Private Endo and T3

[Devonlad]

Hi all, I haven't posted in a few months as I've been waiting for a telephone appointment with a private endo. In the interim I've been taking my Levo only, alternating 125mcg and 112.5mcg and feeling OKish, but not brilliant, low energy etc.. Had total thyroidectomy 2 years ago.

I had my private consultation with the Endo 2 weeks ago and he proposed a 3 months trial of Litho - 20mcg a day - split 10mcg on waking (7am) and 10mcg at 2pm (I have a pill cutter) and reducing my Levo to 100mcg for 6 days and nothing on day 7. I received my scrip and bought the 90 day supply of T3 from Roseway labs 1 week ago. I asked him about titrating to this dose and he said not necessary and difficult to cut down to a smaller dose..

I started on this new regime 6 days ago and was OK for the first couple of days then started to get pains around my left armpit/shoulder blade (I have coronary artery issues) and not feeling very good. As a consequence I left out the Levo for one day - as he recommended. Yesterday I was not feeling good in the morning so halved the 10mcg dose for the 2pm dose. I have also now decided to halve my morning T3 to 5mcg as well.

I'm now thinking that maybe I should try this new smaller dose of Lioth 5mcg am and 5mcg pm for a few weeks and to stick with the 100mcg Levo 6 days a week (I take in the middle of the night) and see how I get on.

Do you think this is a sensible course of action? I'm obviously worried about any effect all this may have on my heart and a small part of me says just to stop the T3 and revert back to Levo only. However, after waiting so long for some progress I feel I ought to give the T3 a good go as I've waited so long to try it. Unfortunately I am not a patient person and want immediate results.

Here are my latest blood test results taken for the Endo to have before my consultation. Taken on the 16th Jan under all the recommended protocols.

[TiggerMe]

Yes, you are taking a much more sensible approach than your medic suggested! T3 is a bit like rocket fuel compared to T4

Stick with 5mcg for a couple of weeks and then if all is well add in a second 5mcg 8 hours after first dose and wait at least another couple of weeks, if you feel well here then wait a month or two and test before adding more... too much is as bad as too little

The other part of me would say stick with 100mcg 7 days a week as taking T3 often knocks your fT4 levels back and they often get you to reduce by too much which just makes you feel awful a month down the line

Your other results are rather exemplary! Slightly jealous 🤗

[Devonlad in reply to TiggerMe]

Hi Eeyore, Many thanks for your quick response. Wise advice, I think I'll stick with the 5mcg in the morning only and see how I get on. I know from other meds I am very sensitive to new medications (unfortunately!!!)

[TiggerMe in reply to Devonlad]

Very sensible, you don't gain by rushing it... your whole system needs time to adjust, it's quite useful to keep tabs on your BP, resting heart rate and temperature if you have the equipment to hand as they are a guide to how you are responding.... expect a stronger heartbeat

You often feel the drop off in the afternoon which is a signal you could perhaps need a little more

[Devonlad in reply to TiggerMe]

Interesting comment about stronger heartbeat as I'm on beta-blocker, bisoprolol, amlodipine and ranalozine - not for raised blood pressure, but angina and artery issues, so I'll have to watch that. My blood pressure's always been good.

You mention the afternoon drop off which is a signal perhaps needing a little more - presumably you mean T3?

[TiggerMe in reply to Devonlad]

It sometimes comes as a surprise when the heart beat strengthens as we become so used to having what the Chinese describe as a weak slippery pulse being hypo's

It isn't a bad thing just an unusual sensation which can cause panic, it is just a sign that our hearts are finally getting enough T3 to function correctly

Yes, afternoon dip as the earlier dose of T3 wears off 🤗

I know nothing of angina and artery issues I'm afraid, I shall have to look up those other medications... might be worth having a look here... drugs.com/interactions-chec...

[Auders]

I’m sure there will be some well learned people who will advise you. I do think it’s low and slow! I started off with 5mcg Lio in the morning and went up to 5 mcg twice a day. Then up to 15 mcg (1x10 morning and 1x 5 afternoon) I’ve just started on 20 mcg, I think I prefer it once a day (fits it better for me) It’s taken me since July to get up to 20mcg as I did blood tests about every 6-8 weeks in between increasing dose. Good luck with it all x

[Devonlad in reply to Auders]

Thanks Auders, I think you're right . I'll have to curb my impatience as you say 'low and slow' despite what the endo says, after all he doesn't know me even. So I'll try just the 5mcg a day for a bit and see how I get on.

[pennyannie]

Hey there again :

I think you should maintain your T4 at 100 mcg a day and start low and slow on the T3 -

When you read the average thyroid produces and supports with around 10 mcg T3 + 100 mcg T4 daily - I'd think as without a thyroid - to try, build and settle at around these ball park numbers.

You could take the first dose in the night with your T4 and then leave around 12 hours for the top up - if that suits you better -

you may find you don't need the top up dose in the afternoon - symptom relief can be quite subtle -

and I 'm not sure of the side effects these other drugs may have on thyroid hormone replacement ??

P.S, When I self medicated T3 + T4 - my T3 tablets were 25 mcg which I chopped in quarters :

I reduced my T4 down by 25 mcg and took T4 100 mcg + T3 6.25 mcg In the middle of the night - and slept well for around another 4 hours and awoke feeling calm and relaxed.

I then made myself unwell when I took 12.50 mcg T3 + 100 mg T4 - and with hindsight think I should have reduced my T4 by a further 25 mcg when I increased by T3 dose of 12.50 :

Very rough estimate is that 6.25 T3 equates to around 25 mcg T4 :

I switched to NDT as I couldn't maintain my T3 source.

[Devonlad in reply to pennyannie]

Hi Pennyannie, Many thanks for your reply, interesting and useful information, I think the consensus seems to be for me to stick to the 100mcg levo for the whole 7 days, which appeals as it's easier for me to maintain. I might try taking the T3 with the levo in the middle of the night (normally around 1 or 2 am) and see what happens, but only after things settle down a bit.

[pennyannie in reply to Devonlad]

OK then - there's no rush - slow and steady wins the race - remember the tortoise & hare.