t3 t4 not sure it’s going well

[Topes009]

Hi all.

I have been trying t3 with t4, currently taking 75 t4 and 2x t3 5mcg daily. ( I was taking 50 t4 with 2x5mcg t3 but felt undermedicated.) A week in and I’m feeling over medicated. Shaking and waking early hours. I’m not sure T3 is working for me, my rosacea has got a lot worse since starting it and I’m not feeling any better generally.

What is the protocol for going back to T4 only? Isn’t just a reverse of what I did to add T3 in? Do I stop the afternoon dose of T3 and stay on the 75 T4 and 1x T3 for a week then stop the T3 for a week and add the 25 T4 to go back to 100 T4?

Thanks for all the help on here. It’s such a relief to have this.

[SlowDragon Administrator]

Looking at previous posts

You were on 100mcg levothyroxine

What were Ft4 and Ft3 results when on 100mcg

See a few months before that you were on 150mcg levothyroxine

So that’s been a massive reduction in dose

How long since you reduced dose levothyroxine to 50mcg

Ideally you would retest first

But

Suggest you increase levothyroxine to 75mcg ……

yes if you want to stop T3 ….initially reduce to 5mcg

Wait 2-3 weeks

Vitamin levels need to be OPTIMAL before starting T3

What are your most recent vitamin D, folate, ferritin and B12 results

[Topes009 in reply to SlowDragon]

Hello

Thanks for replying.

I had been on 150 for over 20 years and all was fine apart from low tsh. Around the start of last year it all went crazy. FT4 19.5 (7.9-14.4). Dose was reduced to 125 then 100.

Last results on 100 were

Tsh 0.05 (0.38 - 5.33)

Ft3 4.5 (3.8 - 6.0)

FT4 12.7 (7.9 - 14.4)

Ferritin is low B12 is ok but was low

I take Vit d and k, folate, iron, mineral complex, omega oil and B12

I would give it longer but am very worried about the progression of the rosacea although I don’t know it is that causing it of course .

[SlowDragon Administrator in reply to Topes009]

FT4: 12.7 pmol/l (Range 7.9 - 14.4)

Ft4 was 73.85%

Possibly didn’t need to reduce levothyroxine at all

Reducing by 50mcg was too much

[Topes009 in reply to SlowDragon]

I did think it was a big drop but unfortunately the endo is a tsh guy. My tsh was always 0.001-2 and had been like that for years with no issues.

Maybe I should persevere with the 75 t4 and t3 combo I’m on. Or alternate 50 and 75 as suggested below. Just really don’t want to go hyper again.

All very scary and confusing at the moment.

[TiggerMe Ambassador]

I'd suggest putting your T4 up to 75mcg as dropping from 100 - 50mcg is too much

Under replaced feels much like over.... what are your symptoms? Raised heart rate, BP, temperature?

It takes a while for the fT4 to drop so the fact you started well and then declined suggests too little T4

[beh1]

75/10 feel over medicated, 50/10 under. Why not alternate 75 , 50, or take 62.5 by splitting tablets? Don’t rush to dismiss liothyronine unless it really is the cause of your problems.

[Sparklingsunshine]

Have you ever had any treatment for the Rosacea from your GP, there is no cure, it tends to run in families and is more common in fair skinned women but there are treatments on the NHS to help manage and reduce it.

Azelaic acid is a popular one, Metronidazole gel or long term low dose oral antibiotic therapy. Its an inflammatory condition and could have flared up for other reasons besides the T3, stress, hormone changes, diet, even the weather can affect it.

[Topes009 in reply to Sparklingsunshine]

I use azeliac acid and am careful with diet however so many things trigger it, it’s very restrictive.

This weather is awful for it with the change in temperatures

[Topes009]

Hi all I’d just like to say thanks to everyone for your replies last weekend. I have stuck with the t4/t3 and things seem a bit more settled. I have come to understand that I tend to react a bit quickly to things and maybe panic a bit also so it’s so good to have this site to come to for advice and reassurance. Thanks again