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Started Liothyronine and stopped it after 6 days.....

I've been hypothyroid for almost a year.  My TSH 2 weeks ago was 6.05, FT4 1.26, t3 79.  I asked the doctor if I could take Liothyronine and she is allowing me on a trial basis.  I began 5 mcg,  2x day, morning and mid-afternoon.  I felt fine the first couple of doses, but then I started feeling extremely tired.  I would go to sleep at night and wouldn't wake up until 5 am alarm and then I began feeling draggy throughout the day.  I quit taking it 2 days ago and I woke this morning with a screaming headache.  Does anyone take this and do you have side effects?  My doc was worried that I would have heart palps as I do everytime the Synthroid is increase for 1-2 weeks until body gets used to higher dose.  The new T3 med made me tired, so I don't know why she would have been worried about palps!  Also, has anyone quit taking for same reason as me - tired.....and then have a terrible headache a couple of days after stopping?
4 Responses
649848 tn?1534637300
COMMUNITY LEADER
10 mcg is quite a large starting dose.  Typically, a starting dose is 5 mcg and many people find it works better to split into 2 doses of 2.5 mcg (one in the morning, the other around noon), though that's a pretty tiny dosage.

Being tired is a symptom of both hyper and hypo, so I'm guessing, you simply had too high a dose.  Rather than stopping the med, altogether, you would probably have been okay to just drop your dose (with your doctor's approval).

T3 med is pretty fast acting and stopping it like you did, is probably what caused your headache.

What were the reference ranges for the FT4 and the T3?  Was that a Free T3 or was it Total?  They aren't the same thing.  You should make sure you have the Free T3 every time you have labs.  Reference ranges vary lab to lab and have to come from your own reports, whenever you post labs.

Have you been tested for Hashimoto's?
Avatar universal
FT4 range .82-1.77; mine 1.26, T3 range, 71-180; mine 79. My endo has never done an FT3.  I have severe joint pain as well; feet, knees and left hip. Endo sent me to a dietician because she said abnormal weight gain. Of course I have weight gain! My numbers are still not right. She dismisses joint pain, but I never had until thyroid problem and starting meds in January. This time last year I was doing Zumba 4-5 days a week. I even went and got certified to be an instructor. Now, if I walk 45 minutes I can barely move for 1-2 days afterwards.  I really had to push my endo to give me Liothyronine. I even asked for lowest possible dose. I can't get into see PCP until January because I'm a new patient. I started 5mg of B-12 yesterday because endo does not want to dig further into underlying problem. Yes, I did have Thyroid Ab panel done in July- thyroid peroxidase TPO AB - 98; range 0-34, Antithyroidglobin AB <20, range 0-40. Of course, results were never explained or discussed with me. When i saw her 2 1/2 weeks ago she had chronic hypothyroidism and abnormal weight gain on my chart as my health issues. She's never used the term Hashimotos.
649848 tn?1534637300
COMMUNITY LEADER
You really need to look into finding another endo, or at least someone else to manage your thyroid condition - doesn't have to be an endo.  This endo is going to keep you very ill if she refuses to order adequate testing and treat according to symptoms, not just falling within the ranges.

Your FT4, at 1.26 is pretty respectable.  Rule of thumb is to have FT4 at about mid range; yours is at 46% of its range, so you're awfully close.

Your T3, on the other hand, is horribly dismal. First off, your doctor should be ordering Free T3, instead of Total T3.  She must not keep up with things very well, if she doesn't know that Total T3 is obsolete and of little value, because it shows "ALL" of the T3 in your blood, but some of that (about 90-95%) will be bound by protein and unusable to the cells. We want to know how much is Free (unbound), therefore available for use by individual cells.  Rule of thumb is to have FT3 in the upper half to upper third of its range.  Your Total T3 is only at 7% of its range, indicating that Free T3 would also be very low in its range.

Low FT3 would keep your TSH higher than normal.

Your TPOab is higher than the range, and would indicate Hashimoto's; again, your doctor should know this.

I don't understand your doctor sending you to a dietician for weight gain, when that's one of the most prevalent hypo symptoms there is.  Common sense says to get thyroid hormone levels to a point that's good for YOU, not just in range.  Muscle and joint pain are also common hypo symptoms, and with your low T3, your symptoms are no surprise.

I'm not a doctor and I can't tell you what to do, but if I were you, I'd go back to taking the T3 med, at a much lower dose; 5 mcg split into 2 doses, one in the morning and one around noon (depending on your schedule).  2.5 mcg is a pretty baby dose, but it's better to go slow and let your body get used to it, than it is to try to rush it.  It takes longer to reach the end result, but it also reduces the possibility of reaction.  I, too, take generic liothyronine and it's quite easy to split with a pill splitter.  I've been on it since early 2009 and only in Aug of this year, finally got up to 10 mcg/day, split into 2 doses of 5 mcg/ea.  Some days, I don't feel like I need that much, so I'll split a pill and drop back to 7.5 mcg for a couple days, but I never take it all at once.  I feel good and I'm finally able to lose some of the weight.

As far as the B-12, it might give you more energy, if you are deficient, but it won't do anything to help with the weight or the joint/muscle aches/pain. You really should try to get B-12 levels tested.  

Magnesium can also help with the muscle/joint aches/pains, as can Omega 3's.  You could think about getting magnesium supplement - 200 mg/day Magnesium Citrate; don't get magnesium oxide, as that's just pretty much a laxative.

There's a web site from which you can order some pertinent testing, such as FT3, FT4, TSH, Vitamin B12, vitamin D, etc.  Your order the tests you want, they e-mail you a lab order and tell you which lab to go to, in your area; you get the blood draw and in a couple of days, you get the results.  Last time I looked, the cost for FT3, FT4 and TSH (they should always be run together) was about $105; I don't remember what the costs for B12 and D were.  This testing is not covered by most insurance, but sometimes it's worth paying out of pocket, so you know what's going on. You can check it out at healthcheckusa.
Avatar universal
Thanks for all the GREAT information, Barb. I'm inclined to agree with you about current endo and keeping me ill. I've already put in a request for a call for an appt at one of best endocrinology and metabolism clinics in St Louis. It's a long drive and very busy hospital location, but worth it if I can get to feeling like my old self again. I'll be 50 in February and was hoping to be feeling great going into my 50's! Also, thanks for encouraging words about weight. It really hurt me when my endo sent me to a dietician because I know I eat right and exercise when pain allows and sometimes through the pain! My cholesterol was slightly elevated (224).  Up from 212 in January, but that could be because of the T3 being so low. I've never had problems with cholesterol until thyroid problem. Come to think of it, I was really healthy before thyroid problem. Thanks, again, Barb!
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649848 tn?1534637300
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