I started on Liothyronine only in April 2024 at 2 1/2mcg per day and have been slowly increasing since then.
I have been on the current dose of 22 1/2mcg AM and 2 1/2mcg PM for approx 6 weeks but am going downhill again for the last couple of weeks.
I managed to achieve 6-7 out of 10 for life quality for a few days in the middle but then started dropping off again. Today for instance I am only about 3 out of 10.
I did my bloods at 8AM on Monday before taking the T3 and am not on biotin. I supplement with VitD, K2, Methylfolate and B12 as needed.
The latest results are below:
FEBRUARY 2025
TSH 0.18 (0.27 - 4.20)
Free T3 4.6 (3.1 - 6.8)
Free T4 2.2 (12.0 - 22)
T4 Total 22.7 (66-181)
Anti Thyroglobuline 18 (<115)
Anti Thyroidperoxidase 31.7 (<34)
Cortisol 668 (73.8 - 507.0)
Vit D 159 (50 - 200)
Magnesium 0.9 (0.7 - 1.0)
CRP 4.4 (<5)
Ferritin 303 (13 - 150)
Serum Folate 30.70 (8.83 - 60.8)
Active B12 147 (37.5 - 150)
.
THE PREVIOUS TEST WAS IN OCTOBER 2024 BELOW
.
TSH 11.5 (0.27 - 4.20)
Free T3 3.4 (3.1 - 6.8)
Free T4 3.6 (12.0 - 22)
T4 Total 32.6 (66-181)
Anti Thyroglobuline 20 (<115)
Anti Thyroidperoxidase 37.2 (<34)
Cortisol 677 (73.8 - 507.0)
Vit D 114 (50 - 200)
Magnesium 0.9 (0.7 - 1.0)
CRP 3.72 (<5)
Ferritin 252 (13 - 150)
Serum Folate 11.8 (8.83 - 60.8)
Active B12 >150 (37.5 - 150)
I would be grateful for advice and ideas on an increase as I am not yet feeling more than 5 out of 10 on average each day.
I would, also, be grateful for any thoughts on my Ferritin levels. Is it possible that the increase is linked to me starting Methylfolate after seeing my October results or should I be looking elsewhere or is it as bad as it appears? I notice it can be linked to cancer but I have a scan for that each year and a blood test twice a year which have been clear. This is because I had a small cancerous polyp removed 3 years ago.
Many thanks, in advance.
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Than you for replying and sharing your experience. It is a help as my cortisol is a bit funny but I tend to be better in the afternoons after lunch. When I first really went down the dip I couldn't raise a decent level of cortisol at any time of the day but now seem to be in overdrive but it doesn't seem to help. I hope you keep well and many thanks.
Thanks for that. My GP has been in touch as my recent NHS blood test has shown up the same problem so I have been booked in for a liver ultrasound and more blood tests. Keep well.
I did my bloods at 8AM on Monday before taking the T3
So, how long was the gap between your last dose of T3 and the blood draw?
You're only taking a tiny dose of T3, so not surprising you still have symptoms. By how much did you increase six weeks ago? With T3 you can increase more frequently than every six weeks, you know, and most people on T3 mono-therapy take at least 60 mcg a day.
As Regenallotment said, your high ferritin is more than likely due to your high CRP. I don't think it has anything to do with starting methylfolate. Folate is a B vit, and ferritin is iron stores.
Not much point in taking just two isolated B vits because they all work together and need to be kept balanced. You'd be better off taking a low dose of a good methylated B complex daily as a maintenance dose. And not much point in taking vit D without magnesium as the two work together. And please don't tell me your magnesium is high according to the tests. Testing magnesium is pointless due to the way the body handles it. If your kidneys are in good shape, just take some or the vit D won't do anything except deplete what magnesium you do have.
Don't worry about your cortisol for the time being. See what it does when you get onto a decent dose of T3.
I last took 2 1/2mcg at 1PM the day before the test.
I increased by 2 1/2mcg six weeks ago.
Your advice is really helpful and seems to cover all of my 'frets'. I didn't realise that 60mcg was not unusual so I can now go ahead with more confidence.
Can you advise on a good B complex, please, and thank you so much for your help.
So, you have a very false low FT3 there. The gap should be maximum 12 hours. Even so, you have an FT3 of less that 50% through the range, which is just too low.
There are two B complex that I take, depending on availability. Either Thorne Basic B, or Igennus B complex. There are other good ones but I can't get them in France, so don't remember their names.
Your ferritin level could be associated with taking T3:
"Research indicates that administration of T3 leads to an increase in serum ferritin concentrations. In a study where euthyroid subjects received 75 micrograms of T3 daily for one week, serum ferritin levels rose by an average of 117%, with increases ranging from 23% to 243% above baseline values."
I was on 17.5mcg per day of T3 and my ferritin level was 273 ng/dL.
As greygoose mentioned, you're taking less T3 than what a normal person would produce in a day, which is around 30mcg. So you're already in a deficit. The FT3 level doesn't tell the whole story, you'll want to maintain your trough level above the minimum amount you need to eliminate symptoms. If you were to measure your FT3 throughout the day, it might be 3.6 in the morning but 2.3 in the afternoon, putting you below the minimum and allowing symptoms to develop.
This means making sure that every T3 dose you take covers a span of time without your FT3 blood level going below the minimum you need. Your last dose (2 ½ mcg) would probably not cover the spread. With your first dose you might only have coverage for 6 hours of the day.
Some people have to dose T3 multiple times per day; others can take their T3 all in one dose. I suspect the reason someone can take it all at once has something to do with a combination of: Peripheral resistance to thyroid hormone, along with the ability to produce T3 sulfate in greater quantities. T3 sulfate (T3S) is a metabolite of T3 that can act as a reservoir, converting back to active T3 when needed, making that large dose of T3 act more like a sustained-action drug.
Cortisol has a number of adverse effects when it comes to thyroid function:
1) Suppresses release of thyroid stimulating hormone
2) Inhibits conversion of T4 to T3
3) Desensitizes the thyroid hormone receptor, making it necessary to acquire more T3 than what would normally be expected. This is the endocrine equivalent to insulin resistance, where excess body lipids or elevated cortisol can cause the insulin receptors not to function normally, requiring drugs to stimulate the receptors or increase insulin output from the pancreas.
Thank you so much for taking the time to explain all of this to me and sharing your notes. It is so useful to know. I only had vague ideas about the amount of T3 I should be taking and will certainly increase now more often until I get up to 30mcg. It's little wonder that I am going backwards rather than improving.😅 The T3 sulfate link is also very interesting and new to me. Once I increase my morning dose sufficiently, I might trial dropping the afternoon one to see if I can sustain. In the early days I tried taking T3 at night but it just seemed to keep me awake. Greygoose suggested that magnesium might help my ferritin levels because I am dosing with vitamin D and that can deplete magnesium so I have been reading up on that just now and about to order some. As a point of interest, way back when I was on T4 only, and starting to become very ill on it, I think my liver was affected because I took on a slightly yellowish tinge and I couldn't touch oils and fats because they made me feel so sick so there may be a T4 link too for some people . The GP noticed my ferritin levels and so I am to have an ultrasound. I appreciate their diligence.😊 Once again, thank you. It has been interesting and I hope you keep well yourself.
Thank you, I hope your treatment plan goes both smoothly and quickly towards feeling good again.
The problem with T4-only is that adequate conversion to T3 is necessary. If that doesn't happen, then the liver will lack the T3 to do its job and liver enzymes will increase, potentially leading to NAFLD (non-alcoholic fatty liver disease).
Ooh, thanks for another valuable piece in my jigsaw puzzle as I am a poor converter so that would explain it. It is difficult to find out all of these things by oneself and I am more than grateful for you taking the time to help. All of the replies on here have given me the courage and information that I needed to have the confidence to increase the dose, so fingers crossed.
All the very best wishes for your health and many thanks.
On T3-only you will need a minimum of 30mcg T3....roughly what the body produces daily.....less than that is likely to cause hypothyroid symptoms.
T3 will reduce both TSH and FT4
25mcg T3-only is not a large enough replacement dose and "going downhill" underlines this.
Your FT3 is only 40.54% through the ref range....it should be roughly approaching 75%....we are all different
When and how did you do this test....time, last dose, fasting
Have you considered taking the T3 in a single dose this helps flood the cells ( Ref the late Dr John Lowe, a T3 expert!) It may not suit everyone but worth trying
It also avoids clock watching for different dose times!
I need 100mcg T3 which I take as a single dose at bedtime with no problems
It is important to aim for a good level of cellular T3.....which unfortunately cannot be measured so we have to use the old way and monitor symptoms which are vitally important
What shows in the serum may not reflect what is in the cells which is why symptoms are vital.
My serum T3 does not effectively reach cellular level because I have a form of Thyroid Hormone Resistance which requires me to take a supraphysiological dose of T3
The T3 in the serum is not active....it only becomes active once it reaches the nuclei of the cells and attaches to the various T3 receptors
I would start increasing by 5mcg every 2 weeks, very carefully monitoring and recording your symptoms.
(I'm old school I keep a diary rather than a spreadsheet)
Continue increasing until symptoms improve
Note...T3 can be increased faster than T4
Be aware of symptoms of overmedication, for example
fast resting heart rate
hand tremors
over heating
anxiety
poor sleep
For good health every cell in the body must be flooded with T3 by way of a regular and adequate supply
More T3 will help once you reach your therapeutic dose
You will probably find that other issues resolve once your dose is correct
I no longer have blood tests on T3-only, instead I rely on symptoms as happened before testing was developed.
Thank so much for replying. I am on a big learning curve at the moment😂but that is great! 30mcg minimum as mentioned by youself, Greygoose and Keifer. I had no idea. How can that be, I thought I was good at researching.🤣🤣🤣. I shall creep my amounts up as soon as I can each time now and look forward to better days.
I took my blood on a Monday morning and my last T3 at 13.30PM. I last ate the night before at 10PM.
I am happy to try a single dose in the morning but will wait until I get the dose a bit higher to see if I can last on it. I did try at night originally but found it kept me awake even more than normal.
I keep a manual chart, also. I call it the Peatfield Chart in memory of him. Dose, temperatures, heart rate, steps and score out of 10 for how I feel.
As I mentioned to Kiefer, I will try supplementing with magnesium as recommended by Greygoose because I didn't realise that the Vitamin D that I am taking can deplete magnesium.
Once again thanks for taking the time to help me and I hope you are keeping well yourself.😊
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