How much T3?

I have been hypo for 12 years.  I went to the doctor with hypo symptoms two weeks ago.  She gave me an order for lab work.  My TSH was up a bit but still at the lower end of the normal range.  My FT3 was just under normal. My FT4 was just above mid-range.   After researching and posting questions to a few people and reading some of Shoman's and Blanchard's work, I have decided to add some T3 to my T4.  I read that Kenneth Blanchard suggests only adding 2% of T3.  The lowest dose of Cytomel I could get is 20mcg.  I am taking 150mcg of levothyroxine.  (she just upped it from 125mcg when me T3 was low but I have not had a retest yet.  I still have hypo symptoms).  Any advice?

[gimel]

In my opinion there is no need to increase the Levothyroxine, your Free T4 is at midrange, which is adequate.  If I were starting on the T3, I think I would be cautious and start on only 1/4 of the 20 mcg as a morning dose.  Then after a couple of weeks to see how you accommodate that starting dose, if all is okay, then you could add another 1/4 in the afternoon. The most important thing is to be slow and sure.  That is just my opinion, what did your doctor suggest?

[Barb135]

Rule of thumb is that T4 medication should be decreased by approximately 25 mcg, for every 5 mcg of T3 added.  Not sure where you're located.  In the U.S. we have cytomel available in dosages as low as 5 mcg.  What did the doctor prescribe for dosage?

It's always best to start at the lowest possible dosage, which for most of us is 5 mcg, then work up, very slowly, as needed. If you can only get 20 mcg pills, you may  have to try to quarter them.  You must be very careful with T3 medication, as it's fast acting and can send you hyper very quickly.

[dgray143]

Thank you for the advice!  I will have my levels rechecked early next week and then see my doctor next Friday.  I will definitely start lower than 20mcg!  I will have to quarter them though.  I will check to see if I can 5mcg.  We'll see what the Dr. suggests.  I just want to have an opinion in my mind to take to her so that we can discuss it.  Thanks!

[dgray143]

Thank you for the advice.  I will definitely keep that in mind and talk to my doctor about it.  She is not an endo.  THanks!  ;-)

[Barb135]

You don't have to have an endo, as long as your doctor is good with thyroid issues.