change in dose of meds: Hello there! The... - Thyroid UK

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change in dose of meds

SarahReed11 profile image
12 Replies

Hello there!

The Endocrinologist has advised me to reduce my meds from 175mg Levo and 20mg Liothyronine to 150mg Levo and 10mg liothyronine. The 10mg is split into two doses of 5mg, one in moring with Levo 150mg and 5mg on its own at night.

is there anyone in here who has similar plan and if so how it is helping please?

many thanks!

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SarahReed11
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12 Replies
greygoose profile image
greygoose

Why did he advise you to reduce your dose? Was it due to a low TSH? Is he another doctor that doesn't understand that taking T3 is going to suppress your TSH, that that is what it does?

And that was a huge reduction all in one go! I cannot imagine that that would have been necessary.

So, how do you feel since reducing? And how long since the reduction? It's very likely that you are under-medicated now.

SarahReed11 profile image
SarahReed11 in reply to greygoose

My T-SHIRT was stuck at 0.01 for several months. My FT3 is 5.3 (2.4-6.0) and FT4 is 16.9 (9-19.1). My FT4 went up to 22 six weeks ago. I’ve been on reduced dose for a week now and feeling okay.

SarahReed11 profile image
SarahReed11 in reply to SarahReed11

T-shirt! I mean TSH!

greygoose profile image
greygoose in reply to SarahReed11

Well, you wouldn't feel much different after only a week because there's still plenty of hormone in your system.

We really shouldn't be interested in the TSH unless it goes high. It should not be used to dose by.

Your FT3 - the most important number - is 80.56% through the range, there, which is good. It won't be nearly so good now as T3 leaves the system much faster than T4. So, you'll probably feel the lack of T3 pretty soon.

Did your FT4 go up without any change in dose? Do you have Hashi's?

SarahReed11 profile image
SarahReed11 in reply to greygoose

I have discussed all this with my GP and it was agreed to only reduce the Levi and remain same dose of Liothyronine. Blood test in 6weeks.

My FT4 did increase to 22 then went down to 16 - this hasn’t been stable for a while.

No one has mentioned if I have Hashimoto's??

greygoose profile image
greygoose in reply to SarahReed11

it was agreed to only reduce the Levi and remain same dose of Liothyronine.

Maybe, but some of that T3 in your system is coming from conversion of your T4 (levo). So reducing the levo will have an effect on the FT3 level.

My FT4 did increase to 22 then went down to 16 - this hasn’t been stable for a while.

On the same dose? Pretty certain you do have Hashi's, then. Doctors don't tend to mention if you have Hashi's because they have little understanding of what it is. In fact, they very often fail to test for it. But, if you want to know - and you should know - you need to get your antibodies tested: TPO antibodies and Tg antibodies.

If you do have Hashi's, then the variations in your levels have nothing to do with your dose and everything to do with the disease. That is why you should know.

SarahReed11 profile image
SarahReed11 in reply to greygoose

Thanks so much and will see what happens at next blood test and go from there. I did suspect I may have Hashimoto’s…

greygoose profile image
greygoose in reply to SarahReed11

You're welcome. :)

SlowDragon profile image
SlowDragonAdministrator

That’s a vast reduction……far too much in one go

you should only ever reduce Levo or T3 …..not both

do you always test as recommended with Al, thyroid blood tests early morning, ideally just before 9am, only drink water between waking and test and last dose levothyroxine 24 hours before test

This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip)

T3 ….day before test split T3 as 2 or 3 smaller doses spread through the day, with last dose approximately 8-12 hours before test

When were vitamin D, folate, ferritin and B12 last tested

SarahReed11 profile image
SarahReed11 in reply to SlowDragon

I had tests for cortisol annd iron studies two weeks ago and , vitamin D, folate, ferritin and B12 four weeks ago and all normal though iron was a bit on low side so am taking iron at mo.

SlowDragon profile image
SlowDragonAdministrator in reply to SarahReed11

Can you add actual results and ranges

Never supplement iron without doing full iron panel test for anaemia first and retest 3-4 times a year if self supplementing.

It’s possible to have low ferritin but high iron or vice versa

Test early morning, only water to drink between waking and test. Avoid high iron rich dinner night before test

Stop iron supplements 5-7 days before testing

Medichecks iron panel test

medichecks.com/products/iro...

Look at increasing iron rich foods in diet

Eating iron rich foods like liver or liver pate once a week plus other red meat, pumpkin seeds and dark chocolate, plus daily orange juice or other vitamin C rich drink can help improve iron absorption

List of iron rich foods

dailyiron.net

SarahReed11 profile image
SarahReed11 in reply to SlowDragon

IRON STUDIES

Serum iron level 14 unol/L range 9 to 30

Serum transferrin: 2.32 g/L range 1.80 to 3.82

Serum ferritin: 114 ug/L range 30 to 250

Transferrin saturation index: 23% range 15 to 50

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