Endo has given me T3.. What do I need to know? - Thyroid UK

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Endo has given me T3.. What do I need to know?

JUUJOO profile image
16 Replies

So after many calls and emails over the last 6 weeks, I got an emergency appt with my endo. 2 months ago he dangled the carrot of "maybe needing to add in T3" but then wrote to me saying my bloods are in range and to review in August. Then he's ignored me. After persistence and many messages, I saw him today and he suggested we up thyroxine again or trial T3. So I opted to trial T3. I currently take 6 x125\1x100 thyroxine. He suggested reducing to 100daily and adding in 5mcg of T3 in the morning.

I'm sensitive to increases/decreases, so worried how I will feel. He said if I feel worse to drop to 75/100 alternate days.

Latest bloods :

Serum free T4 level:16.6 pmol/L.

(10.8 to 25.5)

Serum TSH level:0.27 mIU/L

(0.27 to 4.2)

Serum free T3 level: 3.6 pmol/L

(3.1 to 6.8)

What do you guys think?

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JUUJOO
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16 Replies
FallingInReverse profile image
FallingInReverse

Did your FT4 drop from 22 to 16 in just one month?

JUUJOO profile image
JUUJOO in reply toFallingInReverse

These are last 2, Feb one by endo, March one by GP.

28th Feb 0.47 3.9 22

19th March. 0.27 3.6 16.6

Both tests taken 9am, fasting, delayed previous dose etc

FallingInReverse profile image
FallingInReverse in reply toJUUJOO

My experience: When I added T3 - I dropped from Levo 50 to 25 (I still marvel when I look back at how low it was lol), and then added 10 T3.

There is some standard conversion that I can't remember, but I think dropping 25 Levo is pretty standard.

On the other side of things - I can say that for me - adding 10 T3 all at once is NOT something I would do again. I got palpitations right away that lasted for about 9 months. I think part of it was being under-replaced, but also, 10 all at once (taken 5 in the morning and 5 at night) was just too much.

My last test shows T3 is a little too high, and when I reduce I will definitely do in 2.5 increments.

I have read other people's experiences here about adding slowly, and splitting doses as they ramp up slowly.

So just my experience, not really giving advice, other than to agree with the cautious slow approach!

EDIT: Also... please come to the forum often when you do change your dose and add T3... as with any dose change, the first 6-8 weeks can be volatile. Doctors will give bad advice - like "if you feel worse, drop further." Although everyone is different, for myself and many others here, you can EXPECT to feel a little worse until things settle, and we many times encourage you to hold the line! And practice your patience. I did, and I'm glad, and I am finally out the other side.

Curious about your T4 - I will assume at both those tests you were on a steady dose of 6 x125\1x100 for at least 6-8 weeks when both were taken? I have no insights, just curious to see the FT4 drop in a month.

JUUJOO profile image
JUUJOO in reply toFallingInReverse

Thankyou. I really want the slow and cautious approach. I feel I need it. Endo doesn't get that, he is not expecting me back for a blood test any time soon. He doesn't fill me with confidence at all. He will see me in 6 months unless I have a problem. At the beginning on T4 when I felt worse, his advice was to drop T4 further, when really I needed more. Took me months to recover. I'm worried this will happen again especially as I don't have bloods prebooked with no real plan. No idea on the T4, everything was normal?!

helvella profile image
helvellaAdministrator

It would likely to be good to know what products are (potentially) available!

helvella's medicines documents (UK and Rest of the World) can be found here:

helvella - Thyroid Hormone Medicines

helvella has created, and tries to maintain, documents containing details of all thyroid hormone medicines in the UK and, in less detail, many others around the world. There is now a specific world desiccated thyroid document.

I highly recommend viewing on a computer screen, or a decent sized tablet, rather than a phone. Even I find it less than satisfactory trying to view them on my phone.

helvella - Thyroid Hormone Medicines - UK

The UK document contains up-to-date versions of the Summary Matrixes for levothyroxine tablets, oral solutions and also liothyronine available in the UK. Includes descriptions of tablet markings which allow identification. Latest updates include all declared ingredients for all UK products and links to Patient Information Leaflets, etc.

dropbox.com/s/bo2jzxucgp9hl...

helvella - World Desiccated Thyroid

Contains details of all known desiccated thyroid products.

helvella - Thyroid Hormone Medicines - RotW

Contains details of all levothyroxine, liothyronine and combination products - excluding desiccated thyroid products. Details available vary by country and manufacturer.

The link below takes you to a blog page which has direct links to the documents from Dropbox and QR codes to make it easy to access from phones. You will have to scroll down or up to find the link to the document you want.

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

JUUJOO profile image
JUUJOO

pennyannie SlowDragon Could I tag and ask your advice please on my post please? Not sure if this is allowed or not. My GP ran additional bloods as posted but I'm worried about dropping my T4 by 25. Endo shrugged shoulders and basically left it to me to find balance. Either get in touch if struggling or go back in 6 months.

SlowDragon profile image
SlowDragonAdministrator

Free T4 (fT4) 16.6 pmol/L (10.8 - 25.5) 

Ft4 only 39.5% through range

personally I would increase Levo as next step

Looking to get Ft4 up at least over 60%

Which brand levothyroxine are you taking

Definitely 125mcg daily

Perhaps adding another 25mcg per week

(as 12.5mcg twice a week)

How much do you weigh in kilo

What are vitamin D, folate, B12 and ferritin levels

What supplements are you taking

JUUJOO profile image
JUUJOO in reply toSlowDragon

I'm taking 6 x 125 /1 x 100. Mainly Mercury or sometimes Accord. Plus I've been given 5mcg Roma T3 capsules to add in daily and then reducing my levo to 100 daily. Which I'm worried about. I'm taking ferrous fumerate, magnesium, D3/K2, omegas, B Complex. My weight is now 69kg

Serum free T4 level:16.6 pmol/L.

(10.8 to 25.5)

Serum TSH level:0.27 mIU/L

(0.27 to 4.2)

Serum free T3 level: 3.6 pmol/L

(3.1 to 6.8)

Folate - Serum 12.5 ug/L (3.89 - 19.45) 55.3%

Vitamin B12 101 nmol/L (35.5 - 150) 57.2%

Vitamin D 119 nmol/L (50 - 200) 46.0%

Ferritin 64 ug/L (13 - 150) 37.2%

SlowDragon profile image
SlowDragonAdministrator in reply toJUUJOO

Reading your helpful profile

Are you on dairy free diet

Or gluten free diet

If you’re going to add T3 before increasing levothyroxine, you very likely don’t want/need to reduce Levo

Be aware

A) Roma T3 doesn’t suit everyone

B) 5mcg is very small dose

Any dose of T3 will very likely reduce TSH, so if endo is TSH obsessed that can be an issue

JUUJOO profile image
JUUJOO in reply toSlowDragon

Thankyou for the advice. I'm not on any special diet, not gluten or diary free.

SlowDragon profile image
SlowDragonAdministrator in reply toJUUJOO

Always worth trying with any autoimmune disease, but especially thyroid

Gluten Free is easier to start on

See how that goes

While still eating high gluten diet ask GP for coeliac blood test first as per NICE Guidelines

nice.org.uk/guidance/ng20/c...

Or buy a test online, about £20

Assuming test is negative you can immediately go on strictly gluten free diet 

(If test is positive you will need to remain on high gluten diet until endoscopy, maximum 6 weeks wait officially) 

Trying gluten free diet for 3-6 months. If no noticeable improvement then reintroduce gluten and see if symptoms get worse

chriskresser.com/the-gluten...

amymyersmd.com/2018/04/3-re...

Similarly few months later consider trying dairy free too. Approx 50-60% find dairy free beneficial

With loads of vegan dairy alternatives these days it’s not as difficult as in the past

Post discussing gluten

healthunlocked.com/thyroidu...

JUUJOO profile image
JUUJOO in reply toSlowDragon

Thankyou. With regards to my measly 5mcg T3 capsule, Endo said to take it in the morning. Does it matter when? I take my thyroxine around 11 pm. I'm thinking to take my iron at 7am then T3 around 11 am? Thankyou for all your help.

SlowDragon profile image
SlowDragonAdministrator in reply toJUUJOO

I take my thyroxine around 11 pm

So when doing blood tests do you change timing of last dose levothyroxine to 24 hours before test?

If you normally take levothyroxine at bedtime/in night ...adjust timings as follows prior to blood test

If testing Monday morning, delay Saturday evening dose levothyroxine until Sunday morning. Delay Sunday evening dose levothyroxine until after blood test on Monday morning. Take Monday evening dose levothyroxine as per normal

I would take T3 early morning

Iron with food at lunchtime

shaws profile image
shawsAdministrator

I think you're very fortunate that your Endo is prescribing T3.

I take T3 (liothtronine) only now (initially I was prescribed T4 (levothyroxine) butit only gave me palpitations).

I follow Dr John Lowe who was a doctor/scientist/ and expert using T3. He had a bad fall that caused a brain bleed that caused his early demise. He was also an Adviser to TUK.

drlowe.com/thyroidscience/c...

FallingInReverse profile image
FallingInReverse in reply toshaws

Thanks for that article. Was refreshing to see this in print:

“My sorrow is even deeper, however, over the millions of fibromyalgia patients who today are improperly treated for profit with Big Pharma's drugs. As my colleagues and I showed many years ago (and typified by the case we republish today in Thyroid Science), the continued suffering of most of those people is avoidable. But sadly, we now live in a world where drug companies and researchers they fund steadily more make their fortunes from sustaining the suffering of other human beings.”

shaws any thoughts on what biological mechanism of T3-only working… curious since combo in the form of NDT doesn’t work, then I assume Levo/Lio wouldn’t work, and … therefore its an intolerance to exogenous Levo entirely?

shaws profile image
shawsAdministrator in reply toFallingInReverse

I'm not medically qualified so the only knowledge I have is through what gain I got from this Thyroiduk forum and Dr. Lowe.

I found Dr Lowe's information easy and which I found suited myself and the thyroid tablet I took - which is T3 - restored my overall body to good health.

Dr Lowe took his dose in the middle of the night when he awoke and it returned his health and enabled him to return to work i.e. doing research etc. It was very unfortunate that a bad fall caused his brain to bleed and it caused his premature death as he couldn't recover.

P.S. Once I put on Fibromyalgia''s forum information of Dr Lowe's advice on fibromalgia but they were very angry and removed everything I posted -they were not at all happy

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