Taking full t3 dose all at once: Someone here... - Thyroid UK

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Taking full t3 dose all at once

puncturedbicycle profile image
53 Replies

Someone here recommended it and I can't find the post now.

I tried it this morning. Around 6 I usually take 75mcg t4 and half my daily 25mcg dose of t3 but today I just took the whole pill. I did feel like my heart was a little fast at first but I think I sometimes get that even on a split dose. It wasn't crazy, but when I was trying to get back to sleep it seemed to be faster than a usual 6am resting heartbeat when you're half asleep. I didn't take my pulse but I might try doing that some morning when I'm more awake.

Two good things to come out of this experiment are 1) I didn't have to remember to take my afternoon dose, which I often forget until I'm running out of steam and 2) I didn't run out of steam. I felt pretty okay energy-wise all day with no real dips (until now, and it's bedtime so that's okay).

Good result. I'd recommend trying it if like me you have trouble remembering multiple doses or if you have dips in energy throughout the day.

And thanks to whoever suggested it. :-)

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53 Replies
Clutter profile image
Clutter

I think it was probably Helvella. It works for me but taken at night.

If I ever look like having resuming an exciting social life I might have to look at switching to morning dose so I don't run out of steam.

missdove profile image
missdove in reply toClutter

Awwwh Clutter I so relate to that...I thought I had invented the busy social life for the last 25 years, now a trip to the local shops 5 minutes away is a day out for me...But am definitely going to try out a morning dose of T3 instead of split between 3 doses as per Shaws suggestion, I have a funeral sadly of a close loved one to get through so will wait till after that as I am all over the place at the moment...

puncturedbicycle profile image
puncturedbicycle in reply toClutter

I don't think it was Helvella Clutter - isn't he on t4? I think it was someone else but it doesn't matter.

I'm not too worried about my social life. I'm rarely out of my pajamas long enough to get up to much. :-)

in reply topuncturedbicycle

Yes but Rod is a v knowledgeable chappy and might well have suggested it :-)

puncturedbicycle profile image
puncturedbicycle in reply to

Yes, sorry - I should have said someone suggested it because it works for them. It was not Rod. :-)

in reply topuncturedbicycle

Oh dear, please don't apologise, I'm sorry if I sounded *grumpy* - was not my intention at all, just trying to be helpful :-) but can see now that it could have been read that way :-s

puncturedbicycle profile image
puncturedbicycle in reply to

No - not at all!!! :-) I realised I hadn't explained that it was someone who was doing it themselves (would be good if I could remember a single other detail about it, head like a sieve, etc). :-)

(Oh and I think it was a woman, which is how I have the idea it wasn't Rod.) :-)

in reply topuncturedbicycle

Oh I see! Sorry brain fog moment for me there too :-) take care with all this wind and rain x

puncturedbicycle profile image
puncturedbicycle in reply to

Managed to not blow away. :-)

roslin profile image
roslin

I take it all last thing at night as per shaws suggestion as well, 3 grains armour and 40mcg T3. It is a fairly hefty dose of T3 but not as high as some other people here. I have no problems falling asleep (very occationally wake with pounding heart ut much better now). I am warm all day now even in the evening but fatigue is difficult to gage as I am tired most of he time anyway. Taking it all at once ensures better absorption and I have one less thing to remember. I am convinced that my palpitations and fatigue, which is due to B12 deficiency .

Roslin

puncturedbicycle profile image
puncturedbicycle in reply toroslin

It's all so complicated isn't it?

I'm glad to hear I'm not the only person who has the heart pounding thing.

Even though I know the t3 has made me feel much better than t4 alone and I'm careful about taking it I can't stop the worry seeping through from what the naysayers tell you, like t3 will damage your heart, it's so easy to take too much, when you think you're hypo you might actually be hyper, etc. I go through periods of compulsively taking my pulse.

nobodysdriving profile image
nobodysdriving

I have been taking my 180mcg dose all at once in the morning for a while, however am considering going back to multi dosing (only 3 times a day or so).

when you take T3 your body uses cortisol to process it.

My latest saliva test gave me really nice at the top cortisol when I wake up then it plummets like a plane going to crash by lunchtime (however to bottom of normal range not below) and stays rock bottom til bedtime when it is actually slightly over range.

I think it's because that first dose uses up all my cortisol then by bedtime the body is catching up with the shock of it all and raises the cortisol slightly in a 'panic' to make sure it does not go below levels.

I am going to try now: 80mcg on waking, 60mcg lunchtime, 40mcg late PM/early evening

I am not doing this just because of the saliva result, but also as I have been trying to get rid of heart pounding which I feel when I go to bed by nearly a year and a half. Whilst I have improved it HUGELY by moving my once a day dose from bedtime to morning, it is still there. I do get the very occasional day when I don't feel it but it is there 6 evenings out of 7.

I KNOW it is cortisol related as I have excluded any other cause (like food sensitivities, blood sugar, medications, caffeine, exercise blah blah blah blah and of course I have a 'healthy heart')

puncturedbicycle profile image
puncturedbicycle in reply tonobodysdriving

nobodysdriving, do you do these tests off your own back or have you got guidance? I would never have thought of the cortisol issue but I do have adrenal issues.

Your reply made me realise I have no idea what is causing the heart pounding. I assumed it was down to the stimulant effect of the t3 and my worry is that it indicates I'm taking too much (even though I have no other hyper symptoms). To be honest I think I've had it since I was on enough t3 to make me feel better, so it is one of those things I always accepted as inevitable if I continue to take it in sufficient quantities.

I am always impressed at how well-informed some people are here.

nobodysdriving profile image
nobodysdriving in reply topuncturedbicycle

Hi, the pounding with me is 'definitely' due to cortisol reasons, I have tried coming off the T3 completely, reducing, upping, none of these interventions made it go away, of course I have looked at virtually everything else too.

It was by talking to Paul Robinson it made me realise it must be connected to cortisol (high or low they both do the same thing: can give you heart pounding).

I am NOT talking about palpitations, those are 'irregular' or fast heart with the pounding, my heart rate is not fast and not irregular, my heart just knocks on my chest, even at 50 beats per minute, and it is almost always (but not exclusively) when I go to lie down in bed to go to sleep. I could feel NOTHING all day then I go to lie down and 'bang' it starts immediately!

I also do not have ANY other signs of being overmedicated LOL

Anyway T3 uses cortisol, that is why if you have really 'bad' adrenal exhaustion (ie very low cortisol across the board) even the TINIEST amount will give you pounding or fast heart rate and you need to start very very slowly, or those with untreated addisons should not take it.

I have done the saliva test 'off my own back' yes :)

puncturedbicycle profile image
puncturedbicycle in reply tonobodysdriving

Okay, I see - that is different to what I have. My heart just beats faster.

Just when I start to feel like I have a bit of a handle on thyroid stuff a whole extra chapter opens up in front of me that I never knew existed. :-)

nobodysdriving profile image
nobodysdriving in reply topuncturedbicycle

fast heart rate is still very likely to be down to cortisol too

Jow11 profile image
Jow11 in reply tonobodysdriving

Hi nobodysdriving, I have this heart pounding as well, but when I told my Endo about it he told me I have to come off T3 totally. I'm on 85 mcg a day. He wouldn't listen to my explanation that T3 often relieves the heart palps. He actually couldn't believe I take T3, was convinced I was confused. He claimed nobody is on T3 only and certainly no one takes more than 60 mcg.

I just wanted to ask, is your Endo ok with you taking 160 - 180 mcg a day. Mine told me that as my TSH is suppressed and T3 around 7 (range up to 6) I am thyrotoxic; scared me i might have damaged my heart and have osteoporosis. May I also ask if your TSH is supressed and T3 over range? And if so is he ok with that? Thank you.

puncturedbicycle profile image
puncturedbicycle in reply toJow11

Not sure I have ever had a thyroid doc who I trust. The NHS one would have kept me on 150mcg t4 forever (when I complained of feeling awful he told me the tests looked great) and the private one told me I could double my dose and not to worry if I felt a little hyper now and again (which I didn't do and didn't need to do in the end) so I think they both represent dangerous extremes.

Did he say why he wasn't willing to reduce your t3 a little to see what happens?

Funny how they think everyone is on t4/no one is on t3 alone. They will not prescribe/support, so they have no idea what lies beyond t4 and they don't bother to find out.

Jow11 profile image
Jow11 in reply topuncturedbicycle

I saw the Endo earlier this week. He told me to reduce to 60 mcg immediately with a view that in four weeks I'd come off totally. He didn't allow explanations or questions. He made his mind up that I was thyrotoxic based on TSH in the first five minutes of the consultation. I don't think I will see him again.

I went to see him with an open mind. If he'd suggested that I reduce T3 a little and perhaps replace it with T4 or NDT I would have tried it. But he just commanded "reduce your dose to 60 tomorrow". A very stressful and unpleasant visit. He barely talked to me or looked at me, spent half an hour typing a letter to my GP. That was my first experience with an Endo.

puncturedbicycle profile image
puncturedbicycle in reply toJow11

Bonkers. :-(

nobodysdriving profile image
nobodysdriving in reply toJow11

well, I am sure that if I had my blood tests taken as any other normal person my TSH would be suppressed and my fT3 over range, however I don't :D

no my endo is not 'that nice' to be honest. He does use T3 but he's not that good. I have a private doctor and am an ex dr skinner's patient

Jow11 profile image
Jow11 in reply tonobodysdriving

Thank you very much for your reply. I asked as I was wondering whether it is worth me searching for another Endo. Your response has helped me make a decision, that while some are better than others, ultimately if one 's on T3 only it is difficult to get support from endos. I think I'll just stick with my private dr. Thanks again.

nobodysdriving profile image
nobodysdriving in reply toJow11

yes you got it. My endo has tried a few times to get me to reduce my T3 dose, I just simply 'refuse' every single time. I have no problems in stating my mind to him and telling him point blank how I disagree. He's getting used to it :D

Jow11 profile image
Jow11 in reply tonobodysdriving

Good for you.

in reply tonobodysdriving

If you have high cortisol? could that be why i am struggling being on T4 only?

I'm convinced my issues are high cortisol (stress) and total inability to handle any stress

i have ordered T3 from Mexico but it is stating 4 weeks! before delivery because of USA "orange alert" anyone with similar problems

susie59 profile image
susie59 in reply to

hi, I had the same orange alert comment, but mine came 11 days later, hopefully, will be the same for you.

in reply tosusie59

Hi mine arrived today :) panic over lol

susie59 profile image
susie59 in reply to

really pleased for you jacaranda, :)

puncturedbicycle profile image
puncturedbicycle in reply to

Mine has never come in less than three weeks, usually four, so I think this may be the usual way of things.

real_mission profile image
real_mission

I take my doses 4 times a day. Usually the AM dose quite close together. 20mcg when I wake, then another about 10am. Then one mid afternoon .My last one is when I go to bed, I have to take this one just as my head hits the pillow, or I get a slight insomnia reaction. I may experiment with taking dose closer together, I still nod off in the sofa some nights. Last night I nodded off bout 11pm (just after Question Time) ,went to bed about 12.40 when I re-awoke, had my dose, then woke today at 10am :(. I have days where my energy is excellent ,then I have days like today ,where Im just wasted. Been on this for nearly 3 years now. I seemed to have a handle on it to begin with, but over time its like a flame going out. Some days it works, others Im at a loss as to how to get around this without just taking more then my stated dose to bring me out of it.

puncturedbicycle profile image
puncturedbicycle in reply toreal_mission

I can't remember where i heard this so take with a grain of salt but someone's endo (may have been mine but can't remember) said that if you feel like you've run out of energy it is okay to take a little extra as long as it doesn't give you hyper symptoms. Some people adjust this way when winter comes too.

My doc has been okay with me trying different doses to help me figure out what makes me feel better, but then I hear the panic about heart damage, osteoporosis etc and I worry.

real_mission profile image
real_mission in reply topuncturedbicycle

Excellent! I thought this seemed logical, as sometimes I feel 'high' and miss a tablet. I cant work it out at all, somethings going on. I could take a normal days suppl and feel 'ugh', then other days ,get to three tablets and feel like I don't need the last one. I have a dodgy intestinal tract, so I suppose that's a lot to do with. I've had the 'eyes glazed over 'look from my GP and Endo when mentioning it :D

I love this site!!

puncturedbicycle profile image
puncturedbicycle in reply toreal_mission

Well I wish I could remember where I heard it - it would make my info more credible. :-) But certainly some people aren't afraid of giving it a go. It sort of makes sense considering that my thyroid 'output' or whatever does seem to wobble quite a bit and sometimes I seem over and sometimes under on exactly the same dose taken exactly the same way.

When you say your insides are dodgy, what do you mean? Do you think your meds aren't getting absorbed or - ?

real_mission profile image
real_mission in reply topuncturedbicycle

Yes ,sorry, you're exactly right, I think my lactose intolerance is affecting my absorption. I have told the endo and my Gp. My GP actually said ,now get this....'there's no milk in the tablet' , I then went on to tell him about the fillers and how lactose intolerance is a big issue with absorption. There was an 'oh yes' moment, then the eyes glazed over once again :D

Ive only suffered from lactose intolerance since the op. I use to have cereal every morning ..and more and also drank milk daily with no ill effects, now I cant even look at a latte.

puncturedbicycle profile image
puncturedbicycle in reply toreal_mission

The mind boggles. At least I hope you have found a non-dairy alternative which suits. I was off dairy for a number of years due to respiratory allergies and congestion (chronic sneezing and runny nose) and it's nice that you have more than just soya now. I get on okay with rice milk, oat milk, almond, etc.

Jow11 profile image
Jow11 in reply toreal_mission

Hi, I know what you mean. I've been on T3 for 11 years. I take 62.5 - 65 at around 4 am and 20 mcg at around 4 pm. Some days I feel fine, eg in October I could walk 3 miles but in November I couldn't get out of bed. Now I have mixed days, sometimes I feel fine, on other days I wake up and feel as if I hadn't taken any T3. Sometimes I actually take extra on days like those without any overstimulation.

I don't know what do now.

puncturedbicycle profile image
puncturedbicycle in reply toJow11

Interesting. I have heard that some people need a little more thyroid hormone as the days get shorter. Do you think you could be one of them?

I have those wobbles too. I was fine on an increasing dose last spring/summer, felt great on a stable dose for about two months, then went hypo and haven't been able to get on just the right dose/proportions since. I'm not sure if it's that I don't take enough in total or if I need more t4 or t3 but I can't work it out.

A few weeks ago I took my last crumb of t3 (I had split my last dose) and went wildly hyper for a couple of hours - hot, racing heart, air hunger, etc. I was out so couldn't even take a beta blocker (which I didn't bring with me because I had only taken the same dose as I do every single day). Couldn't face reducing again so I carried on as per and have been fine ever since. Deffo not hyper since.

Mystery.

Jow11 profile image
Jow11 in reply topuncturedbicycle

Yes, I think I generally need a bit more in winter. I definitely feel better when it is warm and the sun is shining.

I've been having real problems adjusting my T3 lately. I had been relatively stable for several years but since November I'm finding it difficult. I've actually ordered some NDT today, in the hope that'll help.

Today I'm feeling hypo, I've already taken extra T3, it has helped a bit but i feel I need more. I don't know whether to take more as I'm scared of going hyper. It is so complicated.

puncturedbicycle profile image
puncturedbicycle in reply toJow11

Amen - this was exactly my situation this afternoon. I took an extra quarter, just a crumb really, when I realised the horrible anxiety was beginning to come back.

When your dose changes suddenly it seems like the only thing that will tell you that you have enough t3 is to take too much of it. It is maddening.

shaws profile image
shawsAdministrator in reply toreal_mission

Dr Lowe used T3 within his protocol for patients (as well as NDT). This is a link and these are a couple of extracts:-

As a result, a single dose of T3 will be long gone from the patient's system before he or she experiences most of the benefits of that dose—a molecular and metabolic yield that may smoothly spread out over one to three days.

And finally, why do I specify that the typical patient use one full dose of non-timed-release Cytomel for life? Because extensive testing has shown that this is safe, effective, and most economical—when used within the context of our entire protocol.

web.archive.org/web/2010111...

belwom profile image
belwom

I'm dismayed at how many people need to take multiple doses, some of which in the middle of the night. Surely this in itself must contribute to tiredness with sleep interrupted to take medication? Have just started T3 half a 25 mcg pill at bedtime, no ill or beneficial effects yet and I intend to take it slowly and if I can help it to take it at convenient times.

puncturedbicycle profile image
puncturedbicycle in reply tobelwom

Taking t3 really early/in the middle of the night can make a huge difference to waking up though. Some people wake predictably every night to go to the loo and take it then. And of course if you have to get up at 6am, there may be no other way (esp if you're following the circadian method).

Horses for courses. :-)

sandywandy1 profile image
sandywandy1

Some people take the biggest dose 3 hours before normal waking as this is when the body would naturally have the highest levels of T3. As I understand it, doing so helps the body with cortisol production which happens in the last 3 hours of waking. I am no expert, I have only been on T3 only since 24.12, but I always feel best if I take 30mcg in this way, 20 4hrs later then 10 and 10. If I ignore my alarm and take first dose as I awake, I have less energy. I suspect that I am a little under medicated overall, but feel much better than when I was on a T4 T3 combination and 100 times better than T4 only. My GP has referred me back to endo so I will stick until I have seen him. I don't find it an issue taking multiple doses, I carry half tablets in my handback and take one when I feel my energy starts to dip dips - usually 4/5 hrs.

Sandra

puncturedbicycle profile image
puncturedbicycle in reply tosandywandy1

Yes, if I don't take enough t3 well before I have to get up I feel like I've been drugged.

Alvena-Lesley profile image
Alvena-Lesley

I was really interested in your experiment with one dose in the morning, as I, like you, have a problem remembering to take the dose in late afternoon. I haven't tried it yet but I am going to do so on a day when I don't have a full diary. Many thanks.

puncturedbicycle profile image
puncturedbicycle in reply toAlvena-Lesley

I'm so glad to hear it isn't just me!

I sometimes feel guilty because I moan that I don't feel great and then I forget my dose until my energy is on the ground, or I have to go out and I forget to bring my last crumb of a pill with me (best carried in a bit of tissue in bra cup, top tip) and I think no wonder I don't feel well, I can't be trusted to take my meds properly, etc.

When I first started taking t3 I used to know without doubt when it was time for my dose because I'd be looking around at bed, sofa, etc thinking I wonder if I have time for a nap. I guess that can't be good for you - ? Leaving it until you're in a hole - ?

When I read the Paul Robinson book and saw how organised he was I thought there's no hope for me on t3 alone.

I would love to be able to only take 1 dose per day instead of 3! Have attempted to reduce it to 2 daily doses but felt dreadful.

Am self-medicating, NHS Endo thinks I'm taking too much so gradually reduced and felt poorly. Back up to usual dose which I've worked out for myself and am not prepared to reduce it.

Absolutely refuse to go back to feeling rubbish on the off chance that I'll have health problems when I'm 90. The here and now is what concerns me!

Oh yes, and not forgetting that I've got a bike to ride!

Kitten-whiskers profile image
Kitten-whiskers

Thats great to hear, It's always nice to hear success stories x

puncturedbicycle profile image
puncturedbicycle in reply toKitten-whiskers

Nice when something works. :-)

welliec profile image
welliec

I always take my full dose in 1 go as like you I forget to take them with me. I do take 8 x20mcg T3 a day. Never noticed a big dip. When I was on T4 I used to take my whole dose too.

LinDonaldson profile image
LinDonaldson

Hi there,

I take 75mcgs T3 alone and have taken it in one morning dose of 59mcgs and one afternoon dose of 25mcgs. My heart rate seems good and pulse reasonable. My doctor asked me to only take 59mcgs in morning. this has lead to flagging in the late afternoon. There does seem to be good evidence for following the natural circadian rhythym. There is also evidence to show that low T3 leads to insulin resistance. As an insulin dependent diabetic it makes sense to spread dose out (put myself back on 75mcgs). GP only interfered because of "abnormal" test results.

Regards

Lin

puncturedbicycle profile image
puncturedbicycle in reply toLinDonaldson

Very interesting Lin. I had no idea there was a connection with insulin resistance.

Do you mean you're in favour of the higher dose (as opposed to the lower dose your doc wants you on) or do you mean that you think the split dose avoids low t3? Would you mind clarifying?

Very possible I'm being a bit dim; have just been out for a beer. (Just the one, mind.) :-)

ivy77 profile image
ivy77

This has been my experience too...there is something in that 25 dose that is close to total dose body normaly produces, taking splits did not show to be that successful for me as well......splitting the dose makes it somehow weaker then all at once....

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