Need help with my thryoid

[nothuman]

The exogenous T3 and T4 will lower your TSH secretion and thereby endogenous T4 production.
The ratio of T4 to T3 secretion by the human thyroid gland under physiological conditions, is close to 13:1. So if you take a medication with a thyroid mix of 4:1, you are unlikely to end up with a high T4 and normal T3 levels. Quite the contrary. Naively one would expect T3 might be high-normal and T4 low when taking a 4:1 mix. Though in practice this would be alleviated by reduced T4 to T3 conversion so that most likely you will end up with high-normal T3 and normal T4 levels.

Take the above with a grain of salt though, I'm not too familiar with the literature.

Wow I didn't know any of this. I feared taking T4 because my level is already optimal, but wasn't sure how to keep it there if I am going to take T3/T4. I imagine my Reverse T3 would drop as well (I know there is debate whether RT3 even matters but it would be nice to see it in range). I find it weird how people are prescribed NDT in such little doses.

I won't have T4 for another couple of weeks and already started 10mcg T3 on its own so Idk whether to stop and then wait until T4 arrives or just keep using it until I get a hold of T4

 

[fitzchivalry]

T4 is the one who you have to particularly look out for in regards to empty stomach (calcium, etc.).

 

[LATS]

What do manufacturers of pharma Testosterone recommend for the injection frequency, every 2 weeks? Clearly that is far from optimal, yet it is what they 'recommend'.

Pharma firms create recommendations not to optimize the drugs' efficacy and safety, but to make taking the drug as convenient as possible for patients, while still getting a satisfactory effect. Why do they do that? Because their incentive is to sell as many products as possible. If patient compliance is unlikely, doctors won't prescribe it.

There must really be solid evidence from RCTs about the superiority of a certain dosing scheme for pharma manufacturers to adopt it. In the case of T3, there is a lack of such evidence. This is also why T3 is very rarely used by doctors to treat hypothyroidism: there are no large, reliable studies showing that it is as effective and safe as T4 therapy.

I agree.. but... I have been fighting this thyroid issue for quite a while. . Been to 2 specialist.. my tsh and t4 fall right in mid range. My free t3 is right in mid range..( my t3 is 3.50 out of a top 4.50).. but still have symptoms of hypothyroidism.. but the specialist dont want to do anything..

But I was able to take away some " hints" of what I could do in talking to them. But agreed it would be a conversion problem.. therefore t4 supplementation would be useless.. both, off the record, admitted that t3 woukd be my best choice. But it would have to be enough to push me over 4.0 to know if it would help me feel better. That is where the two of them differed in how to do it..

The first one said that since my numbers were close he would recommend small dose of cytomel a day at 12.5 mcg. He said this dose would not shut down the thyroid but add to it which may help push me to the upper end of the free t3 scale. I asked him if he was sure that taking additional t3 woukd nt shut me down as if it would that 12.5 would most likely plummet my free t3. He said he has seen it more times than he could count and 12.5 never shut down any of his patients but just added to the t3 numbers.

The second specialist stated the exact same things but he recommended I use a t4/t3 combo.. not because it was better but he wanted to keep that pathway open in regards to t4. The t3 woukd be still 12.5. Both said they think I should be higher based on my symptoms but that my numbers were actually good and insurance would never go for it..

So I have studied this at length and can not find any real studies that show if small dose cytomel would shut down thyroid or just add to it as the dr stated. I'm still looking.

The second guy asked about my gear use and I told him.. he stated what I already knew about gear lowering thyroid output a bit. I dont take hgh ( at least not at the moment) so we ruled that out. He said if I went back to low dose trt my t3 may come up on it's own.. but since I alternate trt and cycles I'm more curious as to what to do on cycle..

In other words thyroid manipulation is a struggle and requires constant blood work to see where you land. It's not easy.. the first specialist even said " you could just take 25mcg for a month and see where ya end up on the free scales. I deal with a few bodybuilders and they all take 25mcg year round".. but I'm more for just getting my levels at the high end of optimal and not feeling like crap.. any way.. lots to think over.. I am about to drop to just trt just for a break and stay there awhile. If I do I'll take blood work 2 months after to see if there is any increase in free t3.. again it's a pain in the ass. But we still do it dont we. ?

 

[fitzchivalry]

The first one said that since my numbers were close he would recommend small dose of cytomel a day at 12.5 mcg. He said this dose would not shut down the thyroid but add to it which may help push me to the upper end of the free t3 scale. I asked him if he was sure that taking additional t3 woukd nt shut me down as if it would that 12.5 would most likely plummet my free t3. He said he has seen it more times than he could count and 12.5 never shut down any of his patients but just added to the t3 numbers.

The second specialist stated the exact same things but he recommended I use a t4/t3 combo.. not because it was better but he wanted to keep that pathway open in regards to t4. The t3 woukd be still 12.5. Both said they think I should be higher based on my symptoms but that my numbers were actually good and insurance would never go for it..

So I have studied this at length and can not find any real studies that show if small dose cytomel would shut down thyroid or just add to it as the dr stated. I'm still looking.

Purely anecdotally, I felt like junk whenever I attempted that "adding on top of your own t3" method.

Using a combo this time (Thiroyd i.e. equivalent to Armour) and feel much, much better. Like night and day difference.

Many users on thyroid forums report feeling good for a few weeks starting on a dose such as the one recommended to you with t3 (or even Armour if too low) but eventually symptoms return as natural production does get shut down eventually.

Same as you, I do not know which school of thought is correct, but I am inclined to believe the later based on my experience and what I have seen reported.

 

[LATS]

Purely anecdotally, I felt like junk whenever I attempted that "adding on top of your own t3" method.

Using a combo this time (Thiroyd i.e. equivalent to Armour) and feel much, much better. Like night and day difference.

Many users on thyroid forums report feeling good for a few weeks starting on a dose such as the one recommended to you with t3 (or even Armour if too low) but eventually symptoms return as natural production does get shut down eventually.

Same as you, I do not know which school of thought is correct, but I am inclined to believe the later based on my experience and what I have seen reported.

What were your t3 numbers if you dont mind me asking? Also what dosage of armour are you using ?

 

[nothuman]

I agree.. but... I have been fighting this thyroid issue for quite a while. . Been to 2 specialist.. my tsh and t4 fall right in mid range. My free t3 is right in mid range..( my t3 is 3.50 out of a top 4.50).. but still have symptoms of hypothyroidism.. but the specialist dont want to do anything..

But I was able to take away some " hints" of what I could do in talking to them. But agreed it would be a conversion problem.. therefore t4 supplementation would be useless.. both, off the record, admitted that t3 woukd be my best choice. But it would have to be enough to push me over 4.0 to know if it would help me feel better. That is where the two of them differed in how to do it..

The first one said that since my numbers were close he would recommend small dose of cytomel a day at 12.5 mcg. He said this dose would not shut down the thyroid but add to it which may help push me to the upper end of the free t3 scale. I asked him if he was sure that taking additional t3 woukd nt shut me down as if it would that 12.5 would most likely plummet my free t3. He said he has seen it more times than he could count and 12.5 never shut down any of his patients but just added to the t3 numbers.

The second specialist stated the exact same things but he recommended I use a t4/t3 combo.. not because it was better but he wanted to keep that pathway open in regards to t4. The t3 woukd be still 12.5. Both said they think I should be higher based on my symptoms but that my numbers were actually good and insurance would never go for it..

So I have studied this at length and can not find any real studies that show if small dose cytomel would shut down thyroid or just add to it as the dr stated. I'm still looking.

The second guy asked about my gear use and I told him.. he stated what I already knew about gear lowering thyroid output a bit. I dont take hgh ( at least not at the moment) so we ruled that out. He said if I went back to low dose trt my t3 may come up on it's own.. but since I alternate trt and cycles I'm more curious as to what to do on cycle..

In other words thyroid manipulation is a struggle and requires constant blood work to see where you land. It's not easy.. the first specialist even said " you could just take 25mcg for a month and see where ya end up on the free scales. I deal with a few bodybuilders and they all take 25mcg year round".. but I'm more for just getting my levels at the high end of optimal and not feeling like crap.. any way.. lots to think over.. I am about to drop to just trt just for a break and stay there awhile. If I do I'll take blood work 2 months after to see if there is any increase in free t3.. again it's a pain in the ass. But we still do it dont we. ?

Well let me tell you, I used T3 only 5 mcg for 3 days and then 10mcg yesterday. I was a complete walking zombie. No energy, felt like I didn't sleep despite getting 8 hours, AND I had to go out and be social all day. It was really brutal.

Needless to say, I sure as shit didn't take it today. I can't live like that. It was miserable how tired I felt.

So I am not sure what that means? Could it have shut down my Free T3? I didn't even know it was possible. I still have a lot to learn about thyroid health.

I will wait for the T4 to arrive and do combo therapy instead. T3 only was a disaster.

 

[ill gotten gains]

Nothuman, are you currently dieting? On low carbs with little to no simple carbs?

 

[nothuman]

Nothuman, are you currently dieting? On low carbs with little to no simple carbs?

I'm not dieting, no. I'm on a maintenance diet of roughly 3200-3500 calories a day (I'm big on getting in as many nutrients as possible) and have been eating this way for a while now. Carbs are about 200g a day.

 

[nothuman]

Question for anyone: Why would 5-10mcg T3 alone cause me to be so tired and helpless, given my baseline numbers? I don't understand what happened.

 

[ill gotten gains]

I'm not dieting, no. I'm on a maintenance diet of roughly 3200-3500 calories a day (I'm big on getting in as many nutrients as possible) and have been eating this way for a while now. Carbs are about 200g a day.

Increase your calories for a week or 2. Metabolism might be stagnant from being on maintenance for so long.

 

[nothuman]

Increase your calories for a week or 2. Metabolism might be stagnant from being on maintenance for so long.

That’s probably just going to make me fat and not boost my Free T3. My numbers were very similar even back in 2015. I need thyroid medication.

 

[MyNameIsJeff]

Question for anyone: Why would 5-10mcg T3 alone cause me to be so tired and helpless, given my baseline numbers? I don't understand what happened.

I have no idea, shouldn't happen. Was is a pharma product? When's the expiry date, and how have the meds been stored?

 

[nothuman]

I have no idea, shouldn't happen. Was is a pharma product? When's the expiry date, and how have the meds been stored?

They were generously given to me by someone we all know from this forum and were legitimately prescribed. I assume they were stored properly.

I felt fine the first two days. Then day 3 I was real tired then day 4 I could barely function.

Strange.

 

[prodaf]

I had normal T4 and TSH but low T3. Endo scripted T3 25mcg and T4 100mcg.
All is great now.

 

[prodaf]

What do manufacturers of pharma Testosterone recommend for the injection frequency, every 2 weeks? Clearly that is far from optimal, yet it is what they 'recommend'.

Pharma firms create recommendations not to optimize the drugs' efficacy and safety, but to make taking the drug as convenient as possible for patients, while still getting a satisfactory effect. Why do they do that? Because their incentive is to sell as many products as possible. If patient compliance is unlikely, doctors won't prescribe it.

There must really be solid evidence from RCTs about the superiority of a certain dosing scheme for pharma manufacturers to adopt it. In the case of T3, there is a lack of such evidence. This is also why T3 is very rarely used by doctors to treat hypothyroidism: there are no large, reliable studies showing that it is as effective and safe as T4 therapy.

Endo wants i take on empty stomach full dose morning.

 

[nothuman]

I had normal T4 and TSH but low T3. Endo scripted T3 25mcg and T4 100mcg.
All is great now.

This is exactly what I wanted to hear since I’m in the same predicament. How low was your T3?

 

[saudades]

I have the following lab numbers I recently got back (besides RT3):

TSH:1.9
FT3: 2.9
FT4: 1.53
Last year's Reverse T3: 28

No doctor is willing to help me but I have access to both T3 and T4 meds. What dosing regimen would you guys recommend based on these numbers?

The "normal" lab ranges are wrong, similar to total testosterone levels.

I've read FT3 should be minimum in the upper 3's (like 3.7+). The thing is my FT4 is already at a good place.

Therefore, I think I should only use T3, but I'm not certain and I also don't know what dose to use. Perhaps 10mcg?

I only skimmed through this thread, but based on the original post, you're in the same boat I was a while back. When reverse-T3 is high, it blocks normal T3's action and you get symptoms of low thyroid even if your numbers of T3 and T4 and TSH are right in the middle. Here the body is converting T4 into reverse-T3 too much so you do NOT want to take more T4. The only way to bring down the reverse-T3 is to take T3. Dosage depends on the person, but for me, I took 10mcg daily in the morning on empty stomach since it doesn't take a lot. The mechanism here is that it shuts down your production of T4 so that the overproduction of reverse-T3 stops. Eventually you clear it out, and then you taper off and hope your regular production goes back to normal. Some people in these cases switch to taking both T3 & T4 and monitor what happens.

You are correct that the FT3 should be in the upper 3's.

 

[MyNameIsJeff]

I only skimmed through this thread, but based on the original post, you're in the same boat I was a while back. When reverse-T3 is high, it blocks normal T3's action and you get symptoms of low thyroid even if your numbers of T3 and T4 and TSH are right in the middle. Here the body is converting T4 into reverse-T3 too much so you do NOT want to take more T4. The only way to bring down the reverse-T3 is to take T3. Dosage depends on the person, but for me, I took 10mcg daily in the morning on empty stomach since it doesn't take a lot. The mechanism here is that it shuts down your production of T4 so that the overproduction of reverse-T3 stops. Eventually you clear it out, and then you taper off and hope your regular production goes back to normal. Some people in these cases switch to taking both T3 & T4 and monitor what happens.

You are correct that the FT3 should be in the upper 3's.

What a bunch of BS.

 

[nothuman]

What a bunch of BS.

Taking T3 does lower T4 production though, right?

 

[Biggerp73]

What do manufacturers of pharma Testosterone recommend for the injection frequency, every 2 weeks? Clearly that is far from optimal, yet it is what they 'recommend'.

Pharma firms create recommendations not to optimize the drugs' efficacy and safety, but to make taking the drug as convenient as possible for patients, while still getting a satisfactory effect. Why do they do that? Because their incentive is to sell as many products as possible. If patient compliance is unlikely, doctors won't prescribe it.

There must really be solid evidence from RCTs about the superiority of a certain dosing scheme for pharma manufacturers to adopt it. In the case of T3, there is a lack of such evidence. This is also why T3 is very rarely used by doctors to treat hypothyroidism: there are no large, reliable studies showing that it is as effective and safe as T4 therapy.

Sure, I agree with you about all of that, I was just stressing that it isn't absolutely necessary to divide the doses and take them on an empty stomach. As you said, "Pharma firms create recommendations not to optimize the drugs' efficacy and safety, but to make taking the drug as convenient as possible for patients, while still getting a satisfactory effect."