T3 only. No tests to compare to, only TSH. How much T3?

[DandyButch]

I have had a very rocky road trying to get better with Hashimoto's Hypothyroidism. When on levothyroxine only, I had increased via GP from 25mg to 50mg and then I needed an increase to 75mg.

A lot happened but now I am with my second endocrinologist (my choice) who has prescribed T3 only due to levothyroxine messing up my life.

I started low, a year ago. I am now on 20mcg a.m. and 10mcg p.m. daily. Although I am very slowly improving, I know I have a way to go hoping for an increase in the dose, at my next appointment next month.

However, the endocrinologist is prescribing based on TSH and weight. I posted before, how she had calculated in October 2023, that I have 20mcg a.m. Monday Wednesday and Friday, and then 10mcg a.m. Tue, Thur, Sat and Sun, and 10mcg p.m. every day. After posting this on here, I was told by the great knowledgeable people on here that even regular dosing is essential. I eventually spoke to the endocrinologist just before Christmas 2023, and she said to take 20mcg a.m. and 10mcg p.m. daily. After each increase, I have been slowly improving. However, as I am still having many hypothyroid symptoms, I am eager for an increase.

Does anyone know what sort of dose I should be on.

I do not have private testing, because I cannot afford it.

How can I best challenge her decision to use inadequate data to judge optimal dosing.

I appreciate the best way is having private blood test results. I weigh approximately 10 stone.

Any suggestions will be gratefully received.

Thanking you in advance.

[Jazzw]

I guess I’ve seen worse approaches to dosing. But this isn’t great. TSH will be suppressed on that amount of T3, so that’s not a result that will provide any useful info.

As for having altering doses each time—can’t help wondering whether your endo has any idea what T3 actually does and how it’s used in the body.

Ultimately, I think your T3 is going to be snatched away without ever having given it a chance because your test results are going to be worse than useless. Makes you wonder if they’re setting you up to fail.

It’s worth having up your sleeve that a full replacement dose of T3 only is judged to be between 50-60mcg liothyronine daily.

But I’m not sure how you can challenge the incompetence displayed here. It doesn’t sound like they’d listen. I see that you can’t afford private blood testing but that seems to me the only way you’ll be able to demonstrate at any given time that you aren’t overmedicated. Or conversely that you need more T3.

[DandyButch in reply to Jazzw]

Thank you for verifying my own thoughts on the subject. I have, only recently, started to get rid of some of the brain fog, although it hasn't gone away by any means, making thinking a bit tough, and retention awful. It takes a lot of concentration and time to complete tasks especially with all the other symptoms. I easily doubt my own rationale.

I will have to try to be on top of everything before the appointment.

Thank you again