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To add T3 or not to add T3...that is the question


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#1 GOLGO13

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Posted 29 April 2020 - 11:52 PM

Need advice...This was the response from my Endo: "Thank you for your message. I do have a handful of patient for whom I prescribe liothyronine. I would say that some of them have found that it has helped them a lot (it is a twice a day dosing), whereas others did not find any difference and preferred to come off so that they did not have to take 3 pills a day. I think it would be reasonable to try you on the twice daily liothyronine and agree that now is the right time to do so while you work from home. If you are agreeable, I would lower your Synthroid dose to 100mcg daily and prescribe name brand Cytomel 5mcg to be taken twice a day, morning and around 4p. If you are agreeable to this, I can send in the new scripts. Hope you are staying safe and healthy."

 

Last labs on 112 Synthroid were: TSH2.069 uIU/mL0.350 - 5.000 uIU/mL T3 FREE2.8 pg/mL1.7 - 3.7 pg/mL THYROXINE (T4), FREE1.08 ng/dL0.70 - 1.25 ng/dL


Original: TSH 71 TPO 1980

Levo 100 (March 2018): TSH 1.02 (range .5-4.5)....FT4 1.65 (range .82 to 1.77).

Levo 100 (April 2018): Felt terrible TSH .68

Levo 88 (May 29 2018): Felt better but low energy TSH 3.010 (.450-4.5)|Free T3 2.8 (2.0-4.4 pg/ml)| Free T4 1.50 (.82-1.77ng/dl) TPO 226

Levo 91 (equivalent) (July 16 2018): Felt sort of OK TSH 4.470 (.450-4.50)|Free T3 2.6 (2.0-4.4 pg/ml)| Free T4 1.44 (.82-1.77 ng/dl)|TPO 181

94 (half 88 and half 100) Best I have felt so far TSH 3.671 uIU/mL (0.350 - 5.000)| Free T4 1.14 ng/dL (0.70 - 1.25)| Free T3 2.2 pg/ml (1.7-3.7)

94 generic (Dec 2018) TSH 4.98...boo...

94 Synthroid (Feb 2019)Name Brand 6 days a week and 100 Sythroid one day a week TSH 4.829 uIU/mL (0.350 - 5.000 uIU/mL)| FT4 1.01 ng/dL (0.70 - 1.25 ng/dL)|FT3 2.6 pg/mL(1.7 - 3.7 pg/mL)

94 Synthroid (April 2019) 5 days a week, 100 twice a week TSH 2.763 uIU/mL (0.350 - 5.000 uIU/mL)| FT4 1.08 ng/dL (0.70 - 1.25 ng/dL)|FT3 2.5 pg/mL(1.7 - 3.7 pg/mL)

94 Synthroid (June 2019) 4 days a week, 100 3 days a week TSH 2.889 uIU/mL 0.350 - 5.000 uIU/mL| FT4 1.15 ng/dL 0.70 - 1.25 ng/dL|FT3  2.7 pg/mL 1.7 - 3.7 pg/mL

94 Synthroid (July 2019) 2 days a week, 100 5 days a week TSH 3.931 0.350 - 5.000 uIU/mL| FT4 1.07 ng/dL 0.70 - 1.25 ng/dL| FT3 2.4  pg/mL 1.7 - 3.7 pg/mL

100 Synthroid (Oct 2019) 7 days a week, 50 once a week TSH 2.479 0.350-5.000 uIU/mL| FT4 1.06 ng/dL 0.70 - 1.25 ng/d

100 Synthroid daily Synthroid 50 once a week TSH TSH 2.874 range .350 to 5 | T3 free 2.5 pg/ml range 1.7 to 3.7

112 Synthroid daily (Jan 2019) TSH 2.43 range .350-5.000 uIU/ml |  FT3 3.3 range 1.7-3.7 pg/mL | FT4 1.04 range .7-1.25 ng/Dl 

 


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#2 creepingdeath

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Posted 01 May 2020 - 04:14 PM

I'm sure you ask your Doc about t3 cause you don't feel right..?

Why not give it a try?

You are lucky an Endo is letting you try it at all. 

Most believe in synthetic t4 only...

 

I personally would give it a try...

When I was sick with Hashi's in the beginning, I would have taken 100 doses daily of whatever if it would have helped...

 

Good luck with whatever decision you make &...…......….. stay safe.....



               


#3 GOLGO13

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Posted 01 May 2020 - 11:57 PM

I'm feeling pretty good right now. Probably the best I have been. I ended up deciding not to try it quite yet. But I may try it in the future. Especially if I start to feel worse again.

 

She is pretty good as far as Endos go. I had to go to the big city to find a good one. The ones locally here were not great. Not bad to travel 1.5 hrs once every 6 months.

 

Reason I decided not to try this right now is that I am doing fairly well, and I'm worried my body will keep compensating and it will be a bit of a roller coaster. I also know Endos won't allow TSH to be suppressed. And I understand often it must be suppressed on combination therapy. 

 

However, I am open to trying it in the future if my labs are correct but I feel crappy.

 

Thanks for the reply. It's been sparse around here! haha.


Original: TSH 71 TPO 1980

Levo 100 (March 2018): TSH 1.02 (range .5-4.5)....FT4 1.65 (range .82 to 1.77).

Levo 100 (April 2018): Felt terrible TSH .68

Levo 88 (May 29 2018): Felt better but low energy TSH 3.010 (.450-4.5)|Free T3 2.8 (2.0-4.4 pg/ml)| Free T4 1.50 (.82-1.77ng/dl) TPO 226

Levo 91 (equivalent) (July 16 2018): Felt sort of OK TSH 4.470 (.450-4.50)|Free T3 2.6 (2.0-4.4 pg/ml)| Free T4 1.44 (.82-1.77 ng/dl)|TPO 181

94 (half 88 and half 100) Best I have felt so far TSH 3.671 uIU/mL (0.350 - 5.000)| Free T4 1.14 ng/dL (0.70 - 1.25)| Free T3 2.2 pg/ml (1.7-3.7)

94 generic (Dec 2018) TSH 4.98...boo...

94 Synthroid (Feb 2019)Name Brand 6 days a week and 100 Sythroid one day a week TSH 4.829 uIU/mL (0.350 - 5.000 uIU/mL)| FT4 1.01 ng/dL (0.70 - 1.25 ng/dL)|FT3 2.6 pg/mL(1.7 - 3.7 pg/mL)

94 Synthroid (April 2019) 5 days a week, 100 twice a week TSH 2.763 uIU/mL (0.350 - 5.000 uIU/mL)| FT4 1.08 ng/dL (0.70 - 1.25 ng/dL)|FT3 2.5 pg/mL(1.7 - 3.7 pg/mL)

94 Synthroid (June 2019) 4 days a week, 100 3 days a week TSH 2.889 uIU/mL 0.350 - 5.000 uIU/mL| FT4 1.15 ng/dL 0.70 - 1.25 ng/dL|FT3  2.7 pg/mL 1.7 - 3.7 pg/mL

94 Synthroid (July 2019) 2 days a week, 100 5 days a week TSH 3.931 0.350 - 5.000 uIU/mL| FT4 1.07 ng/dL 0.70 - 1.25 ng/dL| FT3 2.4  pg/mL 1.7 - 3.7 pg/mL

100 Synthroid (Oct 2019) 7 days a week, 50 once a week TSH 2.479 0.350-5.000 uIU/mL| FT4 1.06 ng/dL 0.70 - 1.25 ng/d

100 Synthroid daily Synthroid 50 once a week TSH TSH 2.874 range .350 to 5 | T3 free 2.5 pg/ml range 1.7 to 3.7

112 Synthroid daily (Jan 2019) TSH 2.43 range .350-5.000 uIU/ml |  FT3 3.3 range 1.7-3.7 pg/mL | FT4 1.04 range .7-1.25 ng/Dl 

 


#4 creepingdeath

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Posted 02 May 2020 - 12:28 AM

Yea....it's a ghost town on here anymore...

 

I wouldn't mess with anything that works.

My TSH is under 0.....my MD b4 this corona thing happened wanted me to go to an autoimmune specialist .

He can't figure out why I don't have hyper thyroid symptoms with my extremely hyper lab work.

I could care less as long as I feel the way I do now  I'm not changing anything.

 

be safe...... 



               


#5 GOLGO13

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Posted 02 May 2020 - 06:16 PM

Thanks...yeah. They don't seem to understand non-T4 treatment. It's a different animal. 


Original: TSH 71 TPO 1980

Levo 100 (March 2018): TSH 1.02 (range .5-4.5)....FT4 1.65 (range .82 to 1.77).

Levo 100 (April 2018): Felt terrible TSH .68

Levo 88 (May 29 2018): Felt better but low energy TSH 3.010 (.450-4.5)|Free T3 2.8 (2.0-4.4 pg/ml)| Free T4 1.50 (.82-1.77ng/dl) TPO 226

Levo 91 (equivalent) (July 16 2018): Felt sort of OK TSH 4.470 (.450-4.50)|Free T3 2.6 (2.0-4.4 pg/ml)| Free T4 1.44 (.82-1.77 ng/dl)|TPO 181

94 (half 88 and half 100) Best I have felt so far TSH 3.671 uIU/mL (0.350 - 5.000)| Free T4 1.14 ng/dL (0.70 - 1.25)| Free T3 2.2 pg/ml (1.7-3.7)

94 generic (Dec 2018) TSH 4.98...boo...

94 Synthroid (Feb 2019)Name Brand 6 days a week and 100 Sythroid one day a week TSH 4.829 uIU/mL (0.350 - 5.000 uIU/mL)| FT4 1.01 ng/dL (0.70 - 1.25 ng/dL)|FT3 2.6 pg/mL(1.7 - 3.7 pg/mL)

94 Synthroid (April 2019) 5 days a week, 100 twice a week TSH 2.763 uIU/mL (0.350 - 5.000 uIU/mL)| FT4 1.08 ng/dL (0.70 - 1.25 ng/dL)|FT3 2.5 pg/mL(1.7 - 3.7 pg/mL)

94 Synthroid (June 2019) 4 days a week, 100 3 days a week TSH 2.889 uIU/mL 0.350 - 5.000 uIU/mL| FT4 1.15 ng/dL 0.70 - 1.25 ng/dL|FT3  2.7 pg/mL 1.7 - 3.7 pg/mL

94 Synthroid (July 2019) 2 days a week, 100 5 days a week TSH 3.931 0.350 - 5.000 uIU/mL| FT4 1.07 ng/dL 0.70 - 1.25 ng/dL| FT3 2.4  pg/mL 1.7 - 3.7 pg/mL

100 Synthroid (Oct 2019) 7 days a week, 50 once a week TSH 2.479 0.350-5.000 uIU/mL| FT4 1.06 ng/dL 0.70 - 1.25 ng/d

100 Synthroid daily Synthroid 50 once a week TSH TSH 2.874 range .350 to 5 | T3 free 2.5 pg/ml range 1.7 to 3.7

112 Synthroid daily (Jan 2019) TSH 2.43 range .350-5.000 uIU/ml |  FT3 3.3 range 1.7-3.7 pg/mL | FT4 1.04 range .7-1.25 ng/Dl 

 


#6 Lovlkn

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Posted 03 May 2020 - 12:06 PM

GOLO

 

Your TSH is still awful high and you have been having issues for awhile with how you feel which I have told you in the past is due to your low FT-3 so I cannot understand why you would not take the T3 and give it a try with the lowered T4 hormone.

 

Fear?


Free T-4 and Free T-3 are absolutely necessary to properly dose yourself.
My experience is that 1/2 - 3/4 of range is your goal for optimal treatment

My Journey... 7 years to receive a diagnosis. TT 2004 after 4.5 years on Tapazole that had to be adjusted monthly - endo ran labs every 4 weeks. Remission was never going to happen for me so I opted for surgery to remove. Final DX by surgeon was Hashitoxicosis, TPO antibodies over 2000 and TSI 316% within the year prior to surgery. I never had a ultrasound or any lab testing to rule out cancer - pathology was negative. Post surgery I was kept hypo for many years - until I figured out how to dose my self, relying on where I fell in the FT-4 and FT-3 labs. I run TSH below range due to positive TBII antibodies. Horrible time adjusting to addition of Cytomel = patience pays off when adding this drug to the mix.

The happy ending ---> Stable dose since 1/10 Unithroid 125mcg, Cytomel 12.5mcg - labs I can live with.

None of the information on ThyroidBoards.com is intended to diagnose, treat, cure or prevent any disease. Information shared is based on my personal experiences and should not be considered medical advice. Please consult a physician before adjusting any medication.

#7 GOLGO13

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Posted 04 May 2020 - 05:57 PM

My biggest fear is my Endo won't know how to dose it in case I am one of those people who the TSH needs to be suppressed. I've been feeling pretty good recently though. When I got below 2.5 it seemed to make a big difference.

 

I'm also worried about adding the T3 my body will be doing a bunch of compensating and I'll be chasing my tail a bit.

 

However, if I start to feel bad despite having good labs, I may give it a go.

 

I've read up a bit on things and it seems like having a highly damaged thyroid is pretty much the same as no thyroid or radioactive iodine (which makes sense). And thus the need for some T3 since they thyroid itself is not putting any out to help...so relying 100% on conversion. So that's why I asked the question. I like that my Endo is willing.

 

Do you think her method above has merit? Many of the guys from my men's group felt the reduction in T4 wasn't necessary at this point...and would have started with 2.5 twice a day vice 5 twice a day.

 

Hope you all are doing well.


Original: TSH 71 TPO 1980

Levo 100 (March 2018): TSH 1.02 (range .5-4.5)....FT4 1.65 (range .82 to 1.77).

Levo 100 (April 2018): Felt terrible TSH .68

Levo 88 (May 29 2018): Felt better but low energy TSH 3.010 (.450-4.5)|Free T3 2.8 (2.0-4.4 pg/ml)| Free T4 1.50 (.82-1.77ng/dl) TPO 226

Levo 91 (equivalent) (July 16 2018): Felt sort of OK TSH 4.470 (.450-4.50)|Free T3 2.6 (2.0-4.4 pg/ml)| Free T4 1.44 (.82-1.77 ng/dl)|TPO 181

94 (half 88 and half 100) Best I have felt so far TSH 3.671 uIU/mL (0.350 - 5.000)| Free T4 1.14 ng/dL (0.70 - 1.25)| Free T3 2.2 pg/ml (1.7-3.7)

94 generic (Dec 2018) TSH 4.98...boo...

94 Synthroid (Feb 2019)Name Brand 6 days a week and 100 Sythroid one day a week TSH 4.829 uIU/mL (0.350 - 5.000 uIU/mL)| FT4 1.01 ng/dL (0.70 - 1.25 ng/dL)|FT3 2.6 pg/mL(1.7 - 3.7 pg/mL)

94 Synthroid (April 2019) 5 days a week, 100 twice a week TSH 2.763 uIU/mL (0.350 - 5.000 uIU/mL)| FT4 1.08 ng/dL (0.70 - 1.25 ng/dL)|FT3 2.5 pg/mL(1.7 - 3.7 pg/mL)

94 Synthroid (June 2019) 4 days a week, 100 3 days a week TSH 2.889 uIU/mL 0.350 - 5.000 uIU/mL| FT4 1.15 ng/dL 0.70 - 1.25 ng/dL|FT3  2.7 pg/mL 1.7 - 3.7 pg/mL

94 Synthroid (July 2019) 2 days a week, 100 5 days a week TSH 3.931 0.350 - 5.000 uIU/mL| FT4 1.07 ng/dL 0.70 - 1.25 ng/dL| FT3 2.4  pg/mL 1.7 - 3.7 pg/mL

100 Synthroid (Oct 2019) 7 days a week, 50 once a week TSH 2.479 0.350-5.000 uIU/mL| FT4 1.06 ng/dL 0.70 - 1.25 ng/d

100 Synthroid daily Synthroid 50 once a week TSH TSH 2.874 range .350 to 5 | T3 free 2.5 pg/ml range 1.7 to 3.7

112 Synthroid daily (Jan 2019) TSH 2.43 range .350-5.000 uIU/ml |  FT3 3.3 range 1.7-3.7 pg/mL | FT4 1.04 range .7-1.25 ng/Dl 

 


#8 creepingdeath

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Posted 06 May 2020 - 05:39 PM

If you go by everything your doctor says you'll probably get nowhere....

If your doc lets you try t3 cut it in half first. If you don't feel a difference within a few days take the whole dose..

 

B4 I got on desiccated thyroid I tried it all.....

I was even given synthetic  t3 only.....

It did absolutely nothing....

I even doubled the dose....

When I had lab work done my TSH was in the hundreds....

That's when I searched for a new MD who let me try the cure......

Armour thyroid....  

"but if you feel ok I wouldn't mess with anything"



               


#9 graves84

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Posted 26 May 2020 - 05:33 PM

I LOVE my T3 (I take gluten free version) and can hardly get out of bed without it. I am having the same issue that my Dr wants to drop my Tirosint from 100 to 88 because it has suppressed my TSH a bit to 0.19. But no hyper symptoms. I say go for it. Maybe people do not convert t4 to t3 well. 



#10 Lovlkn

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Posted 27 May 2020 - 01:38 AM

Graves84. I have a TSH if .088 last month with 1/2 range FT-4 and FT-3.

Are your frees within the 1/2-3/4 of range?
Free T-4 and Free T-3 are absolutely necessary to properly dose yourself.
My experience is that 1/2 - 3/4 of range is your goal for optimal treatment

My Journey... 7 years to receive a diagnosis. TT 2004 after 4.5 years on Tapazole that had to be adjusted monthly - endo ran labs every 4 weeks. Remission was never going to happen for me so I opted for surgery to remove. Final DX by surgeon was Hashitoxicosis, TPO antibodies over 2000 and TSI 316% within the year prior to surgery. I never had a ultrasound or any lab testing to rule out cancer - pathology was negative. Post surgery I was kept hypo for many years - until I figured out how to dose my self, relying on where I fell in the FT-4 and FT-3 labs. I run TSH below range due to positive TBII antibodies. Horrible time adjusting to addition of Cytomel = patience pays off when adding this drug to the mix.

The happy ending ---> Stable dose since 1/10 Unithroid 125mcg, Cytomel 12.5mcg - labs I can live with.

None of the information on ThyroidBoards.com is intended to diagnose, treat, cure or prevent any disease. Information shared is based on my personal experiences and should not be considered medical advice. Please consult a physician before adjusting any medication.

#11 Sabrina

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Posted 13 August 2020 - 02:13 PM

Starting on T3 changed my life, and brought me from feeling better than I had from before my thyroidectomy, to feeling good!  Before starting it, I could not resume a life where I could enjoy exercise and running.  Now I'm back to running when I want (did a few half marathons). 

 

I had a lot of trepidation starting on T3, and actually cut the 5mcg into quarters to start.  Note that it has a 4 hour half life, so the effects can run out pretty quickly, that helped me feel comfortable taking it at all.  My body just was not able to produce enough T3 from levothyroxine alone, taking T3 helps.  I take it three times a day, the first dose with my levothyroxine, and the other two 5.5 hours apart during the day.  I take it with food, I don't think it's impacted like T4 is.

 

Good luck!


  • Lovlkn likes this
Total Thyroidectomy 2016
75mcg Levothyroxine | 3 x 7.5mcg Liothyronine Daily
Most recent labs 1/30/18:
FT4 0.9 (.8-1.8)
FT3 3.9 (2.3-4.2)

RT3 7 (8-25)
~~My Thyroid Journey~~




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