Advice on taking T3 for first time also best ph... - Thyroid UK

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Advice on taking T3 for first time also best pharmacy to use Private prescription please

nannieJen profile image
10 Replies

Hello everyone, I have finally obtained a prescription for T3 from a private endo. I’m excited but also apprehensive and want to get off to a good start, so would like some advice about the doses of T3 and T4 to take . Also information about the cheapest way of obtaining the T3 from my prescription.

My last blood tests were last done by NHS on 15th Feb and privately on 17th Jan. The reading on 15th Feb seems to be a bit of a blip because my T4 is normally 17 or 18. I think I had been ill just before. I have been on 5mg of Folic acid since Feb for 4 months via my GP so I am hopeful my Folate levels are now higher

17 Jan 24 (125mcg Levo 5 days 100mcg 2 days pw) Monitor My Health

TSH: 0.81 (0.27-4.2)

Free T4: 17 (12-22)

T3 3.5 (3.1-6.8)

15 Feb 24 (125mcg Levo 5 days 100mcg 2 days pw) NHS

TSH: 2.3 (0.27-4.2)

Free T4: 15.3 (12-22)

Vit D: 65

B12 734 (197-771)

Folate 3.4 (3.9-26.8)

Serum Ferritin: 109 (13-150)

Plasma Cortisol 9am 473 (133-537)

My Endo has told me to reduce my T4 from 125mcg per day to 100mcg and to take 10mcg of T3 twice a day. Everything I have read on here tells me this seems high. What level of T3 would you suggest I start on and should I reduce my T4.

Also I need to find the cheapest way to obtain my prescription. It’s a private prescription and has been made out for a 20 mcg dose.

Thank you I would be very grateful for any advice and your thoughts.

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Forestgarden profile image
Forestgarden

I got my 20mcg lio from Roseway labs. It was straightforward. They sent me a price for my prescription by email, with a link to pay. My meds were posted out and received within 2 days. I think 20mcg per day is a very high starting dose. Get a pill cutter and cut into quarters, so 5mcg dose. I would try a 5mcg dose and see how you feel. I had similar bloods to yours and was able to tolerate 2x 5mcg doses, 5-8 hours apart, quite quickly. I stayed on my 100mcg levo and 10mcg lio for 6 weeks, retested, and have now added in a third 5mcg dose, while reducing my levo to 87.5mcg. So far, this seems to be working well for me. I find when I take my first 5mcg lio together with my levo at 7.30am, I can feel it kick in and I get a slight feel of jitters, but I've worked out I need to 'use up' that extra energy boost, and I quickly feel fine again. I'm loving having the flexibility of lio. I even had an evening out, timing a lio dose a couple of hours before I went out. Its a really useful 'tool', just don't go too fast.

nannieJen profile image
nannieJen in reply to Forestgarden

Thanks Forestgarden I thought maybe 5mcg might be a good dose to start on so it's good to know you had similar bloods and that worked for you. I feel better doing that now. If I go with Roseway do I just send them the prescription in the post and do I need to sign for the delivery of tablets. Roughly how much is it for the 20mcg tablets

Forestgarden profile image
Forestgarden in reply to nannieJen

I paid £60 (which included postage) for 100x 20mcg tablets Thybon henning which is unlicensed in the uk, but pretty standard to get these I think. My private endo is also a practising NHS endo, and she sent my prescription directly to Roseway (digitally) and I had an email from them immediately, so I had ordered and paid before I'd even left her office. I believe if you actually have a paper copy of the prescription, you might need to email them a copy, then they will give you a price. rosewaylabs.com/

nannieJen profile image
nannieJen in reply to Forestgarden

Thank you that's very helpful I will give them a call tomorrow.

SlowDragon profile image
SlowDragonAdministrator

15 Feb 24 (125mcg Levo 5 days 100mcg 2 days pw) NHS

TSH: 2.3 (0.27-4.2)

Free T4: 15.3 (12-22)

Vit D: 65

B12 734 (197-771)

Folate 3.4 (3.9-26.8)

Serum Ferritin: 109 (13-150)

what are you doing about deficient folate and inadequate vitamin D

Important to maintain OPTIMAL vitamin levels, ideally improving BEFORE starting T3

Exactly what vitamin supplements are you taking?

is your hypothyroidism autoimmune

Are you always getting same brand levothyroxine at each prescription

Were both tests early morning and last dose levothyroxine 24 hours before test

You don’t need to reduce dose levothyroxine, or if you decide to dd so ……not by much eg 100mcg 3 days per week 125mcg 4 days

MMH test Ft4 only 50% through range

NHS test Ft4 only 33% through range

SlowDragon profile image
SlowDragonAdministrator

Low folate

supplementing a good quality daily vitamin B complex, one with folate in (not folic acid)

This can help keep all B vitamins in balance and will help improve B12 levels too

Difference between folate and folic acid

healthline.com/nutrition/fo...

Many Hashimoto’s patients have MTHFR gene variation and can have trouble processing folic acid supplements

thyroidpharmacist.com/artic...

B vitamins best taken after breakfast

Igennus B complex popular option. Nice small tablets. Most people only find they need one per day. But a few people find it’s not high enough dose

Post discussing different B complex

healthunlocked.com/thyroidu...

Thorne Basic B recommended vitamin B complex that contains folate, but they are large capsules. (You can tip powder out if can’t swallow capsule) Thorne can be difficult to find at reasonable price, should be around £20-£25. iherb.com often have in stock. Or try ebay

IMPORTANT......If you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 7 days before ALL BLOOD TESTS , as biotin can falsely affect test results

endo.confex.com/endo/2016en...

endocrinenews.endocrine.org...

In week before blood test, when you stop vitamin B complex, you might want to consider taking a separate folate supplement (eg Jarrow methyl folate 400mcg)

Post discussing how biotin can affect test results

healthunlocked.com/thyroidu...

helvella.blogspot.com/p/hel...

SlowDragon profile image
SlowDragonAdministrator

GP will often only prescribe to bring vitamin D levels to 50nmol.

Some areas will prescribe to bring levels to 75nmol or even 80nmol

leedsformulary.nhs.uk/docs/...

GP should advise on self supplementing if over 50nmol, but under 75nmol (but they rarely do)

mm.wirral.nhs.uk/document_u...

But improving to around 80nmol or 100nmol by self supplementing may be better

pubmed.ncbi.nlm.nih.gov/218...

vitamindsociety.org/pdf/Vit...

Once you Improve level, very likely you will need on going maintenance dose to keep it there.

Test twice yearly when supplementing

Can test via NHS private testing service

vitamindtest.org.uk

Vitamin D mouth spray by Better You is very effective as it avoids poor gut function.

There’s a version made that also contains vitamin K2 Mk7.

One spray = 1000iu

amazon.co.uk/BetterYou-Dlux...

It’s trial and error what dose we need, with thyroid issues we frequently need higher dose than average

Vitamin D and thyroid disease

grassrootshealth.net/blog/t...

Vitamin D may prevent Autoimmune disease

newscientist.com/article/23...

Web links about taking important cofactors - magnesium and Vit K2-MK7

Magnesium best taken in the afternoon or evening, but must be four hours away from levothyroxine

betterbones.com/bone-nutrit...

medicalnewstoday.com/articl...

livescience.com/61866-magne...

sciencedaily.com/releases/2...

Interesting article by Dr Malcolm Kendrick on magnesium

drmalcolmkendrick.org/categ...

Vitamin K2 mk7

betterbones.com/bone-nutrit...

healthline.com/nutrition/vi...

Too much Vitamin D is toxic

Make sure you test twice a year

healthunlocked.com/thyroidu...

nannieJen profile image
nannieJen in reply to SlowDragon

Thank you Slow dragon For the past year I have been working on my gut health and have been taking the following supplements: Vits – D with K2, B complex (pink tribe) with folate not folic acid (stopped before blood test), Magnesium Glycinate / malate/citrate. Although my last blood tests were disappointing for Folate and Vit D. I have now reluctantly started taking folic acid prescribed by GP as the folate in b complex didn't make any difference although it increased my B12.

My hypothyroidism is autoimmune. I know my T4 isn't the best that's why I was wondering if I needed to reduce my levo at all. Is it likely to go down lower once I take T3.

SlowDragon profile image
SlowDragonAdministrator in reply to nannieJen

I know my T4 isn't the best that's why I was wondering if I needed to reduce my levo at all. Is it likely to go down lower once I take T3.

Yes it is likely to drop further

How much vitamin D have you been taking. Suggest you increase dose a little

When taking vitamin B complex, when you stop for week before test, best to take a separate methyl folate instead

As you have Hashimoto’s

Are you on gluten free and/or dairy free diet

nannieJen profile image
nannieJen in reply to SlowDragon

I take 4000IE vit D per day. I don't eat much gluten but I'm not gluten free or dairy free. I have tried but it's just a step too far for me

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