I'm due to see an endocrinologist privately tomorrow for the first time. I've been on levo for 13 years after a TT for ThyCa. I've never taken T3 so I'll be asking to try it since I've felt rubbish for 13 years! So my question is what kind of dose of T3 would I expect to take initially? I'm on 150mg of levo a day and 125 at weekends. How quickly will it help with energy levels?
Any questions I should ask the endo or anything else to be aware of? Thanks.
Hello DarkStar :
Just for reference - a fully functioning working thyroid would be supporting you on a daily basis with trace elements of T1. T2 and calcitonin + a measure of T3 at around 10 mcg + a measure of T4 at around 100 mcg.
T3 is said to be around 4 times more powerful than T4 :
Depending where your T4 is ' sitting ' your T4 might be reduced to allow ' space ' for the T3 :
If your TSH is already suppressed and below range - some consultants are reluctant to prescribe T3.
No thyroid hormone replacement works well until the core strength vitamins and minerals of ferritin, folate, B12 and vitamin D are up and maintained at optimal levels which we can advise on if needed.
Thanks, this is helpful. I haven't had vitamin and mineral levels checked recently I'll get on that.
I think it’s not only about t3 dosage but also ensuring your T4 dose is reduced if it’s currently over range. With thyroid cancer you usually need a suppressed TSH so your dose currently of T4 will be high and over range. You need to get your T4 just within range and add T3 when your T4 level is dropping to just below the top of the range. My sister who had thyroid cancer has recently been through the same process. Her private only endocrinologist, who is my endocrinologist also, advised on lowering T4 and adding T3 5mcg twice a day 8hrs apart. Take your T4 reduced dose as normal and add T3 twice a day 5mcg 8hrs apart. Then get your bloods checked again after 6 weeks. This will give plenty of time for T4 to reduce and T3 to rise. You’ll still need to keep your TSH suppressed. You may have felt awful for all those years due to too high T4. My sister feels much better now her T4 is in range and T3 higher. She has more energy and her many symptoms have virtually disappeared after 4 months of adding T3 and reducing T4. Her TSH is still suppressed but that lowering of T4 has made as much positive impact as adding the T3.
Thanks for replying, I'm glad your sister is feeling better. What dose of T4 does your sister take please?
Depending on there understanding of T3 they might issue anywhere between 5-20mcg but we always recommend starting low and gradually building up, for some it kicks in quickly for others who have been low for a long time it can take quite some time for your body to adjust, important to have all your vits and mins optimised and really useful to know where your cortisol levels are
Has your fT4 dropped back into range since you last lowered your dose?
Thanks, yes T4 is in range. I will need to get vit and min levels checked.
I had a TT for ThyCa in 2012 and struggled endlessly to get help when Levothyroxine failed me. I eventually got T3 when an enlightened Endo agreed that no one without a thyroid could function without the addition of exogenous T3
Thanks for replying. Mine was 2011. How long have you been on T3? What dose of T3 and T4 do you take please? How long did it take for the T3 to improve your energy levels? Actually can't believe I've struggled on like this for 13 years and with 3 young kids to run after.
I really don’t know how you’ve coped DarkStar.
It took a long time for Endo to get the balance of Levo and T3 correct as my bloods (and me!) were in such a mess. Eventually progress was made on 75 mcg Levo and 20 mcg T3.
It then became difficult to source T3 at all as NHS, CCGs and GPs were going through their ‘hissy fit’ phase about prescribing T3. I don’t think that it’s much better now tbh. As a result, I changed to 2 grains of NDT and have been settled on this since 2018. Although I didn’t set out to take equivalent amounts of T4 and T3, it’s interesting that the amounts in my daily dose of Thyroid S are roughly the same: 78 mcg T4 and 18 mcg T3.
As I had a fully functioning thyroid before it was removed for ThyCa, I had the benefit of knowing what my levels were when they were tested before surgery. My blood results now run at about the same levels.
Where did you have your thyroid removed DarkStar?
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