T3 dosing advice

[Sammy333]

Hello, a little advice needed. I'v been on T3 now for about 6 months.

My recent test results show an inadequate conversation rate of T3 if ik working it out correctly :/

I take 10mcg liothyronine with 100mcg levothyroxine.

Recent labs show...

TSH 0.07mu/L. (0.27 - 4.20mu/L)

FT4 18.6pmol/L. (11.30 - 21.60pmol/L)

FT3 4.7pmol/L (3.10 - 6.80pmol/L)

Would it be suggested I increase the liothyronine to 15mcg whilst leaving the levothyroxine at 100mcg. Or with the TSH being low would I increase the T3 whilst dropping the levo to 75mcg? I prefer my T4 sitting where it is at 18ish but worried about being "hyper" if I increase T3 and leave the levo dose.

Thanx!

[Buddy195 Administrator]

TSH is low because of the Liothyronine; so please don’t worry about that. Knowledgeable medics understand this and should not base recommendations on TSH alone.

It’s very much trial and error to find a combination dose that works for you. Personally, I don’t like my FT4 high in the range, although I’m fine with FT3 higher. For me high FT4 brings anxiety, tremor and palpitations.

I would only make one change at once, adding another 5mcg Liothyronine and then retesting levels in 6-8 weeks (I prefer to wait the full 8 weeks). Some members take their Liothyronine in one dose alongside their Levo, but I prefer to take 10mcg Liothyronine in the morning (with Levo) & an additional 5mcg in the afternoon.

[SovietSong]

Personally I’d try adding in a little more T3.The t4 isn’t bad at around 70% but t3 is only 43%.You won’t be over medicated unless it’s over range and your a fair bit off that.

[Viviennet]

Hi Sammy, I'm curious, as on similar dosage with similar results. 4.7 seems well within range to me, and often where I sit. What makes you feel it's low or represents inadequate conversion - the blood test itself, or do you feel below par? Thanks, and sorry that this isn't directly perhaps helping you.

[Sammy333 in reply to Viviennet]

Hello! I think I worked out the conversion rate wrong. So when I looked at the T3 conversion rate in comparison to where my T4 is sitting it appeared suboptimal. I may have worked it out wrong though. It came to about 2. I divided my T3 value by T4 but perhaps I should be doing it the other way around? 😵‍💫

I am still also highly symptomatic so figured maybe I could push the T3 further up the reference range as it's sitting in the lower half ATM x

Chart

[Viviennet]

Oh, I don't know anything about the conversion rate, just check I'm in the reference range and feel OK. Please could you say more about your calculations in case I ever wish to take these on board. Thanks Sammy, and good luck managing your dosage and health

[Bearo in reply to Viviennet]

There’s a calculator for percentage through the range in pinned posts. Work this out for both FT3 and FT4. If the results are too wide apart, or any result is below 50% then it may need addressing.

The division thing is for working out the ratio of FT3 to FT4 but I find that less useful.

[Viviennet in reply to Bearo]

Thank you. Could you tell me how i'd search for that in pinned posts pls (or what I'd put in)? i've never heard anything about this, and don't understand 50% reference etc. If I'm in the T4/T3 range given on blood test and feel ok, is all I've known to go on, and googling here didn't come up with anything. I'd love to educate myself. Many thanks for any pointers anyone!

[RedApple Administrator in reply to Viviennet]

See here healthunlocked.com/thyroidu...

[Sammy333 in reply to Viviennet]

Hi Viviennet, I'm new to working out the percentage thing also! I'd say the best thing to go by is absolutely how you feel. When I feel off which is often I do tend to think if it's worth tweaking things hence me wondering if I need a little more T3. If you feel good then I wouldn't over analyze where you are at. But also I understand knowing exactly what's going on is useful in case you start to feel off at any point! It's good to check your staying in track right may I ask out if interest what your dosage of T4/T3 is? I'v always wondered if dessicated hormone would help me more but im scared to change anything so drastically at the moment xx

[Viviennet in reply to Sammy333]

hi Sammy, I'm on 75 and 10, 2 split doses. I have many issues going on right now, so hard for me to know what's due to what!

[Sammy333 in reply to Viviennet]

Isn't it just! I have a bit on cfs/m.e which could be long covid orrrrr could it be hashimotos 🙃 it's all so complex! I'm on 100mcg and 15mcg now and feel like maybe I'm overdosing 😵‍💫 I guess I'll just have to see how I go xx

[Bearo in reply to Viviennet]

Can you start a new post if you have more questions? You’ll be more likely to get replies.