T3 starting dose too high?

[Hippocamp]

Hi all, looking for some advice. Have had hashi's for 3 years and my GP has had me undermedicated for all of that time (25mg Levo rising to 50mg after about 1. years and only 7 weeks ago he allowed me to increase to 75mg at weekends and 50mg during the week).

My results in February were:

FT4: 14.6 (11.9-21.6)

TSH 3.82 (0.27-4.2)

Wouldn't test FT3

b12 477 (>260)

Vit d 44 (>50)

ferritin 58.2 (23-393)

I have felt like a walking zombie through all of this and GP didn't even mention at this stage that my Vit D was low. I started taking b12 and iron at that stage in February.

3 weeks ago I went to a functional doctor and he told me that my vit D was low and to take two sprays of the 3000ui Vit D and put me on Thybon.

My results at that stage were:

FT4: 16.9 (11.9-21.6)

TSH 1.24 (0.27-4.2)

FT3 4.1 (3.1-6.8)

b12 639 (>260)

Vit d 46 (30-125)

ferritin 35 (13-150)

Folate 3.9

He told me to take 20mg Thybon and didn't say anything about starting slow or splitting the dose. So I started taking one tablet in the morning 1 hr before food/drink straight away and moved my levo to night. I then took at bad dose of bronchitis a few days later and ended up on steroids and antibiotics and was very unwell. The thing is that I have not felt any benefits from the T3 at all. I am still exhausted with aches everywhere. I don't feel like I am overmedicated either though, no increase in HR, palpitations, anxiety etc. I am thinking that I started on too high a dose of T3 but also that my eltroxin is not high enough dose either. I have decided to move my eltroxin back to mornings as I am eating late at night so not taking it always on an empty stomach. So wondering which of the following to do:

- continue with 20mg T3 and increase levo to 75mg for every day

- continue with levo as 75 w/e and 50w/d and reduce T3 to 5 or 10mg and build up over a few weeks.

Any advice? Thx

[TiggerMe Ambassador]

Umm... caught between two idiots 😕

Ideally what you would have done is increase your T4 until it was in the upper part of the range but almost more importantly sort out your deficient Vit D (if using the Better You spray then each squirt is 1000iu) so I think functional idiot actually means for you to take 6 squirts at least, did magnesium get mentioned as important for Vit D uptake?

grassrootshealth.net/projec...

Your folate is also pretty much deficient so adding a good B complex would sort this out and get you B12 a little higher

healthunlocked.com/thyroidu...

Both of these being low will make you feel awful

I'd suggest you need to drop the T3 and try 75mcg T4 and look to retest and increase that to 100mcg before even dabbling with T3 and it'll give your body chance to make use of the supplements

How much do you weigh? It'll give us an idea of likely T4 dose you'll require

Free T4 (fT4) 16.9 pmol/L (11.9 - 21.6) 51.5%

Free T3 (fT3) 4.1 pmol/L (3.1 - 6.8) 27.0%

T4:T3 Ratio 4.122 

[Hippocamp in reply to TiggerMe]

Thank you . Do you mean stop the t3 altogether until I get ft4 optimised? I weigh about 65kg and am 5ft 10.

[TiggerMe Ambassador in reply to Hippocamp]

Yes, stop the T3 as it is just complicating issues (we always aim to optimise fT4, vits and mins first) and like you say your body isn't appreciating it or can't make use of it due to other imbalances, it is strong stuff and can do as much harm as good

So around 100mcg is likely to be what you need 65 x 1.6 = 104mcg