What is happening when I reduce T4 ?

[marsaday]

Does anyone have any idea on why I feel good after reducing down my thyroxine dose, but then I run into problems about a week later. So I have increased again.

I have been on T4 for about 12 years now. I sometimes use a bit of T3, but not that often. I take 125mcg T4

Bloods 0ct 2023

FT4 23 pmol/l (12-22)

Ft3 4.67 pmo/l (3.1 - 6.8)

TSH 1.16 (0.27-4.2)

If I take more T4 then I feel not as good. I feel tighter in my stomach and chest area. Sort of a greater pressure in the body.

I have noticed my blood pressure has been going up recently so thought I might try a reduction to see how less T4 worked out. I dropped down to 100mcg per day.

I felt really good initially. The pressure in my chest and stomach dropped a lot. I felt like the body was working a lot better. I lost weight around my stomach area (I am not over weight here, but I could tell the body was loosing some fatty tissue).

After a week I started to have wind in the evening (farting a lot) and I needed to go to the toilet much more suddenly in the mornings (my normal time). It seemed like I was experiencing some symptoms of when I first became unwell and didn't know what was happening to me. I also was getting a bit more tired.

So I have gone back to a dose of 125/100 alternate days. I am still getting adjusted, but feel a bit down as I thought I might not need the T4 as much any more.

I also take testosterone 100mcg per week. Its a normal physiological dose and it has helped my hormone issues.

Possible reason:

The body needs the T4, but not as much as I take and it would be better to add in some T3 instead.

 

[sweetpeat]

Based on your labs, it certainly looks like you have plenty of t4. Maybe your body is struggling a little to convert to t3 this time of year, if it's winter where you are. So the t4 is pooling a bit, rather than getting converted. I find I need a little more t3 in the winter.
I think I remember that you've read Dr. Blanchard's book on hypothyroidism? He says TSH values tend to go down in fall and winter. This would also affect conversion.

 

[marsaday]

I do think that my T4 is too high. So I am dropping down to 112.5 per day. I will also try use more T3 at 6.25mcg per day. I've used some today and I certainly feel better for it this evening. I didn't know TSH drops in the winter, but do know I generally feel worse in the winter most years. I'm in the UK. It's just frustrating as I feel like I am close to being in a really good space, but then I get blown off course.