsules, then following dosage change, Mercury Pharma tablets as well as Roma capsules.

I didn't read the packaging!!!!

One morning when I should have taken 2 x 10mcg capsules, which I had run out of, I took 2 x Mercury Pharma tablets.

However, after I had swallowed them, I realised the MercuryPharma tablets were 20mcg each. So, I had taken 40mcg instead of 20mcg.

I expected to feel overmedicated. But, I didn't. I thought that as T3 is the active hormone and has a short half life that I would certainly feel the impact and was waiting for a reaction. Nothing happened.

Is this right?

I don't understand.

Can anyone help explain please.

[greygoose]

T3 is the active hormone, and does have a shorter half-life in the blood than levo - about 24 hours - but that doesn't mean it acts instantly. The T3 in the tablet you took this morning could swim around in the blood for a couple of days before latching on to a receptor. And in the blood, it doesn't do anything. And just because you took an extra amount on one occasion, doesn't mean that all of that T3 is going to get into the cells anyway. It might, it might not. So, it's really nothing to worry about if it only happened once. just miss the next dose and you should be fine.

What is worrying is that you are taking different amounts of T3 on different days, and you just can't do that. With T3, if you want it to do what it's supposed to do, you have to take the same dose every single day.

[DandyButch in reply to greygoose]

Yes , the endocrinologist told me to take liothyronine as follows:Mon 20mcg am 10mcg pm

Tue 10mcg am 10mcg pm

Wed 20 mcg am 10mcg pm

Thu 10 mcg am 10 mcg pm

Fri 20mcg am 10 mcg pm

Sat 10mcg am 10mcg pm

Sun 10mcg am 10 mcg pm

This was around October last year. I thought it was odd, so posted it on this forum, to be told it was wrong and to contact endocrinologist.

I immediately contacted the endocrinologist via the endocrinology dept, via email. After several phone calls, she eventually called me just before Xmas, and agreed to change my dosage to 20mcg am and 10mcg pm every day, which I am now on.

I am still experiencing hypo symptoms. My next appointment is towards the end of February. I think she is being over cautious when prescribing and is only using TSH within NHS 'normal ' ranges to calculate dosage. She does not seem to listen to my symptoms and my lack of marked improvement. I think I need a higher dose, but she works on weight calculations.

[greygoose in reply to DandyButch]

You're on T3 mono-therapy I gather? 30 mcg is really not enough. She doesn't know much about thyroid, does she. You absolutely can't be on T3 mono-therapy and keep your TSH in-range. And dosing by weight is only a very rough guide for T4, not T3. So, really not surprising you still have hypo symptoms! But they never do listen to our symptoms because they don't even know what they are. Frankly, one is better off self-treating when on T3 mono-therapy.

[DandyButch in reply to greygoose]

Thankyou for that. I need you as my advocate. It is not easy trying to tell an endocrinologist that they are wrong, when I am a mere mortal, and they are the 'specialist'. Ha! Ha!I did source some T3 when I was on levothyroxine only, only a starter dose but in hindsight, I think that the damage the T4 was making masked any improvement.

All I can do is challenge her, if necessary. But, she may not listen, in which case I will be doomed to never being better.

[greygoose in reply to DandyButch]

I think that the damage the T4 was making masked any improvement.

What damage?

she may not listen, in which case I will be doomed to never being better.

That's a bit defeatist. You could buy your own T3 and give yourself a rise in dose.

[DandyButch in reply to greygoose]

Hello greygoose I was on levothyroxine in increasing doses for 18 months, and not once felt better on it. Actually, the more I had, the worse I became. It made my hypo symptoms 100 times worse.

[greygoose in reply to DandyButch]

Yes, I understand that. But that doesn't mean it's doing any damage. People are so negative about levo but many of the things they complain about have nothing to do with the levo itself, but their own bodies. It's only a hormone, after all, not the devil's snakeoil.

[DandyButch in reply to greygoose]

Even when I was supposedly within range, I still felt worse. My gp was not at all helpful. He is very young and couldn't understand why I was not feeling great.

[greygoose in reply to DandyButch]

Yes, well, we all know that 'in-range' is meaningless. It has no bearing on symptoms. As you're not on T3 only, I imagine that you were a poor converter and/or have some degree of thyroid hormone resistance. T4 is basically a storage hormone that doesn't do much until it is converted into the active hormone, T3. So, probably, the amount of T3 you were getting from your various doses of levo just wasn't enough. I was the same.

[DippyDame]

I'm assuming you are T3-only from the hormone doses you list.

I'm on high dose T3-only and have always understood that T3 must be taken as a consistent dose....pleased to read you are now on 30mcg daily. Well done!

On T3-only labs are no longer very useful, we need to learn to dose by clinical evaluation using signs and symptoms to identify how the T3 is working

T3 needs first to settle into the system, from serum to the nuclei of the cells where it becomes active and attaches to theT3 receptors....then it gets to work. Depending on how long ago you double dosed it may just be that you do need more....hence no reaction.

It's a long slow process finding the therapeutic dose so patience is essential

Meantime forget about the double dose, it won't do any harm, and return to 30mcg daily.

Sorry but I don't think your endo has much of a clue about T3....few of them do. It takes lived experience! You must listen to your body!

[DandyButch in reply to DippyDame]

Thank you for your time to reply. Yes, I am now on T3 only. Levothyroxine made me ill.I have noticed an improvement in my symptoms since starting T3 only last February, but still feel there is quite a way to go.

I fear the endocrinologist may not increase the dosage when I speak to her, because she is concentrating on the wrong parameters.

[Charlie-Farley in reply to DandyButch]

Hi Dandy

you may need to quote references at her and supply a printout. If they ae not prepared to fact check they shouldn't be in practice. Diabetes specialists

this may help lots of references within the article Thyroid Canada produce some amazingly thought out work.

 humanbean shared this the other day (pure gold)

thyroidpatients.ca/2018/07/...

Tatty has a pinned post on TSH you will find some references in there as well.

[DandyButch in reply to Charlie-Farley]

Hi Charlie - Farley,Thankyou for the humanbean post. Great.

I think the tatty link has been removed by moderation team.

[Charlie-Farley in reply to DandyButch]

It was well down the list under the iodine post - I missed it at first glance 😜 here is a link to it 😊👍

healthunlocked.com/thyroidu...

[DippyDame in reply to DandyButch]

I suspect your fears are well founded.

30mcg is inadequate when on T3-only and endos are not sufficiently clued up to understand this

Be prepared that you may need to source privately

I need around 112.5mcg to function and have no hope of having that prescribed. Those of us in this position have to learn how to treat ourselves.

TSH has nothing to offer when on T3-only

thyroidpatients.ca/2019/08/...

[DandyButch in reply to DippyDame]

Thanks DippyDame, I shall use this too, if she will listen. Thankyou

[DippyDame in reply to DandyButch]

Refuse to be dosed by TSH.....that test was devised to diagnose hypothyroidism by high thyroid hormone levels.....for nothing else.

It was tweaked as a lazy and inaccurate way to dose patients....resulting in the poor health of many hypothyroid patients who became wrongly medicated

It tells us nothing about the individual Free hormones T4 and T3 which are the most important readings ..especially FT3

T3 is among the most important hormones in the body.

Anyway, I'm T3 ranting again!!

Good luck with the endo....you are most likely better informed about T3 than she is now!!

[pennyannie]

Hello DandyButch :

Just to add - I read that most people need to have/convert to/ find around 50 T3 daily just to function :

Paul Robinson has a few books on recovering with T3 only treatment for hypothyroidism.