Could I still benefit from a T3 medication if my T3 levels are in the top half of the normal range?

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I have just been diagnosed with hypothyroidism and am seeking an effective treatment. I recommended to my endocrinologist to put me on T3 medication as well as the T4 medication I am already on. But she said my T3 levels looked perfect (she did not check reverse T3). Could I still benefit from a T3 medication if my T3 levels are in the top half of the normal range? I don't think I am feeling as well as I could, but my endo only trusts the numbers and when I tell her I still have symptoms she said that they must be unrelated, in fact she told my my hypothyroidism symptoms never had anything to do with my hypothyroidism because my levels were never too far from normal range (but still abnormal). I am trying to find another opinion so I can decide if it's time to switch endocrinologists.

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  • Posted

    Hi Sasha, what symptoms are you currently suffering with? I am assuming you take t4 levothyroxine?

    In short the answer is yes, you could feel better on a t3 med (liothyonine) or even a combination of T4 and t3 - from my experience doctors usually recommend a bit of both if you want to take T3 as they say we need some t4. However, it is my understanding that the majority of the t4 our body receives from medication is converted to usable t3 in the body, so as much as medical professionals often say t3 is meaningless or is only a small part of the picture,it can sometimes be the missing piece.

    For a lot of people the t3 med gives them a bit more "get up and go" (it really helped me get out of bed in the morning). However it isn't for everyone (as levothyroxine isn't) and there can be downsides. Such as it can cause heart palpitations/racing heart and it is quite short lived in the body (I believe the half life of liothyonine is 24 hours, whereas levothyroxine has a half life of seven days) I'm sure someone will correct me if that isn't correct.

    The other option, is natural hormone rather than synthetic known as NDT - this is a combination of t3. T4, t1 and t2 natural hormones and is sometimes the answer for a lot of people as it is the closest you can get to your own natural hormones. This isn't available on the nhs in the UK but is available privately.

    If you are in the UK, liothyonine is generally only given on a trial basis by an endocrinologist (GPs will not prescribe it usually). If you are still symptomatic on levothyroxine then push for it as I am quite sure the nhs can give you a trial of t3 meds at least. If not find another endo - I live in the Berkshire area and have contact details of a good one if that's any good. Pm me if you would like the details.

    Hope the above helps!

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    • Posted

      I only started levothyroxine a month ago. So far I have seen improvement, more energy, alertness, better mood, weightloss (despite being pregnant)...But I've had a few days, but these were the days I did not take my medication properly, I didn't wait to have breakfast or I ate diary too early. Other then that I've been feeling a lot better, I don't even need coffee anymore, and then I had one disasturous day that made me reconsider what I am taking...no energy and intense mood swings, anxiety, fear, but now that I think about it, this was the day I took no medication at all, I had ran out of my supscription and I could not leave the house in a snowstorm (I live in Canada). Other then my few bad day the only thing that has gotten worse is my hairloss, it's falling out even faster now, but I read that that is a normal side effect of levothyroxine and should stop. So I am wondering, when can I expect my hairloss to stop and my hair to srat growing back?

      I think I should give it more time before I desided to change medications, my next apppointment is only in a month.

      Is anyone using a naturopath as part of thier tretment? I am also considering holistic treatments like suppliments and diet and things like that that a naturopath can help with. Anyone have good results?

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    • Posted

      Hi Sasha, it can take 8-12 weeks for your levels to fully adjust so it's still quite early days. I wouldn't recommend changing medication whilst pregnant as your levels can be slightly too high or low whilst making the transition which affects your Tsh. It is imperative your Tsh is within normal ranges for the health of your baby. Usually pregnant women with hypothyroidism have their bloods tested every four weeks during pregnancy so I hope they are monitoring you.

      I have heard hair loss can be a side effect of levothyroxine and I too have suffered with this. However, my endo said when my hair started dramatically falling out last year that hair loss is usually a result of too much medication - might be worth getting your levels checked again. Pregnancy can be tough on people with hypothyroidism so it sounds like you are doing great and you should expect some tiredness, hormonal/emotional issues anyway. Any hormone can affect hair growth and loss so it is possible it could also be pregnancy related. However I have heard it is meant to be a temporary side effect of levothyroxine but as I said before it can be an indicator of too much medication.

      With regards to other supplements/therapies be very cautious during pregnancy - if it were me I would wait until after the pregnancy to experiment with anything. I know things like reflexology can help stimulate the thyroid gland (and can also affect your lab results). With regards to supplements, I would get the vital vitamins tested first before you start supplementing anything (you don't want to overdose on anything). The main things to test that can impact the thryoid are: vitamin D, vitamin b12, foliate, ferritin, iron, cortisol and there are a couple of others (I'm sure someone else will comment with any I have missed).

      Let me know if you have any questions

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    • Posted

      I forgot to mention weight loss can also be an indicator that you may be on too much medication so get your levels checked again asap
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  • Posted

    It sounds to me like you've been doing your homework! Way ahead of the game. If you're still experiencing symptoms, I believe it's important to check your Free T4 and the Reverse T3. Something I'm missing out of what you are saying is how you have settled on increasing T3 when maybe it's T4? I'm not a doc but then again, I've definitely learned that the average results of symptomatic patients vs asymptomatic do not line up with the lab results. Some doctors still only check TSH for assessing the Thyroid. I took the entire list of bloodwork recommended by the STTM website and it was then my doctor discovered I needed T3 and I have Hashimoto's as opposed to just Hypothyroidism.

    I just read on the website last night about "pooling" T3 and you will need to have your Reverse T3 value to know if you are experiencing that.

    It sounds like you know that you need additional bloodwork but I definitely wouldn't eliminate other aspects of potential problems other than enough T3. I hope this comes across as I intend it to -as in- it's complicated. Not that you are jumping to a conclusion. It is so complex and it would be critical to know the RT3 before increasing since it's at the high end. Also, maybe one day have them check your Adrenal Glands. Many times it is after a patient begins treatment of the Thyroid that the Adrenals get noticed!

    Hope this randomness helps!

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  • Posted

    Hi Sasha  I can't actually answer your question but I'm interested because I am trying to get an appointment with an endocrinologist. I was born with hypothyroidism and T4 Levothyroxine has done the job most of the time. However I am now in menopause and want to get my T3 checked too. What is reverse T3? My GP doesn't want to look beyond T4.
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  • Posted

    While I do not have all the answers right now I do know that women who are hypothyridic during pregnany need to have their medications increased during this time. After the baby you can drop the dose again to one which suits just you. Read up on this, it is really important, I believe that it is T3 which should be maxed out, i.e. up agaist the upper limit, but not over. Most gynocologists should know all about this, see if you can ask one.
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  • Posted

    Sasha, it's worth doing some self monitoring as there is a time lag before the blood tests reflect your levels. Check your pulse first thing in the morning before move. Ideally it should be 60-80. Also check your temperature. It should be around 37C or 98.4F. Higher on both and you may be getting too much thyroxine. Lower in both and you may be getting too little thyroxine. Write them down so you can compare the trend over time.
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  • Posted

    Please try really hard to remember your levo. It is essential for the health of your baby. Build up at lwast 3 minths as tock so you don't run out.
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