Hello :)) do I cut down my levo as starting some t3? Grateful of advice as endo has said keep on the same dose?

My tsh is 1.32 I'm on 75mcgs Levi and endo prescribed 20 mcgs t3, what is 25mcgs t3 equivalent to compared to Levo?

[helvella Administrator Thyroid UK]

Sorry I am not understanding, why you don't do what the endo suggested?

(Yes - I know we spend all of our time saying why NOT to do that in general! )

A very rough and ready, possible estimation can be 4 micrograms of levothyroxine being equivalent to 1 microgram of liothyronine. But it really does not always work like that.

Are you going to split your T3? Have you got a pill splitter?

Rod

[Hidden in reply to helvella]

Thanks rod, he's happy with my dose at 75mcgs levo I was expecting him to drop some levo Add the t3 so its still a similar dose and I don't want to panic him if my tsh is ultra low next time then takes it from me. I have a pill cutter thanks, but don't think I'll need it, I think he's prescribed x2 t3 10 mcgs one at 8am and one at 2 pm

Thanks

[helvella Administrator Thyroid UK in reply to Hidden]

Trouble is the ONLY UK tablets are 20 micrograms.

So unless he has expressly prescribed, say, 5 microgram Cytomel from the USA, you will have to split them to abide by what he has prescribed. With TSH = 1.32 that is not suggesting you are currently over-dosed.

[Hidden in reply to helvella]

So, rod. My maths isn't great. Do am I almost doubling my dose, although it doesn't always work like that

[helvella Administrator Thyroid UK in reply to Hidden]

75 mcg of T4 plus ( 2 times 10 ) of T3 each day?

And translating T3 to T4 as 4 to 1?

Then we get 75 plus ( 4 times 2 times 10 ) = 75 + 80 = 155.

Which is the tiniest bit over double. If the translation works like that for you.

Rod

[Hidden in reply to helvella]

:)) thank you, I think I want to reduce some levo off first, will have a think x thanks for your help x

[helvella Administrator Thyroid UK in reply to Hidden]

If you can mange the splitting, maybe split to 5 mcg and only take two a day to begin with?

[Hidden in reply to helvella]

You read my mind, yes I will do just that!! :)) thank you all i can offer in return is dental advice lol.. From the dental nurse

[Hidden]

Oh I see, no he didn't go that far. Oh thanks for the heads up!! Yes very true ref the tsh thank you x

[nobodysdriving]

I would not drop the levo but it's up to you of course. T3 is 'fast acting', if you end up feeling overmedicated you just stop the T3 and the same day you feel better. Up to you.

[Barbaraj]

Effectively, your replacement dose has been more than doubled in one fell swoop. From what I have learned this is not a good idea. I understand that, for every 10 mcg T3, T4 should be reduced by 40mcgs as it is four x more powerful than T4. In your case this would mean, as you have been prescribed 20mcgs T3, that this alone equals 80mcgs of T4. Maybe I have it wrong but I'm only stating the knowledge I have gained. Is your endo up to date with the literature?

[Hidden in reply to Barbaraj]

Thanks, yes this is exactly what I think, I know he rarely perscribes it as his junior said as much, I've just taken 50 today and then I will take 2 5 mcg doses and keep increasing the t3 see how u feel then if needed bring the t4 back up, I didn't dare out any more pressure on the endo as I was so delited to get it in the first place, and he perscribed it even though he doesn't really feel I need it, so I kept quiet and left quickly

[nobodysdriving in reply to Hidden]

keep in mind it takes up to 8 weeks for levo to be 'totally' out of your system, that is why I suggested not to drop it to begin with, then if you felt 'hyper' you could have reduced the T3 slightly temporarily unti you introduced a reduction of levo.

anyway, good luck with whatever you do, at the end of the day you can ultimately take the whole lot when you are ready for it and if you wish to

[Hidden in reply to nobodysdriving]

Thanks nobody's driving I appreciate your advice and its a good point about the levo and 8 weeks, so, I guess this is why I asked these questions, as there are many ways to approach this bit ultimately I feel a little nervous about my usual dose one day and nearly doubling it the next. I will go back to my normal dose tomorrow if levo, just have 10 t3 to start with and go from there. Maybe I will post I. Here a that point. Thank you for all advice x

[deb25426]

You take the thyroxine prescribed and the T3 prescribed at same time, that's what I do... X

[polly3]

Everyone will respond differently to t3...eg .I take t4 150mcg at nite and 37.5 mcg split 3x daily.

I would do what your endo says really but split t3 evenly throughout the day. I have uk t3 and this splits quite well into 4 pieces. X