T3 Only Dosing Advice

[tiwas]

Below are my most recent labs....


TSH = 1.28 Range = 0.450 - 4.50
FT3 = 3.7 Range = 2.0 - 4.4
FT4 = 1.39 Range = 0.82 - 1.77
RT3 = 26.2 Range = 9.2 - 24.1
T4 = 7.8 Range = 4.5 - 12.0


I started on T3 for 8-12wks just to clear my elevated RT3 then I will taper back off. I've never used any type of thyroid meds before so hopefully I won't after bring down my RT3 - which was caused by an infected root canal and being on antibiotics for 6-8 months but all of that was fixed mid-2017 but my RT3 never went down and I've been presenting with hypothyroid symptoms since January 2017.

Currently I am taking 6.25mcg 4x a day for a total of 25mcg per day.

FFS - look at your rT3. No wonder you're exhibiting symptoms. 25mcg T3 won't clear up your rT3. You need the big guns. Your TSH doesn't indicate hypothyroidism at all. Mine's 0.02. Your endogenous production is alive and kicking, and as long as you're producing T4 you'll convert to rT3. You need to suppress the T4 production in order to get rid of rT3.

Think of it this way:
x% of the T4 you produce end up as rT3
Your body senses lT3 is ok, so it'll just produce *more* rT3 to not make you hyper
What you're basically doing is keeping lT3 artificially high, forcing your body into making more rT3 from the T4.

 

[shltn]

Well I wasn't stopping at 25mcg (6.25mcg x 4) a day; just titrating up my dose to avoid any side effects like heart palpitations, etc. My goal was to get up to 50-75mcg and hold there for 6-8wks then taper off.

Those were my plans but I just had those two questions (weight gain and tiredness) regarding T3 on my way up.

 

[tiwas]

Well I wasn't stopping at 25mcg (6.25mcg x 4) a day; just titrating up my dose to avoid any side effects like heart palpitations, etc. My goal was to get up to 50-75mcg and hold there for 6-8wks then taper off.

Those were my plans but I just had those two questions (weight gain and tiredness) regarding T3 on my way up.

Weight gain should be oposite, unless you're eating like a horse while tanking your own production. If it's water, you can see if mild laxatives can get rid of it. Can you get hold of dandelion root extract? Noticed an elevation in blood pressure? Edema?

I'm not giving you the short answer because your symptoms are potentially very dangerous.

Check your blood pressure. Check for edema. Do you have a family history of cardiovascular disease?

 

[shltn]

Well my diet has been horrible the past few months. My blood pressure has actually gotten a little better in the past week or so but that may be due to my starting Gene's N.O. Stack (minus prescription products). I do have a family history of cardiovascular disease (one of the reasons I wanted to build up my T3 dose slowly as I am super paranoid about any heart side effects). I have not noticed any edema anywhere.

 

[tiwas]

Well my diet has been horrible the past few months. My blood pressure has actually gotten a little better in the past week or so but that may be due to my starting Gene's N.O. Stack (minus prescription products). I do have a family history of cardiovascular disease (one of the reasons I wanted to build up my T3 dose slowly as I am super paranoid about any heart side effects). I have not noticed any edema anywhere.

You should definitely go to a medical professional with experience with elevated rT3. Rapid weight gain, hyper symptoms, etc is not a good sign. I do have several potentially good ideas, but you need to get a professional opinion first. Someone who can assess your symptoms without bias.

 

[tiwas]

Put it like this. You've gained a quarter lbs every day since starting. If that was fat you'd have to eat 1000kcal in excess every single day - while having a higher than normal metabolism. If it's water, then it might be even worse for your health.

EDIT: Sorry. Brain fart. You've gained almost a full lbs every day. Multiply my comment by four. Both calories and how bad it might be for you.

 

[shltn]

I'm actually talking to another doctor tomorrow. I've been to about 5-6 so far and not a one of them believe RT3 is "thing" even though I have all the hypothyroid symptoms (lethargy, weight gain, cold body temps, cold hands and feet, anxiety, etc.) so that is why I had to order T3 (Cynomel) on my own but I am still looking for a doctor to help me get this cleared.

You should definitely go to a medical professional with experience with elevated rT3. Rapid weight gain, hyper symptoms, etc is not a good sign.

I am not by any means arguing with you as I came here looking for some info BUT I am not sure I am experiencing "hyper symptoms"? I mean weight gain is hypothyroid - correct? And my body temps are still low and haven't increased since starting the T3.

 

[tiwas]

I am not by any means arguing with you as I came here looking for some info BUT I am not sure I am experiencing "hyper symptoms"? I mean weight gain is hypothyroid - correct? And my body temps are still low and haven't increased since starting the T3.

Yeah, finding a doctor that believes in rT3 being "a thing" is hard. They claim it's inactive, and yeah - they're right. But it still binds to receptors making the active lT3 just floating around doing **** all.

Lethargy is a hyper symptom. It can also be a hypo symptom. Weight gain should not be that rapid, which is a hyper symptom. All in all, hyper was the first impression I got. And it makes sense if it's your first days of T3 treatment. You'll get hyper, then TSH lowers and you'll get normal. Then you increase T3 again and go hyper for a period.

 

[1Draw]

Below are my most recent labs....


TSH = 1.28 Range = 0.450 - 4.50
FT3 = 3.7 Range = 2.0 - 4.4
FT4 = 1.39 Range = 0.82 - 1.77
RT3 = 26.2 Range = 9.2 - 24.1
T4 = 7.8 Range = 4.5 - 12.0


I started on T3 for 8-12wks just to clear my elevated RT3 then I will taper back off. I've never used any type of thyroid meds before so hopefully I won't after bring down my RT3 - which was caused by an infected root canal and being on antibiotics for 6-8 months but all of that was fixed mid-2017 but my RT3 never went down and I've been presenting with hypothyroid symptoms since January 2017.

Currently I am taking 6.25mcg 4x a day for a total of 25mcg per day.

Shitn your labs are identical to mine and I too was coming off a round of several antibiotics to clear up a severe sinus infection in January. I have no energy at all, trouble sleeping, feeling cold, etc. all the symptoms. Dr Calkins at Defy tested only the following:

Thyroxine T-4 Serum 7.6 Range 4.2 - 13.0
Free T 4 0.97 .8 - 1.7
Reverse T3 Serum 28.1 9.2 - 24.1

During consult yesterday he is prescribing the T3 only medication Liiothyronine 5mcg. He said to start out taking 1 in the morning 30 minutes before food and 1 at night for 2 weeks and, if symptoms do not improve, go to 2 in the morning and 2 at night. Give it 2 weeks and if no improvement go to 3 2xday and on until symptoms improve.

He said if I take too much, I will have anxiety, feeling hot, excessive heart beat, etc. Then fall back to previous dose. We are going to test levels again in 3 months to see where they are and how I feel. I think from what I have read that I will know when I have the dosages correct by the way I feel.

So his protocol is 5mcg 2 x day to begin with then go up from there if no improvements in 2 weeks. Your starting dose may be a bit too much for the slow reduction of RT3. Also, Liiothyronine is a very powerful drug and may not need as much as other RT3 lowering drugs.

Good luck and let us know how you are feeling in a couple of weeks.

 

[Dr Justin Saya MD]

A lot of the online “guides” are very aggressive with the T3 titration. There is no reason to be too aggressive or impatient, as the risks of T3-induced hyperthyroidism are real.

The best and most general answer is that you gradually titrate up on the T3 and periodically CHECK THE RT3 to track its progress downward, while concurrently (and constantly) monitoring body temps, HR, and any signs or symptoms of hyperthyroidism.

 

[1Draw]

I too was dealing with high rT3. For me, what worked was changing from Synthroid to a NDT like Armour Thyroid and adding Milk Thistle to my supplement regimen. There are some evidence that Milk Thistle from the seed clears up a lot of rT3 from the liver. Mine results went from 22 to 11 in about 6 weeks. Armour Thyroid has a higher T3 amount than T4.

Kaliman what was your starting dose of the Armour Thyroid and did you tirate up any?

 

[Kaliman911]

Kaliman what was your starting dose of the Armour Thyroid and did you tirate up any?

I started with 30mg for about 2 weeks, then gradually started increasing it by 30mg per week until my symptoms and blood work started improving. I am at 120mg now, that is 2 grains. I also split them in morning and late afternoon dose about 2 hours before going to bed. You can take it in an empty stomach or with food. It really doesn't matter with NDT. Whatever is more convenient. I chew mine. I read Armour has some fillers and it is better to chew them to help breakdown the fillers. Also read that because of the fillers it is better to take it with food. So it is up to you. Just don't take it with calcium or iron supplements. They will bind with the thyroid and not get absorbed.

 

[Sjbond67]

Any update shltn? My labs look pretty similar to yours however my tsh is around 4, others numbers almost spot on. After going thru half dozen doctors and huge mess with t4 and ndt meds I finally found a dr willing to rx t3 only. He’s having me start on 9mcg for I believe 6 weeks then blood test.