Experience of taking Thybon Henning Liothyronine

[Gosierunn]

I am currently taking 50mcg of Levothyroxine and have just been prescribed 20mcg of Liothyronine by a private dr.

I just wanted to gather some experiences of other people taking it particular from other women in their early 40s with Hashimoto’s.

[TiggerMe]

That is a low dose of T4 to be adding a big dose of T3 too?

What were your last results looking like? You certainly wouldn't want to add that in one go, 5mcg at most every couple of weeks to build up

Looking back your last results showed...

T4 - 11.1 pmol/L (9.00 - 19.00pmol/L)

B12 - 445 ng/L (187.00 - 883.00ng/L)

Folate - 3.4 (3.10 - 20.50ug/L)

Vit D - 59.8 nmol/L (>49.90nmol/L)

Looks like you haven't been given a full replacement dose to T4 yet.... have you been supplementing to sort out your terribly low folate and Vit D?

What sort of weight are you 50mcg unless you are around 35kgs this is too low a dose added to the other lows you are going to struggle to make good use of it... have you checked your fT3 levels?

[Gosierunn in reply to TiggerMe]

Thanks for taking the time to reply - I have a protocol from the dr and won’t be starting on 20mcg immediately - I will start low and slow.

Really I’m keen to know what people’s experiences have been like taking it.

[TiggerMe in reply to Gosierunn]

Well that's good but how about all the other bits? Did he not suggest an increase in T4 first?

Adding T3 without adequate T4 is likely going to make you feel pretty crappy and there is a good chance you'd be better on T4 only but without trying and no testing of fT3 you are blindfolded and walking a plank

[Gosierunn in reply to TiggerMe]

I started on 25mcg and then increased to 50mcg. 8 weeks after the increase there has been no change in my TSH levels (negligible change). Everything points to poor conversion.

I’m currently taking Ashwahganda and Biocidin to try and address adrenal/cortisol issues and gut imbalances (respectively)

My understanding is that treatment plan is exactly that - low level dose of T4 with the T3… he specifically said not to increase

We will also address my low levels of B12, further testing to begin with.

TiggerMe - are you taking T3 medication?

Image of test results

[TiggerMe in reply to Gosierunn]

So these results show that you are very low in B12 and Vit D which will hamper conversion and that you needed an increase in T4 as it is only 44% through range and needs pushing up... 50mcg is still a starter dose

I'd be very wary of this Endo 😕

Yes I take a combination of T3&4

[TiggerMe in reply to Gosierunn]

Is the Ashwagandha helping? It is hard to guess if it will raise or lower cortisol levels

[PinkSkittles in reply to TiggerMe]

Why would it make you feel crappy?

[TiggerMe in reply to PinkSkittles]

Unless your body doesn't tolerate T4 then you often need a decent level even when taking T3

[PinkSkittles in reply to TiggerMe]

It seems to only be a few people I've come across who experience that, most seem to be fine. Would you agree?

I've not come across a reason yet as to why some people need optimal ft4 plus ft3. It goes against the science doesnt it.

Having said that it doesn't matter if its not common or if it doesnt make sense, if it happens to some people then its real in my opinion.

[TiggerMe in reply to PinkSkittles]

Far less people need T3 only, the vast majority find T4 works well and the ones who don't convert need to add a little T3 and most feel better with good fT4 levels, no idea why but it seems to be a thing 🤷‍♀️

[PinkSkittles in reply to TiggerMe]

Ah no I dont mean that

[TiggerMe in reply to PinkSkittles]

Are you feeling any better? You are doing the low T4 high T3 route (for the benefit of the OP)

[PinkSkittles in reply to TiggerMe]

No, physically not better, still terrible. Mood wise a little bit better but still not good.

[PinkSkittles in reply to TiggerMe]

So Ive found that the majority of people dont need good ft4 levels when taking t3. Ive only found a couple of people who do.

[Gosierunn in reply to PinkSkittles]

How long have you been on T4 / T3 PinkSkittles ?

[PinkSkittles in reply to Gosierunn]

Ive been on 31.25 mcg t3 for 2 1/2 weeks.I was on 50 mcg of t4 for 6 weeks before that.

[greygoose]

I would have thought you would need your FT3 tested before starting T3.

8 weeks after the increase there has been no change in my TSH levels (negligible change).

That's because you're not taking enough levo. It only 'works' if you take enough of it. And, besides, it's not about the TSH, it's about the thyroid hormones: T4 and T3. I wouldn't trust this endo as far as I could throw him.

[Gosierunn in reply to greygoose]

It’s strange because after 25mcg it was changing - ie from 6 down to 4 but after the next increment up it’s sticking at 4…

[greygoose in reply to Gosierunn]

Because you're not taking enough levo. It's not a linear up and down. You cannot predict what the TSH is going to do. So, just because it came down two points on 25 mcg levo, it doesn't mean that it will come down another 2 points when adding another 25 mcg levo. It just doesn't work like that. And, the pituitary is obviously still not happy with the amount of thyroid hormone in your blood. It's not strange at all.

[Gosierunn in reply to greygoose]

Won’t the T3 flatten the T4 down to near 1 in any case?

[greygoose in reply to Gosierunn]

Given your current level, probably. But not if you have your FT4 high in the range where it should be. Taking T3 will reduce it, certainly. Which is why you need it a lot higher to begin with. I think you're looking at this backwards. If you are one of these people that need good levels of T4 as well as T3, starting T3 with your FT4 at that low level will make you ill, and then you'll blame the T3. There are protocols for these things for a reason.

[TiggerMe in reply to Gosierunn]

I don't think you have a very good understand of this and your Endo certainly isn't helping, is he to be found on Facebook by any chance?

[Gosierunn in reply to TiggerMe]

Clearly I don’t which is why I coming on here! Appreciate the advice.

[TiggerMe in reply to Gosierunn]

It's a bit frightening that this Endo is handing out strong hormones without fully explaining things 😕 I'm glad you found the forum 🤗

[Gosierunn in reply to TiggerMe]

He is on Facebook - I had a private message with one or two people who said they were fine working with him. It’s extremely hard and so easy to feel completely unsupported.

[TiggerMe in reply to Gosierunn]

It certainly is, but be aware there are many charlatans that make the most of this situation I'm afraid... I'd suggest getting a good book, the library stocks Dr Durrant-Peatfield or you can buy it from Thyroid UK...

Or Dr Myhills latest book?

[Gosierunn in reply to greygoose]

I have been testing fT3 - see attached results above

[greygoose in reply to Gosierunn]

OK, but the fact remains that your FT4 is still only 44% through the range. It should be more like 75% through before you can say with any conviction that you have a conversion problem. And, with a TSH over 4, you're a long way off optimising your FT4. To see how well you convert you need the FT4 a lot higher, and the TSH around 1.

[Gosierunn in reply to greygoose]

Ok that makes sense to me, thank you. So would a natural next step be to increase the T4 medication and address B12 and VitD before considering T3?

[TiggerMe in reply to Gosierunn]

Yes absolutely, is your GP not giving you any guidance?

[Gosierunn in reply to TiggerMe]

No, well the last blood test I had with them was “in range” so they said no action 🙈 my private blood test was just out of range.

[TiggerMe in reply to Gosierunn]

Did the NHS blood test get done before 9am and last dose 24 hours before?

[Gosierunn in reply to TiggerMe]

It was.

[greygoose in reply to Gosierunn]

That would be the correct thing to do, yes, absolutely.

[Sparklingsunshine in reply to Gosierunn]

Just my experience but I spent 3.5 years on Levo alone (FT4). In that time I increased my dose from 50mcg to 200mcg. Although my FT4 was around 90% through the range my FT3 was lagging behind quite a bit. And consistently high FT4 levels can have health implications and arent good for us. So I decided to drop Levo dose and add some T3. And have felt much better.

As the others have said FT4 can work well for many of us, if we take enough of it. 50mcg is just the starter dose. We need to give Levo a chance and that means gradually increasing it in 25mcg increments every 6-8 weeks.

We need to be on a good amount and give it time, before deciding we need to add T3. Its a pain in the rear and an additional expense using T3, so if you can manage without and feel well then imo that's the best way.

I personally feel that some of these private doctors are too keen to push T3 too early, before they have given Levo a chance to work.

[Gosierunn in reply to Sparklingsunshine]

Thank you for your insight, that’s really helpful. What are the health implications of a high T4?

[Gosierunn in reply to Gosierunn]

Sorry I realise what you are saying eg hyper symptoms…?

[Sparklingsunshine in reply to Gosierunn]

Elevated FT4 is associated with an increased cancer risk, particularly solid tumours and dementia.

[Gosierunn in reply to Sparklingsunshine]

So could this be a rationale for going the combined low T4 + T3 approach?

[Sparklingsunshine in reply to Gosierunn]

Well it depends, if you cant convert enough FT4 into the active FT3 then yes. Some people have a very high FT4 but a low FT3 level, poor conversion. Low FT3 levels are what make you feel crap when hypo.

But you need to be on a reasonable dose of Levo to see how you respond, before adding T3. Some lucky people convert very well. Levo is always the first choice and a lot of people get on well with it.

People on this forum tend to be those who haven't. Or whose doctors dont know what they're doing and dose by TSH. Keeping them undermedicated and ill.

[Gosierunn in reply to Sparklingsunshine]

Thank you, thus is a very balanced and thoughtful response. Much appreciated.