Help with not tolerating T3 Liothyronine

[1965Katy]

Hi again,

This might sound like a stupid question but does Levothyroxine increase T3 or does it just increase T4 (and of course lowers TSH)?

The reason I ask is that I have now been taking Liothyronine 5mcg once a day for over two weeks and I feel worse than just on Levothyroxine. If I increase to 7.5mcg or 10mcg I feel awful. I am meant to be on 10mcg as prescribed by endocrinologist on 17th July but I asked if I could initially halve the dose as my body adjusts.

I received her clinic letter following appointment (17th July) which included the latest blood test results from bloods taken on that day before I started the Liothyronine.

Bloods 17th July were:

FT4 17.1 (10.8 -25.5)

FT3 3.4 (3.1 - 6.8)

No TSH result

At appointment 17th July she reduced my Levothyroxine to 75mcg daily and introduced 10 mcg Liothyronine to be taken in one dose in morning with Levothyroxine but I think she was going on the below blood results taken on 15th July.

If I take more Levothyroxine will it increase my T3 as well as T4? (I was previously taking 100mcg Levothyroxine 4 or 5 days and 75mcg 2 or 3 days a week, alternating those two doses alternate weeks as was planning to increase slowly to avoid palpitations from Levothyroxine).

(Lab wouldn't test TSH as tested two days before. The results two days before were totally different and yet I followed all the guidelines (fasting and no Levothyroxine or biotin) for both. In fact the bloods taken at endo appt were at 11am whereas the ones below (15th July) were taken at 8.45am).

Bloods taken 15th July were:

FT4 22.2 (10.8 - 25.5)

TSH 0.38 (0.27 - 4.2)

FT3 not tested

I am wondering should I just stop Liothyronine and increase my Levothyroxine to 100mcg instead? I did not feel as bad just on Levothyroxine (but I am a poor converter of T4 to T3 hence the introduction of Liothyronine).

My key vitamins are optimal.

For the first 8 hours after taking 5mcg Liothyronine I feel dreadful and then I feel better but still tired with brain fog.

Or I am wondering if I should ask my endocrinologist if I can increase my Levothyroxine to 100mcg every day and continue with just 5mcg a day but to take it at night? At appointment she instructed me to take Liothyronine together with Levothyroxine in the morning.

Sorry this is garbled and repetitive I have terrible brain fog and it's difficult to think and write.

Many thanks

[TiggerMe]

Adding T3 raises fT3 it can't turn back into fT4 but it often reduces it

17th July...

Free T4 (fT4) 17.1 pmol/L (10.8 - 25.5) 42.9%

Free T3 (fT3) 3.4 pmol/L (3.1 - 6.8) 8.1%

T4:T3 Ratio 5.029 

15th July...

Free T4 (fT4) 22.2 pmol/L (10.8 - 25.5) 77.6%

So I'm a bit confused but I'll give it a bash... with either of those results I wouldn't have reduced T4 before starting T3 and we always say only change one thing at a time

I'd go back to your previous dose of T4 and stick with that whilst you add T3... have you tried taking the T3 before bed as some find this works better for them?