episode of VT T3 heart risk?

[Louie25]

Hi. On Sunday I was taken to hospital in an ambulance as I had an episode of VT that was deemed potentially dangerous. I was kept in hospital for 2 days whilst they checked out my heart which fortunately is in good shape.

unbeknown to me the endocrine dept without my consent sent an email to my endocrinologist suggesting they drop my T3 ( I take 15 gms in 2 doses) completely I also take 100 T4

My results at the hospital were

T4 13 .5 ( range 9-19)

TSH 0.25 (range 0.35-4.00)

Free T3 6.00 (range 2.4-6.0)

I argued my case that I feel terrible with no T3 and finally they agreed to leave things as they are whilst my heart checks continue. I'm due an MRI but my echoey was good and I have perfect blood pressure and pulse rate

Question is does anyone have any information around these levels of T3 causing episodes of VT in an apparently healthy heart. I don't want to be stupid and insist I continue if it is in fact doing me harm but then again I know I feel rough with no extra T3 and it's about quality of life isn't it.?

I know there is a drive to get everyone off T3 due to expense and I don't want to be a victim of this. I am a fit and heathy active 70 yr old.

Thoughts please

[SlowDragon Administrator]

T3 ( I take 15 gms in 2 doses) completely I also take 100 T4

My results at the hospital were

T4 13 .5 ( range 9-19)

TSH 0.25 (range 0.35-4.00)

Free T3 6.00 (range 2.4-6.0)

Is that 15mcg per day in total T3

Which brand of T3 and which brand of levothyroxine

Was test early morning, ideally just before 9am, only drink water between waking and test and last dose levothyroxine 24 hours before test

This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip)

T3 ….day before test split T3 as 2 or 3 smaller doses spread through the day, with last dose approximately 8-12 hours before test

ESSENTIAL to test vitamin D, folate, ferritin and B12

What vitamin supplements are you taking

[Louie25 in reply to SlowDragon]

Well I didn't have a choice as they tested as I arrived in hospital on the ambulance which was prob about 2.00 pm I take my T4 at night and I had taken a dose of T3 at 11.00. Which might account for the high reading which seems to have freaked the endos out.

The cardiologist do not seem to think my VT episode is related to my thyroid meds even though the endoscopy said stop T3 completely which seems bonkers to me and I won't give in without a fight.

[SlowDragon Administrator in reply to Louie25]

Retest yourself including vitamin levels and with correct time gap

Come back with new post once you get results

If test was roughly 12-15 hours after last dose Levo

Ft4 looks a bit low as it’s only 45% through range

Result would be lower if tested with last dose 24 hours before test

Free T4 (fT4) 13.5 pmol/L (9 - 19) 

thyroid.chingkerrs.online/?...

[Louie25 in reply to SlowDragon]

No it was about 15 hours after last dose.of Levo

[SlowDragon Administrator in reply to Louie25]

You might need to experiment with slightly less T3 and possibly slightly more Levo

But get retest first and optimal vitamin levels

[Louie25 in reply to SlowDragon]

Thanks I will do. Problem is everyone talks as if they are in control of chopping and changing the doses but I have to get the go ahead from the endo writing to my gp to make a change and it's not so easy to speak to either partic Endo!! I have my next appointment in June!!

[jimh111]

It could be too much hormone it might not be. If you take 15 mcg LT3 + 100 mcg LT4 it equates to 145 mcg LT4 which may be a touch too much. What is your resting heart rate?You could try dropping to 10 mcg LT3 taking half at bedtime. I try to have the blood taken half way between liothyronine doses so I get a rough average fT3.

[Louie25 in reply to jimh111]

Yes I can do that thank you but my problem is my GP is talking about stopping the T3 completely!

[jimh111 in reply to Louie25]

We don't know if the problem or too much thyroid hormone or not and even if it isn't it's possible a reduction would be helpful. It makes sense to monitor the heart on your current dosage and a lower one.However, whilst liothyronine can cause heart problems via the genomic action of thyroid hormone levothyroxine has dual action, genomic and by acting on a cell membrane receptor. See healthunlocked.com/thyroidu... for details. Endocrinologists may turn a blind eye (or be ignorant) but the truth is that on an equivalent dose basis levothyroxine causes more cardiac harm than liothyronine.

[Buddy195 Administrator]

It sounds like you’ve had a very scary experience Louie25; I’m so glad that you are not having ongoing cardiac issues.

I need to increase/ decrease thyroid medication super slowly, as otherwise I get palpitations, fast pulse, tremor etc and have ended up in A and E with these symptoms. I now adjust Levo by 12.5mcg or Lio by 2.5mcg, in the first instance . If I don’t experience any adverse symptoms, I then adjust again.

I’ve found that adjusting slowly means I don’t miss my ‘sweet spot’ where I feel most well. If you do decide to reduce your medication, consider doing this slowly over time, to reduce chances of negative side effects.

[Louie25 in reply to Buddy195]

Thanks I think you're do right. I can't understand the endo suggesting I stop the T3 altogether in one go?!

[DippyDame]

As someone who needs high dose T3-only (100mcg) to function I'd suggest you either reduce the T3 to 10mcg or reduce the levo to 75mcg

I'm afraid it's often. trial and error....if you feel well on 15mcg T3, in your shoes I'd reduce the T4!

It's your body, you must decide

Some of us just need a bit more T3 and, like me, cannot tolerate T4.

How long have you been on 100mcg T4 plus 15mcg T3....is this dose well established?

Medics are trained to be wary of T3.... but it's importance is not highlighted....they often fear it which is wrong. It is arguably the most important hormone in the body

How we feel is paramount and as our much missed diogenes wrote....

For the moment mechanical thinking has traduced medical diagnosis.

It's not all about numbers!

Your heart appears to be healthy. Monitor your heart rate on a daily basis.....I use an oximeter or smart watch...and keep a note of the results....my normal RHR is 65bpm.

I'm aged 79 and without enough cellular T3 I become very unwell. The level that shows in the blood does not necessarily reflect what ends up in the cells. T3 does not become active until it reaches the nuclei of the cells. I need that large dose to ensure enough of it can reach the cells....overcoming a form of resistance.

hriuk.org/health/learn/card...

You know your body better than anyone else....listen to it

Take care!

[Louie25 in reply to DippyDame]

Thanks for the reply. Actually my dose of T4 was only increased about 10 weeks ago from 75 prior to that I'd been on 75 and 15 T3 for years. Maybe 100 is too high for me with the T3

But to suggest I stop the T3 altogether seems mad and I can't believe an endocrinologist suggested it. I even said I would be willing to reduce it or reduce the T4 back to 75 but he seemed to think the T3 was the culprit!

[Jazzw in reply to Louie25]

I think that might be really pertinent to the situation—that your levothyroxine has recently been upped. I’d certainly question whether it was the liothyronine or whether it was simply the increase in levo. And that if an adjustment needs making, lowering levo would possibly be the first thing to consider.

[Louie25 in reply to Jazzw]

Yes I think I'm coming to the same conclusion. It's odd that the cardiologist didn't seem to think it was the thyroxin at all as my level was T4 13 which is pretty low.

[Jazzw in reply to Louie25]

Yes, but that’s often what happens when you take T3 (liothyronine)—that your FT4 can be lower than you might expect.

Not sure of the mechanism for that, sorry, just something that I’ve observed in both myself and others.

[DippyDame in reply to Louie25]

The whole T3 issue is madness....it is a vital hormone.

If you felt well on 75mcg T4 plus 15mcg T3 for years then that proved the point, it was working ....why change it to satisfy a medics lack of knowledge.

[Louie25 in reply to DippyDame]

I did know as soon as I was admitted with the ventricular tachycardia that the first thing they would jump on was my T3 meds and it happened. What annoyed me was they emailed my consultant recommending stopping the T3 completely without even discussing it with me first. I then asked an endo bod to come and talk to me and I reasoned him out of making that change but of course the email had been sent and I heard from my GP that my T3 has been stopped in recommendation from the hospital!! Now I have to fight to get it reinstated. So frustrating!!

[DippyDame in reply to Louie25]

It's more than frustrating.... it's tantamount to medical neglect through ignorance.

How can we recover if those treating us have scant knowledge of the condition.

They are duty bound to discuss medication changes with their patients

I self medicate with T3-only and have done so for about 8 years...that, after a great deal of research. Long story all in my bio

My GPs initially thought I would kill myself but now leave me in charge of my thyroid treatment....they saw it was working! Their hands are tied behind their backs by those in high places and med students are taught to be cautious of T3. It's no more dangerous than any other treatment if used correctly

I have no NHS thyroid support which is madness but at least none of them interfere with my medication and it makes no difference to any other treatment I need

I guess I'll have a problem if I ever have to be in hospital or in care

I hope you can make them all see reason very soon.

The whole thyroid issue is a mess

Take care

[Judithdalston]

I’ve been taking exactly the same 100 T4 15 T3 dose for some years generally getting my Frees more like high 40s%, so Forum members suggest I need to up my doses to get frees in 60-70%. My TSH tends to be stuck c.0.02-0.03. But over nearly last 5 years had Long Covid and lingering symptoms have remained high BP and high HR ( diagnosed with dysautonomia and postural hypotension), and as cardiologists not interested since echocardiogram/ ecgs show heart are ok, I have had GP panicking it’s ‘overmedication on levothyroxone’ creating the high HR. An endo.i was referred to looking back at 22+ years of blood results was happy it wasn’t the replacement T4 nor T3 giving the high HR etc. Lots of other things, other than LC, give high HR like low ferritin, vitamins etc…have you had these checked?