Restarting T3: Hi, I’m restarting T3 tomorrow... - Thyroid UK

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Restarting T3

DownAndDesperate profile image

Hi,

I’m restarting T3 tomorrow after I do a finger prick test tomorrow to see what my thyroid levels are like after being off T3 since the end of January. I’m starting on a quarter tablet.

How often should I raise the amount? And after how long should I get my levels tested?

Thanks

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DownAndDesperate
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Buddy195 profile image
Buddy195Administrator

I’m unsure what a quarter tablet of Liothyronine is….how many mcg is the full tablet? (There are 5, 10 &20mcg tablets etc)

I’m an advocate of making low and slow adjustments, as this means you are less likely to miss your sweet spot, where you feel most well.

We recommend retesting thyroid bloods 6-8 weeks after being in a consistent dose.

Do share results with us when you get them, so we can offer better advice

DownAndDesperate profile image
DownAndDesperate in reply to Buddy195

The ones I have are 25mcg. I was 50mcg in Jan (built up over 2 years) and felt good but I had a heart attack and the T3 was blamed because my heart rate was too high but it had been high for years before starting the T3. I feel it was scapegoated and the more likely explanation is my APS (blood clotting disorder) which is known to cause a lot of heart attacks in people below 50. The Thyroid UK CEO and a representative from APS UK both agreed with this.

So, do you mean I should take one quarter of a tablet for 6-8 weeks and then test?

Thanks

Buddy195 profile image
Buddy195Administrator in reply to DownAndDesperate

Due to your heart issues, I would share results from your planned blood test first, BEFORE considering a change in medication.

humanbean provided some very informative links re heart health & your other medical conditions in your last post.

DownAndDesperate profile image
DownAndDesperate in reply to Buddy195

Ok, thanks

DippyDame profile image
DippyDame

I understand you are desperate to resolve this but please slow down, rushing won't help

Do the finger tip test tomorrow, wait a few days for the result which will give you a baseline and help to point the way forward.

A quarter tablet tells us nothing....sorry....

But Buddy195 has advised on that.

I would start on 2.5mcg then add another 2.5mcg every 2 weeks until you reach 10mcg....that will take you to your next test (6 weeks)

Use a pill cutter to divide the tablets....it will be tricky but you need to start with that low dose...pick the crumbs up with a slightly damp fingertipand store the rest in a little lidded pot.

If you reach 10mcg without incident then after testing you could try 5mcg daily ( split if you like)

This should let the system adjust to the T3...the test results will guide your further increases

Bear in mind that the heart needs a great deal of T3....has your FT3 been low?

Unfortunately there is no quick fix....but with correct treatment a fix should exist

Good luck, we're all here to help

DownAndDesperate profile image
DownAndDesperate in reply to DippyDame

I’m not rushing - I was going off what SlowDragon advised me to do in my last post. I couldn’t remember how long they said to leave it before testing but I did remember that they said 1/4 tablet at 6.25mcg at a time. Given that SlowDragon is an admin and seems very knowledgeable I assumed that this was a fine amount to start on, particularly as I have discussed past test and health issues with them. I went back to check and they said to start on 6.25mcg and raise by this every 6-8 weeks and retest before each raise.

I don’t know where to purchase smaller tablets as the place I get them from only sells the 25mcg ones and cutting them into quarters is tricky enough already. The place I got them advised me to start at half a tablet so I’m actually going much slower than first advised.

In terms of FT3 being low, the only results I currently have access to are ones I did at 25mcg of T3 and 100mcg T4. The levels were 4.47pmol/l with a range of 3.1-6.8. FT4 was 11.5pmol/l with a range of 12-22. The hospital told me to come off T3 all together and go up to 150mcg. They took tests while I was on the T3 but I haven’t been able to get hold of them. I’ve done a request for all my hospital records but haven’t heard back yet. The doctors followed up but only tested TSH as usual which was 9 something. I know that doesn’t really tell you much.

Thanks for your help.

DippyDame profile image
DippyDame in reply to DownAndDesperate

By rushing I was referring to starting T3 before you have the lab results...it wasn't a criticism. Sorry if you felt that.

I think I now have a clearer picture of what is gong on. and I'm not sure that your medics are on the right track given your ECG result

Given your medical history I was suggesting that you re-introduce T3 very low and very slow to avoid over stimulating the heart.....but maybe we should lay that aside for now until your new results come back

None of us here are medically qualified we use our personal experience and knowledge to offer support and suggestions as to what might help.

Maybe re-read my reply to you 2 months ago

Looking at the results you quote above....

Dose....25mcg of T3 and 100mcg T4.

FT3 4.7 (3.1 - 6.8) = 43.24% through the reference range

FT4 11.5 (12 - 22) = -5% through the reference range

Your results seem unusual for your dose.....despite T3 lowering FT4 the result of -5% through the ref range is very low

Did you test at 9am, at least an hour away from food and drinks, 24 hours after previous dose of Levo/ T4 and 12 hours after previous T3 dose

I'd suggest that the results of this new test on 100mcg T4 will help clarify things.

Once you have those you should have a clearer picture of how much hormone you actually need so post them and members will have a look and advise

DownAndDesperate profile image
DownAndDesperate in reply to DippyDame

Thanks for your reply.

I’m sorry that I was defensive. I’m very sensitive to criticism.

Oh, nobody had previously said to wait for results. Actually, I’m not sure anyone said to test before I started T3 again - I just wanted to get them as a baseline. But I’ll wait if that’s best.

I don’t think they’re on the right track either, especially given the APS. It seems the only indicator of a heart attack was the elevated troponin levels and the symptoms I had at the time of the attack. Once I was on a monitor my heart rate was high but that certainly isn’t a one off for me. The ECG was fine - it was listed as a non-STEMI which I believe is when the ECG doesn’t show anything. Echo also didn’t show anything. Though someone on here linked me to an article about blood clots that are so small that current tests, even an angiogram can’t detect them. I do wonder if the car crash I was in 6 months prior had anything to do with it. I was on the monitor in the ambulance for quite some time because my heart rate was high and wouldn’t come down. I went to A&E a week later because they left glass in my knee and they did a CT and x-rays because some blood marker was high and they said the bruising from the seatbelt was extensive and deep when they felt it (we overturned so I was suspended by the seatbelt).

I’m sorry I didn’t reply to your message on my previous post, it was very helpful, thank you. I was really overwhelmed at the time and thought I had replied to everyone. I did read the studies you linked though. In reply to your question there - when I was diagnosed hypothyroid my antibodies did come back raised but I don’t remember what the results were. It was a good 10 years ago, but I wonder if I can find the letter. When I was pregnant with my 7 year old a doctor said to me ‘you’re very antibody-y, aren’t you?’ So I’m not sure if that gives you any indication 😂 but I do have several autoimmune conditions. All this to say, when I did the antibody tests through medicheck they all came back in range. I’m assuming this is down to having been taking LDN for several years now.

In regards to treatment for PCOS and APS - I have been refused treatment for APS but I intend to ask for a referral (tried through econsult due to being impossible to get appointments but they just said to book an appointment. Though the last time I tried to speak to the doctor she told me I was too complicated, that GPs could do no more for me and that any issues I have should be given to my Endo) but I have never been offered any treatment for PCOS. In fact, I have no idea what treatment there actually is.

I believe I did the test early morning, but I’m not 100% sure when. I followed the protocols for not taking medications for the recommended time and I never eat during the day. I might have had sugar free juice - would this effect things?

I’m on 150mcg T4 at the moment as per Endo’s instructions.

Sorry for the very long reply!

DippyDame profile image
DippyDame in reply to DownAndDesperate

Long replies are what I do too.

No need to apologise!

I empathise, I've been upside down in a ditch after skidding on a patch of ice....that was nearly 50 years ago and I still suffer from the whiplash involved! I'm still having treatment...

Your juice shouldn't have had much impact.

150mcg levo sounds like a better dose but results will tell if you need to add T3

If your T3 is too low that can/will affect any or all parts of the body....and very definitely mental health.

But I guess you know that

You sound very brave.... so hang on in there until you have the labs

DownAndDesperate profile image
DownAndDesperate in reply to DippyDame

Oh no, I’m sorry to hear that. I’m still waiting on physio for my knee and shoulder but luckily we weren’t going too fast. I think the impact mentally has been the hardest part, particularly as my little one was in the car.

Judging by the high TSH (and how I feel) I’m assuming my levels won’t be coming back as ideal.

Yes - I research the life out of everything 😂 I have a degree in psychology so I’m used to reading studies 😊

Thank you

Buddy195 profile image
Buddy195Administrator in reply to DownAndDesperate

I will shout out  SlowDragon for further input

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DownAndDesperate profile image
DownAndDesperate in reply to Buddy195

Thanks 😊

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