adding T3 to T4 and feeling exhausted

[Citta]

Hello! I know it’s still early days, but for the past 2 weeks, I’ve been taking 20mcgs of T3 ( split dose) and 75 mcgs of T4 (levothyroxine , reduced from 100) and I’m feeling increasingly tired. My sleep has improved somewhat and my anxiety is reduced which is good: I’m hoping that when I have my bloods checked again in 2 months my thyroid hormones might be optimised with a reduction in my high cholesterol (6.4). Does it take awhile for the body to adjust to adding T3?

[elaar]

What was your FT4 reading before the change? You might have made the same mistake as myself where the addition of T3 causes your FT4 measurement to drop anyway, and so the 25mcg reduction isn't necessary.

[tattybogle]

20mcg's of T3 is an unusually large dose to add all in one go ,,,more usual/ cautious approach would be to introduce smaller doses at first and increase slowly depending on your response.

re. the Levo dose drop i recently added 6 mcg, then 9mcg T3 to reduced dose of levo ,,and i agree with elaar, my fT4 level fell much more than i was expecting .. and i didn't feel right until it was put back up a bit , closer to the dose i was on before .

[Citta in reply to tattybogle]

here are my last results before adding T3

Blood results

[jgelliss in reply to tattybogle]

This is so interesting. When I dose with T3 to a smaller dose T4 the T4 goes up by me. I figured because less T3 needs to be converted to from the T4 from the additional T3. This is just my experience.

[Citta in reply to jgelliss]

It is interesting to feel how our body responds to these changes in medications. I’ll be glad when my settles.

[jgelliss in reply to Citta]

Lets hope very soon.

[Buddy195 Administrator]

THYROID STIMULATING HORMONE 1.03 mu/L NORMAL RANGE 0.27 - 4.2 mU/L

THYROXINE 23.6 pmol/L NORMAL RANGE 12-22 pmol/L

TRIODOTHYRONINE 4 pmol/L NORMAL RANGE 3.1 - 6.8 pmol/L

These were results you posted 2 months ago on 100mcg Levo. As FT4 was over range in this test, reducing Levo was a good idea before introducing Liothyronine.

Going slowly with increments of Lio means you don’t miss your ‘sweet spot’ where you feel most well. For me, I didn’t have a ‘eureka’ moment when adding Lio, it was more a steady improvement over time. We recommend re testing levels 6-8 weeks after being on a consistent dose.

[Citta in reply to Buddy195]

Thanks, that’s helpful.

[jimh111]

20 mcg LT3 is equivalent to 60 mcg LT4 so I suspect it is too much. Also, the T3 will build up much quicker than T4 will fall because of the different half-lives.I suggest you try 10 mcg LT3 instead.

[Citta in reply to jimh111]

Thanks, I will from now on. I’ll take a quarter of the 20mcg tablet morning and lunch time.

[jimh111 in reply to Citta]

I find taking the second dose at bedtime improves my cognitive function and vitality the next day. The brain works hard during sleep and needs its T3.

[Citta in reply to jimh111]

Good idea. I slept like a log last night but today I have reduced the T3 dose to 10mcgs. No so tired today but I will continue to monitor things.

[McPammy]

I think you’ve started on too high a dose of T3. Reduce it by half and split twice a day 8hrs apart. Too much T3 and you can feel exhausted not energised as you should. It’s all about balancing your t4 and t3 and not going over levels.

[HotelHurricaine]

To add to all these comments on T3 dose being high I would also say that my T4 has been raised from 125 mcg to 175 mcg since adding just 5mcg T3 - T4 fell so low when adding T3 I felt exhausted for quite a while.

Now I'm feeling great but it took 3 dose changes over 9 months to get it all right.

[Citta]

it’s not straight forward at all by the sound of things. Glad you are feeling better.