How should T3 be taken, are there any side effects and how often should I have blood tests. (I'm taking 75 mcg of T4 and 20 mcg of T3 daily)

[wellly]

[Jackie]

Hi T3 should be taken 12 hours apart, a split dose, If just going on it, also a good idea to go on half the dose for the first week, lessens side effects.Blood test before you start, then 6 weeks after on the full dose, Always take thyroid and Beta Blockers , after thyroid test, or false reading..After every rise in meds , new tests, or any way minimum of 6 weeks, or if feel going "off"

Best wishes,

Jackie

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[wellly in reply to Jackie]

Thanks Jackie, I've been on T4 for ten years without getting rid of symptoms. Normally see the Junior Doctors at the clinic who wouldn't accept that meds need changing as blood tests were in the range, accused me of having chronic fatigue syndrome, finally got to see the Consultant Endocrinologist in October last year who changed medication to T4 and T3. I feel a great improvement almost back to being normal, but have put weight on and having palpitations at night. All I was told was to cut 20 mcg in half (not easily done) and take half in morning and half around dinner time, not sure if this should be midday or early evening, he gave the impression it should be midday.GP not much use other than repeat prescriptions was supposed to see Consultant in January but with cuts to public services never happened. I'm not on beta blockers should I be?

[Jackie in reply to wellly]

Hi T3 is best split 12 hours if possible. It can cause palpitations, especially if the dose is wrong. Have you got your last TSH, T4 and Free T3 result?Did you have a test before and after going on the T3? Ask at receptionist for their blood tests result. with ranges and then phone the secretary of the unit at hospital, probably the Endo`s and ask for theirs, make sure they have ranges or no use. Also if you did not have a copy of the letter to the GP ask for that too. If no tests, try and get them ,otherwise the only option is on line, they are just so important, especially if having problems.Also ask the Endo`s secretary for a cancellation, stipulate you want to see the Endo who was useful, when ever you get to the hospital say the same. You can insist but may have to wait., make sure they are there that day first, secretary.

Regarding palpitations, thyroid disease can bring on early inset of Atrial Fibrillation ( A. A. ) quite common. ECG will not show this, it is more noticeable at night ,just because you are more aware. First test for this is do pulse ( heart rat), 3 times a day, including when "off", If it swings, very noticeable at that time, then you need to chart 3 times a day, for 1-2 weeks, then ask GP for a home heart monitor, 24 hour or better still 7 day. This does tiny non stop ECG`s, the only way to easily diagnose it. If this is the case then see a cardio who specalises in electrics, large teaching hospital, as an electrical disturbance of the heart, there are others.

No to Beta Blockers, unless used for a known conditions, heart related

I use Blue Horizon for my thyroid bloods, very easy,Main site, quote TUK 10 for a discount, finger prick or venous blood £60-£70, results to you, well known Lab

Best wishes,

Jackie

[Stourie in reply to wellly]

When I was on t3 only l was taking 20 at 8am and took another half about 1ish because I had palpitations. Within 5 mins of taking the other half the palps had gone. I think if you get palpitations a while after the first half it could be time for the rest. But I am only giving my opinion and I am not medically trained.

Jo xx

[katherine107]

I take 4o MCG of t3 split 3 times a day, but never feel well. Am so tired and fatigued all the time. I was taking thyroxine as well but had bad side effects so stopped it. I am seeing endo this Wednesday. Maybe he can help. My go said my latest blood tests are in normal range

[puncturedbicycle in reply to katherine107]

I had high hopes for more energy on t3 and felt quite good for about a month but then I suddenly felt very unwell - I think I had a sinus infection and gp put me on antibiotics - and I haven't felt okay since. Like you, I'm tired all the time. My hair is falling out again too.

Good luck with your endo.

[Stourie in reply to katherine107]

If you are only on 40mcg t3 you are probably on too low a dose. I used to split 60mcg into 3 but now take it all at bedtime and now also take 50 levo but don't think it is good. I am getting pains in my feet since trying the levo again.

Jo xx

[vajra]

Not sure if the above is accepted/proven fact, but when adding T3 from being more or less 'fully' replaced on T4 - even when the new combined dose is nominally equivalent based on the x4 rule - it may be best to gradually phase in the T3 in order to give time for the T4 to clear the system.

On the basis that due to the long half life of T4 we're likely to absorb T3 much faster than we lose T4, and could end up over replaced during the resulting overlap. That's where the legacy T4 in the blood and the T3 taken could add to deliver too much hormone.

I do seem to find that it takes me a week or so to get comfortable with a significant increase in the proportion of T3 - even if the combined total dose is nominally the same.

Personal experience also suggests that T3 in larger doses/as a higher proportion of the total dose can have a tendency to make the gut a bit crampy or whatever if taken on an enpty stomach - perhaps because it absorbs more quickly that way/creates a local spike in levels as seen by the gut?

Only surmise, but quite a lot goes on in the gut regarding use of thyroid hormone, so it wouldn't be too surprising if it takes it a while to adapt to dose changes. e.g. there seems to be mention about of processes in the gut that may determine the rate of absorbtion and use of T3. (there's seemingly a natural mechanism that entails the liver removing hormone from the blood and returning it to the gut in the bile for re-absorbtion) The gut and gut bacteria are also significantly involved in conversion of T4 to T3, and there's scope for gut condition/health to influence the situation too: chriskresser.com/the-thyroi...

I seem for whatever reason to find that i may at first feel a little hyper (and show a slightly raised resting pulse) on (significantly) increasing the proportion of T3 taken, but that this settles/it's possible to handle more hormone over a week or so.

Another perspective (given the short half life/potential for variation in blood levels of T3, and the recent suggestion from research that blood plasma levels of T3 are regulated by means other than the TSH loop) might suggest that TSH may not be all that useful for determining the correct dosage of T3 anyway - that it may even be misleading.

My personal inclination is for this reason to take notice of the blood tests, but to in the end be guided by how i feel/the symptoms...

ian

[vajra]

Typo, first sentence - meant to say 'Not sure if this is accepted/proven fact...'

[puncturedbicycle]

I take mine in one dose in the morning about four hours before I need to get up. I feel it helps me sleep well. My doctor said I could try splitting the dose but I found it unwieldy (forgot to take the second dose) and went back to taking it in the morning. Still struggling with tiredness but I've also had a sinus infection/antibiotics and haven't felt well since so not sure how much to blame on the thyroid.

I thought I was a bit speedy when I began taking them (I started with half the dose) but I may have imagined that. I get palpitations but have had them with just the t4 as well as before treatment. I've also had diarrhoea but I'm still working out the ideal combo of t3 and t4 (blood tests showed I had gone a bit hyper adding in t3). Have reduced t4 and hope to see some resolution in the gut department.

I felt good for the first four weeks of t3 but now I'm almost back to where I started. I'm very grateful that the persistent oedema is 90% better though. That only happened on t3.