Reduced liothyronine dose & symptoms

[Girlslovescifi]

I was advised to reduce my t3 from 15mcg per day to 10mcg per day. I also take 100mcg Levo per day. I started on the reduced t3 on 12th Sept. For over 2 years, I haven’t gained weight, regardless of what I ate or drank. I also had loose bowels, but as I ate a largely plant-based diet, I thought that might be the cause. Over the last week, I’ve found I’ve gained 3lbs and my bowels are now firm. Could this be the reduced t3? I recently took an NHS test for blood in stools and that was fine. I don’t have other symptoms.

[TiggerMe Ambassador]

Sounds like it could well be that your ideal dose is 12.5mcg?

[DippyDame in reply to TiggerMe]

Out of interest  TiggerMe ....Why?

She has no symptoms on 10mcg

10mcg seems to be working well.

I was advised by a T3 expert that we should aim to take the lowest effective T3 dose, not the maximum we can tolerate.

There is a difference as I discovered on my journey to reach a therapeutic supraphysiological dose of T3-only

[TiggerMe Ambassador in reply to DippyDame]

Weight gain and firm stools are symptoms… I’ve not seen any results hence the ?

5mcg when fine tuning is a significant drop of a third of dose

[DippyDame in reply to TiggerMe]

I wondered because your response looked more like a statement than a question.....despite the question mark.

Sounds like it could well be that your ideal dose is 12.5mcg?

She had already stated that she no longer has symptoms

Symptoms are as important as numbers when dosing with T3.

Agree, it might appear a significant drop but her symptoms were also significant.

Contrary to many beliefs there are no rules set in stone and it's vital that we listen to our body...it's not straightforward.

Our ideal dose is where we feel well not what a list of numbers suggest....if that were the case I would now have departed this mortal coil!

[TiggerMe Ambassador in reply to DippyDame]

I was working on her symptoms of loose bowel movements on 15mcg and overly firm on 10mcg (enough of a change for her to have stool testing) and the mentioned weight gain assuming that was an undesirable change.... so it seemed likely that the middle dose might be the next trial....

As someone that does take 15mcg of T3 I'm aware that 12.5mcg isn't enough for me whereas 17.5mcg brings no benefits 🤷‍♀️ Very different to your experience and usage of T3

Looks like some pretty dodgy advice has been handed out in the past by her Endo... healthunlocked.com/thyroidu...

[Girlslovescifi in reply to TiggerMe]

The stool test was routine - nothing to do with my bowel change. I lost a lot of weight initially, then couldn’t gain for 2 years. Now I’m gaining (only 3-4lbs so far) but I’d rather not! Maybe 12.5mcg is what I need.

[DippyDame in reply to TiggerMe]

No mention of stool being OVERLY firm.The stool testing had nothing to do with her bowel movements as you suggest.....and which she confirms

However I just hope she can settle on a dose....and trial and error is often the way.

It's not unusual to experience fairly sudden weight loss/ gain until the hormone level settles....been there and still have the clothes in different sizes to prove it!

As someone that does take 15mcg of T3 I'm aware that 12.5mcg isn't enough for me whereas 17.5mcg brings no benefits .....

so if 17.5mcg adds no benefits over 15mcg your experience underlines my point that we should aim for the lowest effective dose.

Anyway this is about Girlslovescifi ...we are all different so our experiences are unlikely be the same as hers.

I see nothing wrong with trying 12.5mcg T3 if that works. I just felt it better to keep the dose as low as possible....in relation to her symptoms. Time will tell.

Thank you for explaining your thoughts....none of us here can claim to be expert so we learn from each other.

[Girlslovescifi in reply to DippyDame]

I got my dates wrong. I reduced from 15 to 10mcg in July. That’s enough time for the effects to be showing now I think.

[DippyDame in reply to Girlslovescifi]

Yes!

[TiggerMe Ambassador in reply to DippyDame]

Agreed, lowest dose is the aim, but dropping 1/3 for us would be like someone suggesting you dropped your dose from 125 to nearer 80mcg 😕

Smaller changes are key to hone in on the sweet spot

[DippyDame in reply to TiggerMe]

After almost a lifetime of thyroid related problems I'm very well aware of what you say.

In any case I'm quite sure Girlslovescifi Is perfectly capable of reading suggestions made and drawing her own conclusion.

I appreciate you are trying to help and to share your experiences but ultimately none of us here is an expert.

[TiggerMe Ambassador in reply to DippyDame]

Indeed... all detectives

[DippyDame]

YES!! It sounds very much as if your T3 dose was too high....your symptoms suggest overmedication.

The signs and symptoms of overmedication can vary but may include...

Elevated pulse and blood pressure

Anxiety, nervous energy, tremors

Feeling irritable, overemotional, erratic, or depressed

Difficulty concentrating

Difficulty sleeping

Fatigue or feeling extremely tired

Feeling overheated, even when others are cold

Diarrhea

Feeling like your heart is skipping a beat or racing

Weight loss with no change in your diet or exercise routine

Increase in food intake with no weight gain

I need high dose T3-only (125mcg) and have experienced both over and undermedication during my journey towards a therapeutic dose!

It's not unheard of for a person to go to their doctor because they think they need a higher dose of their medication only to find out their symptoms are actually being caused by overmedication.

Your doctors should have recognised this sooner but unfortunately their thyroid knowledge is generally basic at best.

Hopefully you have now found your therapeutic dose. If you feel well don't agree to another dose change....usually wrongly based on TSH alone.

T3 naturally lowers both TSH and FT4.

As humans we are all different with very different requirements....there are no set rules and sometimes we need to think out of the box ....as I discovered.

Good to know you eventually received correct advice...life should be easier now.

Take care.

[Girlslovescifi in reply to DippyDame]

Thank you!!

[Girlslovescifi in reply to DippyDame]

I didn’t have racing heart - in fact I often still had a slow heart rate. But I can get very anxious, so not sure if that increased because of the t3. I do get tired and can’t take heat from the sun but then I can also feel cold. My bone density isn’t great (osteopenia) so the endo thought I should reduce.

[TiggerMe Ambassador in reply to Girlslovescifi]

I also have osteopenia but this is due to years of low T3 slowing bone growth rather than high levels 🤷‍♀️

[radd in reply to TiggerMe]

E and Girlslovescifi

Both excess or inadequate levels of FT3 can cause osteoporosis.

Excessive means bone absorption exceeds bone production with a net loss of bone mass, and inadequate means both bone resorption and production decreases resulting in fragile brittle bones.

And depending upon genetics excess FT4 can also be a problem because it may convert to T3 within bone cells that express D2 enzyme (there's no D1 enzyme in bone cells).

Also according to Tania Smith many bone cell types are equipped with a D3 enzyme self-defence mechanism which deactivates excesses of both T3 and/or T4 that then risks elevated RT3 that may create its own host of other issues 😬

[TiggerMe Ambassador in reply to radd]

Oh Radd! 😖🫠

[radd in reply to TiggerMe]

😆🥰

[SlowDragon Administrator]

Initially you are likely to feel hypo after reducing dose

You need to wait at least 8 weeks before retesting

What were your TSH, Ft4 and Ft3 BEFORE reducing dose

Look at taking magnesium/ vitamin C to reduce constipation

[Girlslovescifi in reply to SlowDragon]

Just before I reduced, levels ft4 18.3 (7.8-18) and FT3 5.95 (3.5-6.8). Tsh was suppressed. Had them redone on 12th Oct (too soon, I know) and FT4 was 17.3 and ft3 5.83. I’ll wait another month and have them retested and I’ll try to get b12 etc checked. I take (when I remember) viridian high five b complex with magnesium ascorbate. I did take a separate b12 spray for a while. There’s 20ug of b12 in the complex. Adenosylcobamin and methylcobalamin.

[SlowDragon Administrator]

Also retest vitamin levels at next test

6 months ago your B12 was extremely low

healthunlocked.com/thyroidu...

What vitamin supplements are you taking

If not eating meat, you will need separate daily B12