I now have my T3 but I am not sure exactly what to do with it!

The Endo recommended a "low dose" of T3 alongside the 100mg Levo and the GP has given me a prescription of 10mg of T3 a day.

Is it usual to keep to the same level of T4 or is the T3 so low it doesn't matter? I am also not sure when to take it. I remember some people split the dose. Last question- do I take it with or away from the T4 ? I am definitely going to get the Paul Robinson book but I would be really grateful for some advice now. Many thanks Jx

29 Replies

  • You may find you don't need as much Levo after you start on T3. For me I started 5mcg and upped it every few days and now take 25 mcg. I actually went up to 50 mcg but backed down to 25 mcg. Now, it is the only hormone I take. I think it is much easier on the system than T4 which a person may or may not process very well. You may feel it kick in within a couple of hours and I like to take it in the morning since it helps if I am active that day.

  • Hello Heloise I have done the same as yourself, reduced the levo down from 100 mcgs down to nothing and just take T3 Cynomel from Mexico 25mcgs. I am now upto 50 to 56mcgs and supporting it well. Already lost 5lbs in one month. So regret taking Levo for 18years, and have no confidence in Doctors or Endos.

  • Same here, marm. Although I did finally find a doctor who would prescribe Armour after six years on Synthroid. It has been more than ten years but still have muscle issues. I, too, have lost a few pounds. I only used my current GP to get my Armour but now that I am on T3 only which I order myself as well, I think I will drop her entirely. It's really unfortunate but I hope that others will learn from our experience and find hope. I'm so glad you are doing well and hope you continue to post. Good for you.

  • I could be totally wrong, but I thought Paul's book was designed for people on T3 only.... Could be wrong.. :)

    It's a shame that the Endo did not give more specific advice! *sigh*

    Can you drop me an email with the details of the Endo please - louise.warvill@thyroiduk.org




  • I've just got his book "Recovering with T3" and from what I've read so far it is only about T3 only.

  • I was on 100mcg Levo. I was prescribed 10mcg of T3, so reduced 50mcg of levo and took T4/T3 together.

    Excerpt from Dr Toft's article in Pulse Online:-

    Even while taking the slightly higher dose of levothyroxine a handful of patients continue to complain that a sense of wellbeing has not been restored. A trial of levothyroxine and tri-iodothyronine is not unreasonable. The dose of levothyroxine should be reduced by 50µg daily and tri iodothyronine in a dose of 10µg (half a tablet) daily added.

  • Hi,

    Just wanted to add that I tried t3, got upto 75ug a day and I noticed nothing other than a slight increase in heart rate. No impact whatsoever so to speak, but I understand I am not the norm. This was on top of Levo as well.

    Hope it helps

  • What do you take now then Starfish?

  • Im just on t4 at present but other than a few minor changes eg less pain and slightly smoother hair nothing has changed. My adrenals were checked by scanthen test but were apparently normal, 432 base and 600ish peak.

    I think I've been ill all my life but only diagnosed last year when I was given the tpo antibodies blood test. I have a problem with having to drink lots of water and read this could be another form of diabetes that is linked to hypo being present a long time, so this may be the issue as I'm so tired I feel like a zombie, it's almost like being in a dream like state all the time. This tiredness is also a symptom. Sorry if you think I'm off track but I think this why no amount of T3 worked for me personally.

    I'm at hospital this week for another problem with my water works so will see what they say then, I've been told I drink far too much for any normal person, I talking water here as I don't tolerate alcohol anymore. Makes me very unwell.

    Anyway I hope t3 works for everyone else as it should.

  • That's a shame Starfish-T3 seems to do the trick for most people. It just goes to show yet again that there's not one thing out there that suits absolutely everyone. I'm having no luck with T4 and really feel that T3 will be the thing for me...but if it's not I dunno where to go from there!

  • Sometimes taking t3 with t4 is the problem. I was not well until I dropped t4 completely. I am now on t3 only and feeling much more normal. I still have a little way to go but so much better than on any other combination of thyroid replacements.

  • Thanks Carolyn. How did you know that the removal of the T4 would help? Was it just trial and error? I know it is early days (day 3) but I don't feel a lot different yet . Jx

  • ...mostly people are advised to reduce T4 when adding in T3. Good to space it out through the day as it is short acting - but I understand it's effects are longer lasting. Maybe worth having a look at Pauls website rwt3.com where you may glean some information. His book is about his own personal journey with Hashimotos and his eventual arrival at T3 treatment. New information on his website. He is a member on this forum so you can check out his posts and answers.....

    As a guide it may be helpful to remember that T3 is four times more powerful than T4. Can't help thinking we are reading about T3 being prescribed more often on this forum. Praise must go to the people behind this forum who have enabled us all to learn so much and challenge our treatment.

    Wishing you wellness soon........

  • Your absolutely right - this site has given so many of us the understanding that we don't have to settle for T4 treatment if it doesn't work for us, and that we can question our medical treatment and ask for alternatives.

  • Hi Low starting dose is always a good idea. retests for TSH, T4 and Free T3 , then probably some med adjustment. Ideally T3 should be split in half and taken about 12 hours apart. As such a low dose you may not manage that, if you can ,it is much better. Be sur to never take any thyroid meds or Beta Blockers before a blood test for thyroid. t3 has a high 2 to 3 hours after taking, that especially causes havoc with the blood teT3 makes such a difference with the T4, it is considered the"best " thyroid treatment for hypo.t

    Best wishes,


  • I take my T4 and T3 together! I'm on 125mcg t4 and 10 T3

  • I'm on 125mcg Levo (T4) and 10mcg liothronine (T3) too. Initially I felt great but now feel I need an increase of T3. As symptoms are returning and fatigue is getting worse! January can't get here fast enough when I see my endo again. Good luck with your new treatment. This combination has transformed my life. Hope you feel the same benefits.

  • Hi. I starting taking T3 alongside T4 about 18 months ago. Initially I took 20mcg alongside my 150mcg of T4 all at once in the morning. I felt slight hyper, so then split the pill in half (takes some practice) and now take half in the morning and half at supper time. This combo is by far the best I have ever had and I feel pretty good! I would keep to the 100mcg of T4 and take the T3. If you feel hyper at all, then a better dose will probably by 50mcg of T4 with 10mcg of T3 in the morning alongside the T4 and 10mcg of T3 in the evening. With the higher potency of T3, this would a thyroxine dose equivalent of 120mcg. If you then feel hypo, take the T4 to 75mcg. One of these combinations will be perfect! You are lucky to have T3 prescribed, its hard to get but makes all the difference! Good luck.

  • This is interesting ! I am on 175mcg of levothyroxine like your self i have been prescribed T3 at my request.

    I was told to cut down the levothyroxine to 150mcg & take a small dose of T3 10mcg, i am told it only comes in 20mcgs in the uk & I shall have to halve the dose.

    Was you told the same ? I have not got the prescription as yet but I am praying it helps.

    Lets hope it gives a little releif. Jillymo :-)

  • My GP checked in her book and it said 20 mg but when I went to Boots they had 5 mg but apparently they are special order.

    They have me a few 5mg and I will get the balance in 20s when it arrives. Good luck to you too. Jx

  • I pray it helps us I cant go on like this any longer i feel so weak.

    Jillymo X

  • Can I just say that Paul Robinsons book is of interest for anyone taking T3 whether that be on its own, with T4 or NDT and is well worth reading. He also has a new book out on adrenals which I am really looking forward to reading because I have very low cortisol.

    I am also on a very low dose of T3 (2.5 twice a day) and I had to fight for that, but it is only because of the brilliant contributors to this site that I realise how minute this dose is. Anyway I have an appointment with my "I go by the book" Endo next week and I am going to demand an increase. Wish me luck.


  • Good Luck, Holly! We'll put on a special 'Mexican T3 wave' for you at the due time ;)

  • Thank you tegz, what a lovely image! It will cheer me up on the day.

  • I take 150/175 mcg T4 and 10 mcg T3 first thing every morning. I feel it has made a difference but then I was only on 50 mcg T4 for over four years which wasn't enough and made me poorly.

    Good luck.


  • Thanks everyone for your stories and advice. Fingers crossed for all of us. Jx

  • How do I go about getting my endo to let me try a combo of t3/t4? I'm on 125 thyroxine but it's not helping itv fatigue and muscle aches? Problem is I don't want to lose weight. I am on the skinny side to start with.

  • My approach was just to keep asking and I think he agreed because such a small dose wouldn't do any harm! If you post a question of your own I am sure that others may give better advice. If you do post a question include your latest blood tests with ranges. It means you will get a more detailed response. Good luck. Jx

  • I was Diagnosed some 20+ years ago now with Hashimotos...Although I was ill for many years before...I am on Levothyroxine of between 100mcg and 125 mcg. But I am still ill..I have weight problem that won't shift no matter what I do ..I was a skinny Minnie up till got this horrid disease. My Skin is horrible extremely course &dry..My legs and ankles/ feet swell up as the day goes by, The Fatigue is overwhelming !! I also have Fibromyalgia ( I believe caused by Hashimotos) ..and Hypermobility Syndrone, Degenerative discs, Horrendous IBS !! I often Vomit after meals ! I am intolerant to Gluten, I have ugly fatty tumours all over my Arms...I am in desperate need of help but my Doctor is of little use.

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