Tell me about liothyronine please

[tobee]

Just wondering why people are prescribed it. I’m on thyroxine and was interested in the difference. Thank you.

Levothyroxine is a storage hormone (T4), which gets converted in the body to T3, which is the active hormone. Some people convert just fine, others don’t, either because they have genetic mutations that make conversion impossible, or because their nutrient levels are too low to support the conversion process. Those people need synthetic T3 in the form of Liothyronine.

I was well-treated on a good dose of thyroxine (both t3 and t4 were in the upper part of the range, tsh below 1) and I still had lingering hypo symptoms (mainly fatigue, hair loss, fluid retention, constipation). On a low dose of liothyronine in combination with thyroxine my symptoms resolved and did not come back.

I can't claim conversion issues so would not be granted any special exemption should my doctor stop my scrip. They claim there is little evidence to support prescribing it but I don't think it has been well-researched and anecdotally doctors know it makes some people feel better.

Interesting. I was wondering if gp s were reluctant to prescribe because of the price. Hmmm. Personally I’m relatively ok on thyroxine alone, although I have thin hair and weight loss is slow.

OP do you know what your blood test results look like? That sometimes gives you an idea of whether you will benefit (though as in my case not always).

And yes, I suspect the price (along with some contentious health risks which usually are only a problem if you're on too high a dose) is a major factor.

I just had my bloods done. I’ve not been rung about the results which means they are ok but I need to collect a print off to check the precise breakdown. I’m really just curious because I know there’s a lot of controversy about levels and correct treatment options.

Thyroid UK is a good place to start. I mean, like anywhere else there may be some misinformation there (posters are not doctors by and large) but there are some very well-informed members. If you join and post your test results someone will take a view. You have to be selective about what you listen to ('you need more meds' can be quite pervasive, but is also often true).

If you're otherwise healthy but still symptomatic, you should be allowed to take enough medication to keep your tsh below 1 (ideally within range) and t3/t4 in the upper quarter of the range, to see if there is any improvement in your symptoms. This was okayed by my endo and gp, I'm not just making it up. There are of course exceptions, for example if one is elderly or has a heart condition, or if you develop hyperthyroid symptoms on a higher dose etc. This may be achievable with thyroxine or it may not.

You can get hair loss from anaemia too (as well as other things, but low iron is a common cause). Is that being monitored?

healthunlocked.com/thyroiduk

Thanks for the great replies!

Yes, I was quite severely anaemic 2/3 years ago, have had a hysterectomy and all good now. I don’t know how much the hair loss is due to anaemia, thyroid or whatever and how long it might take to replenish.

Also, I’m definitely aware that it’s a bit of a balancing act on thyroid sites as to what is good information/personal experience and what is something other...

I sometimes feel a bit paranoid that someone will come along here to say I'm giving bad advice, only your gp can advise you, don't join an online forum, everyone there is crazy etc so I was just including my disclaimer for that reason. I find other thyroid sites much more dogmatic and shrill than TUK.

If you were severely anaemic before your op you could still be suffering. Anecdotally people with thyroid issues seem to have this problem. I was just within the normal range (I think it goes down to 10 or 11 and my results were something like 18 despite taking supplements) and my hair was falling out like mad. I started doubling/tripling the supplements and it has improved. (I've used an iron pan for years so that clearly is having little effect!)

I also supplement b12, d and folate as those results are always bumping along the bottom. I've seen significant results from b12 injections, but not in the hair department.

I’m currently taking selenium, vit d and b12.