Opinions please: If one is a good converter, would one always benefit from also adding T3

[FallingInReverse]

My doctor added t3 to my t4 early.

After he left me on a 50 Levo starter dose for a year, and was confused as to why I still felt awful, he decided to drop me to 25 Levo and add 10 daily t3.

I’ve mentioned many times here before - I really wish that didn’t happen. Even besides the 9 months of worrying thumping palpitations…

I wish I’d had the chance to see if I would convert.

Early on here I mentioned this, and that I wanted to try to get off t3 and see if I could do with just Levo. Someone here said - hold onto that t3!!! So I did, and spent time working my t4 up (from 25 to 112 in the past year).

So I find myself now with slightly over range t3. And after going in circles pondering my next step, I think I’m going to take the next 6 weeks to lower it.

But it has me thinking - is it possible to wean off t3 and let my t4 try to convert?

If I lower my t3, and retest in 6 weeks, then lower again and maybe alternate in t4 increases… just wondering opinions on whether it’s better to have low/mid FT4 and high FT3, or higher FT4 and a naturally converting mid/high range FT3.

I will also say my TSH is very suppressed - 2-3 zeros after the decimal. It’s never bothered me before, but we all read here about that 0.04 (?) cut off in that study for risk factors. I know it’s can’t entirely be avoided with t3, but still has me thinking.

With my current doctor, I will always be able to ask for the prescriptions I need.

And of course I’m also going by symptoms. And I know it’s all very personal.

So this really is a biology and physiology question.

Would love to hear from anyone who’s tried to lower t3 significantly or wean off entirely. And opinions from all you smart people who know how our bodies and glands and cells work.

[SlowDragon Administrator]

So I did, and spent time working my t4 up (from 25 to 112 in the past year).

So I find myself now with slightly over range t3. And after going in circles pondering my next step, I think I’m going to take the next 6 weeks to lower it.

I will also say my TSH is very suppressed - 2-3 zeros after the decimal

So you may find TSH doesn’t move at all

But it’s worth experimenting

If I lower my t3, and retest in 6 weeks, then lower again and maybe alternate in t4 increases… just wondering opinions on whether it’s better to have low/mid FT4 and high FT3, or higher FT4 and a naturally converting mid/high range FT3.

Ideally looking for both roughly 60-70% through range

What’s your current Ft4 level

[FallingInReverse in reply to SlowDragon]

FT4 around 40%

FT3 a smidge over range

I haven’t changed dosing in at least a couple/few months. I am the biggest fan of low, slow and “when in doubt” to wait.

A month or so ago I thought I’d hit my sweet spot - for about a week felt pretty darn good.

Then some sleep issues/palpitations and rosacea returned - am considering HRT since nothing else changed and symptoms seem to be post-ovulation. I’m perimenopause and am choosing to observe a couple more cycles and do some more blood tests before committing to HRT.

Then reading here and getting general opinions that over range t3 is probably something to avoid.

So am thinking good idea to try and get t3 at least in range.

But I have always had this dream of t4 mono with good conversion working for me : )

[SlowDragon Administrator in reply to FallingInReverse]

So how much T3 are you taking….10mcg?

and what dose size tablets

If 10mcg you can easily cut into 1/2 and 2 x 1/4

I would try reducing T3 by 2.5mcg per day

Wait 6-8 weeks then retest

Then either increase Levo or reduce T3 a bit more depending on results

[FallingInReverse in reply to SlowDragon]

Yes, I take one 5 Cytomel upon waking another 5 at bedtime.

I think a 2.5 drop is exactly what I’ll do.

[tattybogle]

is it possible to wean off and let body try to convert T4 -T3 itself ?

i've never tried it myself , (having only started adding T3 this year) but in theory , i can't see any logical reason why not to try it ..... but with the caveat that if the body has got used to one thing , it may take rather longer than you'd like for it to get it's act together and settle down to life without it.

as for what sort of levels to aim for ...... dunno .. how long is a piece of string ?

obviously we are now aware that running higher fT4 levels long term could have it's own potential issues .... so in an ideal world you'd look to ending up with both T4 and T3 at roughly similar levels to each other ( like healthy unmedicated people have) , preferably with neither of them too close to the top end.... but in practice , it;s all a massive( and very slow) game of 'suck it and see' to find out what feels best for you as an individual.

[Regenallotment Ambassador]

Yes it’s possible to reduce T3 like this, I’ve played around with mine. The trick is making sure you don’t go too hypo and feel awful, so tiny changes and test again etc. I just went from 15mcg to 10mcg about 6 weeks ago, palpitations much improved (I’m on 100mcg T4). Will test shortly and see 🌱

[FallingInReverse in reply to Regenallotment]

And what’s your ft4 and ft3 6 weeks ago before the change?

[Regenallotment Ambassador in reply to FallingInReverse]

FT4 just over range in Randox 22.6 (11.9-21.7)

fT3 right at top of range 6.88 (3-6.8)

oh and I’ve just restarted HrT so things need to settle for a few weeks now before I change anything else and test again.

[pennyannie]

Hey there -

In a nutshell - if you are optimally medicated and well on T4 monotherapy -

as are around 80% of those who take T4 - you aren't on this forum and asking questions about your health and well being as you will be converting T4 into T3 and not even aware that T4 needs to be converted in the body into T3 and that not everybody is able to do this very well.

Though I'm sure a proportion of people taking T4 - simply just struggle on - under par for years - as it's an insidious disease that can slowly creep up on you - and we tend to be accepting of a lower quality of life as we age - and conditioned to believe and to blame life style choices for our ' falling short ' of what we understood to be ' our norm ' :

[FallingInReverse in reply to pennyannie]

Would a higher t4 that converts naturally be more in tune with our natural feedback loops than low t4 and exogenous t3?

(And yes, I guess we’ll never know exactly how many are truly well on Levo mono… because of all those gaslit, misdiagnosed, wrongly prescribed people with doctors and a healthcare system that reminds me everyday how broken it is.)

[pennyannie in reply to FallingInReverse]

I would think so - with hypothyroidism our bodies are slowed and our thyroids - our human gear box - somewhat compromised - and guess we may not be as economic as once - and use more fuel than previously - just to stand still and maintain ourselves.