# If I get my TSH under 2, FT4 increases out of range



## Gon

Hi guys, I'm new here.

I have hashimoto's disease, and I've been dealing with a strange issue during the last 6 months while trying to adjust my levo dose: Every time I manage to get the TSH under 2.0, FT4 gets high (out of the range). This doesn't makes sense to me, I've confirmed that it is not an error from the lab. I'm currently taking 145 mcg of levo. This are my last tests:

*Normal Range.*

TSH: 1.82 (0.30 - 4.20)

T3 : 92.5 (84.6 - 201.8)

FT3: 3.0 (1..8 - 4.6)

T4: 8.4: (4.6 - 12.0)

FT4 1.75 (0.93 - 1.70)

I'm not feeling well, I'm tired the whole day, lack of energy, some weigh gain, insomnia, poor memory, and difficult to maintain focus, so I believe that something is going on here.

An another strange thing: Previous to this, my TSH was 2.55, then I increased my levo dose to 145 mcg, and 2 weeks after increasing the dose I had the test done in another lab (just to get an idea) and my TSH was 0.74, then a week later I repeated the test in different lab and it was 1.82 (as posted above). This doesn't makes sense either. So I'm no sure if my TSH is going crazy up and down or maybe labs results varies a lot from one lab to another.


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## joplin1975

When was the last time you had your thyroid antibodies tested and have you ever had an ultrasound of your thyroid?


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## Gon

joplin1975 said:


> When was the last time you had your thyroid antibodies tested and have you ever had an ultrasound of your thyroid?


Probably in 2012, both, the antibodies test and the ultrasound. I never did those tests again.


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## jenny v

I would ask for a repeat of antibodies and an ultrasound, but I think you would be a good candidate for adding in a T3 med like Cytomel. You don't appear to be a good converter of T4 to T3, which is why your FT4 soars when you go higher on levo. I would reduce your levo a smidge and add in the Cytomel to help with your FT3 and symptoms.


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## Gon

jenny v said:


> I would ask for a repeat of antibodies and an ultrasound, but I think you would be a good candidate for adding in a T3 med like Cytomel. You don't appear to be a good converter of T4 to T3, which is why your FT4 soars when you go higher on levo. I would reduce your levo a smidge and add in the Cytomel to help with your FT3 and symptoms.


Thanks. What is the utility of the antibodies and ultrasound at this point? I thought it was useful for diagnosis basically.


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## Lovlkn

> T3 : 92.5 (84.6 - 201.8)
> 
> FT3: 3.0 (1..8 - 4.6) *((3.2-3.9))*
> 
> FT4 1.75 (0.93 - 1.70) *((1.315-1.5075))*


Your "goal" is to have both your FT-4 and FT-3 fall into the bold (( )).

You do not appear to be converting your T4 hormone to a high enough FT-3 level to get both FT-4 and FT-3 into those ranges.

You are a good candidate for some T3 hormone, lilothyronine is the generic, Cytomel is the brand. Ask for 5mcg to start and split the pill and take it 6 hours apart. A reduction in your T4 hormone will be necessary- start at 125mcg add the 5mcg T3 hormone and retest in 6 weeks. TSH will lower when you add the T3 hormone.


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## joplin1975

If you have TSI (one of the antibodies), it becomes REALLY difficult to stabilize on meds. At that point, some people move to surgical removal.

Also, you should repeat the ultrasound. New nodules can do goofy things to your lab work.


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## Gon

Thanks for the advices!

So I should only have the TSI antibodies test? Or also the other antibodies tests?


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## joplin1975

I would do the whole kit and kaboodle, if I were you.

If you were stable and not having issues, I wouldn't suggest testing antibodies, but given your experiences, I think it could be informative.


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## Gon

joplin1975 said:


> I would do the whole kit and kaboodle, if I were you.
> 
> If you were stable and not having issues, I wouldn't suggest testing antibodies, but given your experiences, I think it could be informative.


So it would be four antibodies tests? TPO, TGAb, TSHRAB, and TSI?


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## joplin1975

Yes!


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## jenny v

And if you get a push back on TSI (some doctors/insurance companies won't run that one), TRAb can tell you just as much there.


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## Gon

jenny v said:


> And if you get a push back on TSI (some doctors/insurance companies won't run that one), TRAb can tell you just as much there.


Unfortunately, it seems that TSI is not done here in my country. What does Trab tells you? is it only for the diagnosis of Graves? But what if I have hashimoto? Can I still have Graves?


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## Gon

Lovlkn said:


> You are a good candidate for some T3 hormone, lilothyronine is the generic, Cytomel is the brand. Ask for 5mcg to start and split the pill and take it 6 hours apart.


So, I should take 2.5 mcg twice a day? Why not the 5mcg at once? T3 should also be taken with empty stomach?


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## Lovlkn

Gon said:


> So, I should take 2.5 mcg twice a day? Why not the 5mcg at once? T3 should also be taken with empty stomach?


Some people react and also the 1/2 life is only 6 hours so splitting the dose helps keep spiking hormone levels more level.

It's best to take on an empty stomach for better absorption.


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## Gon

Lovlkn said:


> Some people react and also the 1/2 life is only 6 hours so splitting the dose helps keep spiking hormone levels more level.
> 
> It's best to take on an empty stomach for better absorption.


Oh, but it's very hard to take it every 6 hours with empty stomach and for the rest of your life! does it matter the empty stomach as much as with levo?


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## Gon

I got my lab results:

TSH: 3.88 [ 0.27 - 4.20 ]

T4: 7.18 [ 5.10 - 14.10 ]

FT4: 1:.42 [ 0.93 - 1.70 ]

T3: 1.02 [ 0.80 - 2.00

TGAb: Negative

TPO Antibodies: 240.6 [ 0.1 - 34.0 ]

TRAB: <0.3 Negative: < 1.5

Intermediate: 1.5 - 1.75

Positive: > 1.75

What I can see is that my TSH is still fluctuating and I still have a huge number of Anti-TPO antibodies, is this normal?

I'm still waiting for the ultrasound

What do you think guys?


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## joplin1975

Do you know if that t3 result is total t3 or free t3?


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## Gon

joplin1975 said:


> Do you know if that t3 result is total t3 or free t3?


Total T3. I wasn't tested for free T3 this time.


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## Gon

I got the ultrasound results, it says that there are multiple nodules (between 1 and 3 mm) in both lobules of the thyroid


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## joplin1975

Ok. They won't do much with nodules that small.


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## Gon

joplin1975 said:


> Ok. They won't do much with nodules that small.


So, this doesn't explain why I can't stabilize my TSH? which keeps fluctuating up and down.


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## joplin1975

No unfortunately/fortunately, it probably doesn't.

I agree with the other posters that your next step would be to look at Cytomel.


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## Gon

What intrigues me is, why is my TSH fluctuating? Can a T3 conversion problem cause fluctuations?


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## Gon

I come from the doctor.

Yes, those nodules has no relevance, he said are due to the same inflammation of the thyroid.

He reduced my levo dose to 120 mcg (from 145) and added 5 mcg (capsules) of T3 twice a day. I'm a little scare it's way too much T3, as here I was adviced to begin with 2,5 twice a day, and I can't break the capsules in half.

What do you guys think? should I ask him for a lower dose?

Currently, my TSH is 3.88, according to my last lab results


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## Hopeful

I started with 5 mcg T3 in the morning. I knew within a few days that it wasn't enough, so I added a second 5 mcg. Awhile later, I added a third 5 mcg in the afternoon when I felt the slump of T3 reducing in my system.

There's nothing to be afraid of.  5 mcg is the smalled dose it comes in and 5 isn't much of a dose. You will feel better! You could start with one in the morning and see how you feel. You should feel it the same day and will feel better. By late afternoon, you might feel tired because your levels will have dropped due to the short half life of T4. If you do, then add the second T3. Most likely, you will want to take some am and some pm. Some people, like me, take more in the morning than in the late afternoon.

Yes, your TSH is much too high for someone with Hashimoto's like you have and while on medication. Why did your doctor lower your T4?


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## Hopeful

I just read your labs from the previous testing. Your TSH was also quite high for someone with Hashi's and who is currently on medication. The idea for Hashi's is to suppress TSH down at the very bottom of range and getting your T3 and T4 to the levels that were posted on the previous page by one of the administrators. Hopefully by adding T3 you will reach those goals.

TSH is probably fluctuating because T3 and T4 aren't balanced in the recommended optimal ranges, plus antibodies also influence TSH and your thyroid hormones. What were your previous levels of antibodies and the dates you were tested compared to now?


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## Gon

Hopeful said:


> I started with 5 mcg T3 in the morning. I knew within a few days that it wasn't enough, so I added a second 5 mcg. Awhile later, I added a third 5 mcg in the afternoon when I felt the slump of T3 reducing in my system.
> 
> There's nothing to be afraid of.  5 mcg is the smalled dose it comes in and 5 isn't much of a dose. You will feel better! You could start with one in the morning and see how you feel. You should feel it the same day and will feel better. By late afternoon, you might feel tired because your levels will have dropped due to the short half life of T4. If you do, then add the second T3. Most likely, you will want to take some am and some pm. Some people, like me, take more in the morning than in the late afternoon.
> 
> Yes, your TSH is much too high for someone with Hashimoto's like you have and while on medication. Why did your doctor lower your T4?





Hopeful said:


> I just read your labs from the previous testing. Your TSH was also quite high for someone with Hashi's and who is currently on medication. The idea for Hashi's is to suppress TSH down at the very bottom of range and getting your T3 and T4 to the levels that were posted on the previous page by one of the administrators. Hopefully by adding T3 you will reach those goals.
> 
> TSH is probably fluctuating because T3 and T4 aren't balanced in the recommended optimal ranges, plus antibodies also influence TSH and your thyroid hormones. What were your previous levels of antibodies and the dates you were tested compared to now?


I don't remember my previous antibodies results, it was a lot of years ago when I was diagnosed with hashi's, I would have to ask for a copy to the clinic.

So, T3 has a short half life, but does it helps to stabilize the numbers in the long run? or is it just to feel better at the time you are taking it? something like an extra boost of energy for the day?. I'm a little confused about it. My sleep / wake pattern is very irregular. By example, some days I wake up very late and have to work at night. I never had a problem with levotiroxine taking it at different times every day, I could still get good lab results (in the past). Would this be a problem with T3?

So, you think that the doctor shouldn't reduce my levo? He is reducing it because of the T3 addition, similar to what was advised to me by the admins.


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## joplin1975

I definitely think you'll want to reduce your levo.


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## Lovlkn

Gon said:


> Oh, but it's very hard to take it every 6 hours with empty stomach and for the rest of your life! does it matter the empty stomach as much as with levo?


Levo should be taken at least 1 hour prior to eating. 4 hours either side of iron or calcium/magnesium supplements.

Consistency of dose is key. If you are consistent then dose can be adjusted by how/when you take it.

For instance - I take Cytomel and often take before or after lunch and because I take calcium 2x a day it can be a challenge to avoid. I take my levo in the middle of the night as I wake often and always at 2 for some reason??


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## Lovlkn

FT-4 levels rise with the addition of T3 hormone so it's a good idea to reduce T4 hormone slightly when adding T3 hormone.

The reason I suggested splitting the dose initially and only taking 5mcg is to see how your body adjusts to it. I for one had a hard time adjusting and experienced anxiety on doses as small as 2.5mcg or 1/2 a pill taken just 1x a day. The thinking was - I was low on Ferritin levels as well as Vit D and my FT-4 had been at top range thus I probably had some Reverse T3.


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## Gon

Five days taking 120 mcg of Levo and 5 mcg of T3. I'm having a hard time adjusting myself to T3. it makes me tired and nervous, bad anxiety, I'm not feeling good. Will this side effects subside? Or maybe T3 is not for me?

Also, the first 3 days I experienced increased sweating, flushing and cold hands.

I don't think I could add the second pill yet.


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## Lovlkn

Gon said:


> Five days taking 120 mcg of Levo and 5 mcg of T3. I'm having a hard time adjusting myself to T3. it makes me tired and nervous, bad anxiety, I'm not feeling good. Will this side effects subside? Or maybe T3 is not for me?
> 
> Also, the first 3 days I experienced increased sweating, flushing and cold hands.
> 
> I don't think I could add the second pill yet.


I hate to hear this. If it were me - I would wait a few (2-3 days) with lower levo dosage and then try adding again since the 1/2 life for levo is so long maybe you just need your FT-4 to fall a little prior to adding.

Start with 1/2 a 5mcg pill for a few days then see if you can add the other 2.5mcg.

I bought a pill spliter and the pills will split fairly good. Split 1 pill at a time rather than making a bunch of splits because they are not a perfect 50/50 split.

If 1/2 2 x a day isn't working then go to 1/4 pill ( tiny as it is) and try that 2x a day.

I gave up after 6 weeks and suffered for 2.5 years because I really needed the T3 hormone, as do you.

I just looked at my notes when adding Cytomel - the FT-3 definitely went up even with just 1/4 a pill 1 or 2x a day. It went from 2.9 to 3.4 on this low a dose so it definitely would move taking the full 5mcg. Today I take 12.5 mcg daily with the same Levo dose I was on when I struggled adding the T3 hormone.

My ferritin levels were horrible and I have heard chatter on this board with others about low Ferritin levels and the difficulty adding T3 hormone. Have you had Ferritin levels checked?


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## Gon

Lovlkn said:


> I hate to hear this. If it were me - I would wait a few (2-3 days) with lower levo dosage and then try adding again since the 1/2 life for levo is so long maybe you just need your FT-4 to fall a little prior to adding.
> 
> Start with 1/2 a 5mcg pill for a few days then see if you can add the other 2.5mcg.
> 
> I bought a pill spliter and the pills will split fairly good. Split 1 pill at a time rather than making a bunch of splits because they are not a perfect 50/50 split.
> 
> If 1/2 2 x a day isn't working then go to 1/4 pill ( tiny as it is) and try that 2x a day.
> 
> I gave up after 6 weeks and suffered for 2.5 years because I really needed the T3 hormone, as do you.
> 
> I just looked at my notes when adding Cytomel - the FT-3 definitely went up even with just 1/4 a pill 1 or 2x a day. It went from 2.9 to 3.4 on this low a dose so it definitely would move taking the full 5mcg. Today I take 12.5 mcg daily with the same Levo dose I was on when I struggled adding the T3 hormone.
> 
> My ferritin levels were horrible and I have heard chatter on this board with others about low Ferritin levels and the difficulty adding T3 hormone. Have you had Ferritin levels checked?


No, I haven't been tested for Ferritin, I will ask for that.

Well, the problem is that I have 5mcg capsules, not pills. T3 is not available here in the form of pills, I would have to speak with the doctor so they could send to prepare 2.5 mcg capsules for me , just like they did with the 5 mcg capsules.

So, you say that I shouldn't continue with the same dose (120 mcg of levo + 5mcg of T3) in order to see if maybe I will start to feel better in a few days or weeks? Or you think this is not going to happen? and instead, you suggest me to try only 120 mcg of levo for 3 days and then to add the T3 again, right?


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## Lovlkn

> FT4: 1:.42 [ 0.93 - 1.70 ]
> 
> T3: 1.02 [ 0.80 - 2.00


What dose levo were you on when these were drawn? 145?

You might want to wait a few days taking the lower dose of levo - 120 I believe I saw. Then take a 5mcg capsule with a bit of food and water.

Maybe if your FT-4 levels fall a bit you will tolerate better. You also could try to get your ferritin levels drawn. I bet you are low - thus the issue with the T3 addition to your med's.


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## Gon

Lovlkn said:


> What dose levo were you on when these were drawn? 145?
> 
> You might want to wait a few days taking the lower dose of levo - 120 I believe I saw. Then take a 5mcg capsule with a bit of food and water.
> 
> Maybe if your FT-4 levels fall a bit you will tolerate better. You also could try to get your ferritin levels drawn. I bet you are low - thus the issue with the T3 addition to your med's.


Exactly, I was taking 145 mcg before.

Ok, I'm going to try that, let's see what happens. Thanks!


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## Gon

I've been doing for a couple of weeks what Lovlkn suggested, and this way I can handle much better the T3, the nasty side effects have mostly subsided by taking it with food, it really helps. Although sometimes it still hits me, once in a while, and it makes me feel weird, sleepy and disconnected for some time, up to an hour after taking the pill, and then back to normal.

The bad news is that I'm still feeling hypothyroid : ( I'm waiting a couple of weeks to do the tests again.

I've been reading about the T3 conversion problems, and I'm a bit curious because I've found a few doctors who says that most of the time there's a reason for the conversion problem and that it can be corrected. Does anyone know how true is it?

"Underconversion of T4 into T3 is mostly caused by excessive cytokines (immune system messengers that autoimmune patients have a LOT of), excessive cortisol (from inflammation, high blood sugar, stress), or decreased clearance of Reverse T3 through the GI tract (common in patients with malabsorption, leaky gut, dysbiosis). All three scenarios are treatable,"

"Certain inflammatory cytokines involved in the stress response have been shown to down-regulate the enzyme responsible for peripheral conversion of T4 to T3, i.e. when we are stressed, our body's inflammatory response can lead to under-conversion. Fixing this problem requires lab testing to determine the source of the inflammation. It is necessary to also test the hypothalamus-pituitary-adrenal-axis."

"Another source of thyroid peripheral under-conversion is increased gastrointestinal polysaccharides (LPS), an endotoxin produced from bacterial overgrowth. The primary cause of this is intestinal dysbiosis, or a shift in the good versus bad bacteria in your gastrointestinal system. Another common reason for increased lipopolysaccharides is Leaky Gut Syndrome (LGS)"


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## Lovlkn

It's likely.

I for one have cortisol levels out of wack and I also believe my RT3 was probably out of wack when I initially began Cytomel because I was top range FT-4 for awhile. I was unaware at that time of a possible connection nor had I ever had a RT3 test run, nor did I know anything about RT3.

I didn't get through the entire video -of your DC which is a Doctor of Chiropractic. It's interesting how many Chiropractors have comments relating to thyroid issues - and the fact that they have supplements for sale to address but cannot prescribe a hormone replacement medication. My chiropractor at the time of DX never spoke to me about it so I will hold comment on one that does.


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## Gon

By the way, I'm now taking the full dose of T3 that was prescribed to me (10 mcg)

i'm a bit skeptical about alternative medicine. I wonder if traditional medicine has the same posture about the conversion issue.

He even goes further and says that another possibility is that the disease progresses and you may develop antibodies to your own hormones, to T3 in this case. Have you ever hear something like this?


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## Lovlkn

I'm not aware of that antibody that could impact T3.


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## Gon

5 weeks taking 120 mcg of levo + 10 mcg of T3, and this is the lab results:

TSH : 1.71 [ 0.27 - 4.20 ]

T4: 6.74 [ 5.10 - 14.10 ]

FT4: 1.48 [ 0.93 - 1.70 ]

T3: 1.15 [ 0.80 - 2.00 ]

I wasn't tested for FT3 this time but I will within a few days probably. So it seems that my problem was solved, and the labs looks fine, right? Now TSH is below 2 and FT4 in the normal range.

The weird thing is that I'm still feeling hypo. I could sleep the whole day. Probably my symptoms are not explained by thyroid issues? right?


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## joplin1975

My guess is that you ARE hypo. It's hard to tell with total t3 but free t3 usually trends lower. Your total isn't awful but isn't great either so I'd guess your free is hypo.


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## Lovlkn

> TSH : 1.71 [ 0.27 - 4.20 ]
> 
> T4: 6.74 [ 5.10 - 14.10 ] *useless test - ignore*
> 
> FT4: 1.48 [ 0.93 - 1.70 ] *((1.315-1.507))*
> 
> T3: 1.15 [ 0.80 - 2.00 ] *((1.4-1.7))*


Comments in bold above. (( )) is 1/2 - 3/4 of ranges provided.

Total 3 tracks with FT-3 but the FT-3 test result is most accurate. Your T3 is not even close to mid range so you would benefit from an increase of T3 hormone. If you do that you will need to reduce slightly your levothyroxine so not to go beyond 3/4 of range.

It's a balancing act - but once you figure out your "set dose" it gets easier to manage.

How do you feel currently?


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## Gon

Ok. Well, I'm not feeling good, as I told above, I feel hypo, very tired and sleepy the whole day.

So what dose would you recommend? I'm not acquainted with the use of T3, so I'm not sure how to manage the doses.


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## joplin1975

I don't take Cytomel, so I'm not the best person to ask, but I think its reasonable to bump up to 15mcg of T3.


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## Lovlkn

I would start with 15mcg and dose it 3x a day - every 6 hours.

If you have trouble sleeping you could split one pill and take 1 1/2 pills 2x daily.

I for one have issues all the time sleeping at night but have no issue taking a nap in the middle of the day or even a few hours after my first Lilothyronine dose ??

The dose peaks at 2-4 hours after taking. the 1/2 life is 6 hours.


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## Gon

And what should I do with the levo dose?

I thought that the peak of T3 was much faster, because when I first started taking it I felt terrible within the next 30 minutos. Now all the nasty side effects went away thanks to your suggestion of taking it with food, and at this point I can take it without food.


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## Lovlkn

You say you are on 120 - I would try reducing to 100.

Without seeing all your labs on a tracking sheet it's hard to be exact.


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## Gon

Are there any rules regarding how should T3 be taken ? (2x or 3x a day?)

I think it would be better for me to take 7.5 mcg 2x daily, does it seems fine? I will go crazy with 3x a day for the rest of my life (but if I do better with that, then I would do it). In the pharmacy, they can make for me any dose I want, but in capsules, not pills (T3 is not sold here, only mixed with levo), so I can't split the capsule.


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## Lovlkn

I started taking mine 2x a day - previously took 5mcg 2x and 2.5mcg or 1/2 a pill 1 x.

I find loading up early works best for me - I take 7.5mcg around 5-5:30 as I seem to wake then - or before I get out of bed. I then take my 2nd dose 7 hours post 1st dose.

6 or 7 - whatever works for you or you could take before or after lunch. Makes it easier to remember


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## Gon

Lovlkn, could you please clarify me a doubt.

The first time I removed 25 mcg of levo (from 145 mcg, my original dose) and replaced it with 10 mcg of T3 and now I'm removing another 20 mcg of levo (from 120 mcg) but adding only 5 mcg of T3. it doesn't work with an equivalence relation between mcgs of levo vs mcgs of T3?


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## Lovlkn

Gon said:


> Lovlkn, could you please clarify me a doubt.
> 
> The first time I removed 25 mcg of levo (from 145 mcg, my original dose) and replaced it with 10 mcg of T3 and now I'm removing another 20 mcg of levo (from 120 mcg) but adding only 5 mcg of T3. it doesn't work with an equivalence relation between mcgs of levo vs mcgs of T3?


You might consider alternating doses of levothyroxine - 120mcg 3 days and 100 4 days .

Because you are currently at 3/4 of the range - you just want to be sure you do not end up over 3/4 range. There is no way to know exactly how your body will react with another 5mcg increase of T3 hormone.


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## Gon

Lovlkn said:


> You might consider alternating doses of levothyroxine - 120mcg 3 days and 100 4 days .
> 
> Because you are currently at 3/4 of the range - you just want to be sure you do not end up over 3/4 range. There is no way to know exactly how your body will react with another 5mcg increase of T3 hormone.


Ah ok!

But isn't the same as taking 108 mcg daily of levo? it would be better for me to take the same dose every day, because they prepare the capsules for me in the lab without fillers (it can be any dose I want, I'm allergic to the filler of the branded levo) and it would be difficult to send to prepare 2 different doses of levo plus T3.

What daily dose would you recommend? 100 mcg? 108 mcg? 109 mcg?


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## Lovlkn

Oh - since they prepare the dose in a capsule you might try reducing your dose by 10mcg daily.

Also - keep all old meds you no longer take - during the dose dial in process you may need to increase or decrease and it's nice to already have them on hand. Once you get to your set dose you can dispose of any unused medications


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## Gon

Something weird is going on here. A few weeks taking 15 mcg of T3 + 108 mcg of levo and my TSH is higher than before, T3 lower and FT4 lower. I just don't get it. It seems that my tsh doesn't want to stay under 2 (or only for a couple of weeks)

TSH : 2.69 [ 0.27 - 4.20 ]

T4: 6.06 [ 5.10 - 14.10 ]

FT4: 1.27 [ 0.93 - 1.70 ]

T3: 1.10 [ 0.80 - 2.00 ]


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## joplin1975

Any chance you are more active now that you have some t3 in your system?


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## Gon

joplin1975 said:


> Any chance you are more active now that you have some t3 in your system?


Do you mean if I feel more active? with more energy? probably during the last few days I've noticed that feeling, but I need more time to be sure. But numbers shows that I indeed have less T3 in my body than when I was taking 10 mcg of T3.


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## joplin1975

No, I mean are you actually more active (intentionally or not). Sometimes that happens, especially when people add in t3. They get a little boost and suddenly they are doing more, which actually causes t3 to drop a bit.


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## Gon

joplin1975 said:


> No, I mean are you actually more active (intentionally or not). Sometimes that happens, especially when people add in t3. They get a little boost and suddenly they are doing more, which actually causes t3 to drop a bit.


Oh, maybe, during the last few days, but not a big physical thing.


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## Gon

Does anyone has any idea of what's going on? I increase and increase the dose, but my tsh keeps going up and t3 going down. It's been almost a year since I can't stabilize my TSH, it fluctuates all the time and i feel hypo.


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## Gon

Last lab resutls:

TSH 2.51 *(0.30 - 4.20)*

T3 116.0 *(84.6 - 201.8)*

FT3: 3.5 *(1.8 . 4.6)*

T4: 6.8 *(4.6 - 12.0)*

FT4: 1.42 *(0.93 - 1.70)*

Currently taking 108 mcg of levo + 15 mcg of T3.

How do I get my TSH below 2.0? should I add more levo or more T3?

There's no way my TSH stay below 2.0. I can't get it.


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## Gon

Anyone? I don't know how to manage T3 and levo together! Which one should I increase in order to suppress my TSH?


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## joplin1975

I guess I'm wondering why it matters? I don't mean to sound flip. If your frees are good, who cares about TSH. I mean...I don't pay attention to it at all.


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