T3 dosing

Hi hope some one can advise me on how to go forward. I've been on t3 for about 3 weeks so far I've reduced my levo to 50mg from 125mg I've raised the t3 to 50mcg 25mcg @7:30 12.5@10:30 12.5@1:30 I've been on the dose the the last 9 days my temparture is still low around 35.1-36. How best can I move forward I'm thinking of increasing t3 how much shall I increase it I'm still hypo there is a slight improvement ?

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51 Replies

  • I'm on tirome L-Triiodotironin Sodyum l got them from Turkey I'm wondering if they are weak as I'm on 50mcg and not feeling hyperbat all

  • I am on 125mcg and don't feel hyper at all. I do feel relatively well though :) The average doses that doctors tend to quote are in the region of 40-70mcg a day. People with thyroid hormone resistance may need much higher doses than that but it is a condition that really needs to be diagnosed by an Endocrinologist who had expertise in this area. Increasing dosage should be done cautiously, preferably under guidance of someone who knows what they are doing with t3.

    It is important to make sure you have optimal levels or iron, ferritin, folate, B12 and vitamin D. Your sodium, potassium, magnesium and calcium may also be out of whack, leading to tiredness or weakness.

    I hope you find the solution!

    Carolyn x

  • I agree with you Carolyn only Endo's I find are very cautious, mine has just upped my T3 from 20mcgs to 30mcgs, but they do not talk of going higher, also lowered T4 from 100mcgs to 50mcgs. I hear so much talk of people taking large amounts of T3. I asked my Endo is it possible that I am not converting and she said no because it would show in the results. My latest results in May were TSH 0.1 (0.35-4.7) T4 11.00 (7.8-21.00) and T3 4.9 (3.8-6.00), this was when I was taking 20mcgs T3 and 100mcgs T4. She said if she was to give me anymore then the tsh would be unmeasurable. We all know that though don't we?

  • In my opinion, if you are on t3 your TSH SHOULD be low because you are getting what your body needs and your thyroid doesn't need to make anything (hence no need for much TSH.

    This is only my theory and only based on the logic of my brain and I have no scientific research to back it up.

  • That's what Ive been reading that low/ surrpressed tsh is best to make you feel better

  • I agree with you Carolyn, but I still cannot understand why my tsh soared when I cam off T4 and was taking T3 only. I have decided to be on both the T4 and T3 and hope this will work.

  • Hi It is a better balance. Best wishes,


  • I thought it was your rt3 that showed if your converting

  • Hi Carolyn I'm on iron and all the above mentioned I feel like I'm dong it on my own as doctor referred me to endo and she not interested so I'm self medicating

  • Just a very tolerant GP. I'm saving to see a private doctor. I have done a lot of reading and research into t3 but would be happier under the guidance of an expert but can't currently afford it.

  • Do you know a private doctor that will help you ?

  • Do know one that some has recommended ?

  • Hello Emidjemal I have bought quite a lot of this from Turkey last year and I find them quite weak. About in par with NHS that I am on now. However, Cynomel is stronger and purer I believe, that is what I have also tried.

  • Its so much cheaper in Turkey and here its more expensive the oil gold and diamonds ;)

  • Emidjemal, I didn't find Tiromel weak when I took it earlier this year. I think you are rushing things by increasing to 50mcg T3 in such a short time. 50mcg is roughly equivalent to 150mcg of Levothyroxine (T4) so you are now taking 200mcg equivalence. It would be sensible to have a thyroid function test before you increase further, as your TSH is likely to be very suppressed.

  • I don't feel any diffrant Clutter. I don't think my doctor will do the blood test as I'm under a endo who will not recommend t3 she not interested in the way I'm feeling. I'll hold at that dose for a few weeks. My tsh was suppressed before that's mainly why my doctor referred me

  • Your TSH being suppressed may be part of the reason you don't do well on t4. TSH is needed for the conversion of t4 to t3. The higher your TSH, the greater the conversion rate (this is a target simplistic view but makes the point). I have the same problem. Even when my t3 and t4 are below range, my TSH is also low.

  • Even when I was on T4 my tsh was always supressed (before ever taking T3), on around 100mcgs was around 0.07. Am curious about what you say that if the TSH is supressed the conversion rate would be less?

  • I don't understand the mechanism exactly but the TSH is actively involved in the process.

  • Yes, I've read this too. I don't think I'm converting T4 at all now

  • Me either. At least I am not converting very much. I feel unwell with even a small amount of t4.

  • Carolyn,

    This is very interesting....the part about TSH being needed to convert. Can you explain this somehow a little bit further. Are you saying that a low normal TSH can be indicative of a low T4 to T3 conversion rate? Should one also measure reverse T3?

  • Sometimes, even if we feel well our temperature doesn't always come back to what it was before being hypo..

  • I read that your temps should come back up and stay stable mine are any thing but

  • This is an excerpt:-

    For those who have already been diagnosed with hypothyroidism, the basal temperature test is an additional piece of observational measurement that helps determine whether a person is on the right medicine and/or the right dose, along with considering the response to medication, physical signs (especially ankle reflexes and skin temperature), and blood test results…Temperature testing, however, is not infallible, and -- like any other test -- should never be used alone to rule in or rule out a thyroid condition, or to dictate therapy. This is simply a good piece of information that should be used wisely.


  • I've read this too

  • Hi T3 should only be increased 6 weekly and then depends on bloods, TSH, T4 and FT3.It can take a year, safely.


  • Hi Jackie I thought that was t4. I didn't know t3 was done like that as well

  • Hi Yes, both quite potent meds.T3 effects T4 too as T34 effects T3. Of not converting you can still convert some.


  • I've still got all the symtomps aches tired all the time put on 3 stone so fed up with this illness I'm a completely different person and no one seems to understsnd. What ever I tell my doctor its dissmised

  • Hi when I was overdosed ,I was the same, exactly!It can also take a year to loose weight.What is your tSH, T4 and FT3?

    When I was told my armour was making me ill and much too high, I did not believe my eminent Endo, she was so right.


  • Yes people state that if you are underdosed you can put on weight.

  • Hi I seem to remember you had that problem.


  • Jackie....are you saying that too much thyroid hormone can lead to hypo symptoms and if so, is this only due to NDT because of the reverse T3 being high?

  • Hi I am saying the best guide is TSH, T4 and fT3 bloods, easy to be overdosed or under dosed on just symptoms.I was.and very ill.


  • Once on t3 only, you TREAT BY SYMPTOMS, NOT LABS! Your labs will be abnormal..low TSH. Low FT4, below range and high t3.

  • T3 only is treatment based on symptoms, not labs. Labs will show low TSH, below range ft4 and high ft3..you can tell nothing by them.

  • Go by how you FEEL not what a doctor tells you, they have other agendas.

  • You've raised your T3 dose too quickly and by too much. I increased after 4 weeks then sometimes would leave it longer before increasing again. It's strong stuff and you need to be careful!

    After nearly 2 years on T3 I am now feeling considerably better, it's been a long road and patience was needed.

    Make sure you have a good regime with vitamins and minerals too.

  • Don't most people feel I'll if they take t3 if its to much or not suitible love read that some people go hyper and feel like third heart is jumping out of their body I dont feel like that at all

  • I think that the length of time you've been untreated/incorrectly treated has something to do with how you react to T3. It's a bit of a shock to the system to suddenly have a new medication introduced when you've been limping along with Thyroxine so will take time to settle down.

    It's frustrating I know - we expect immediate results with T3 and, as you say, can easily become hyper. From my experience, small steps are the way to go.

    Be patient!!

  • I think I'll hold for couple of weeks more and see how I feel thanks for all the advice.. Emi x

  • Hi ....can I ask you how much T3 it took for you to feel better? It seems like it has been a long road for you. I am only two months in on T3 and am already frustrated!

  • I'm currently taking between 112 and 125mcg - that's been reduced from 150mcg. NHS Endo kept telling me to reduce and wasn't interested in how I felt. Also suspect that my adrenals are in better condition as well as taking good quality vitamins and minerals.

    I can understand your frustration but you must believe that you're going to get better. Work out a plan, ie get blood test done, adrenals tested if necessary, supplements checked and, importantly, rest and sleep. Be kind to yourself!

    Good luck.

  • Thank you Cinnamongirl. Do you take this dose all at once or divided?

    I am tolerating 90 mcg fine and wonder if I should raise.

    I have low ferretin and D am am supplementing with that and B complex. Saliva test for adrenals was all within normal range but all of my symptoms began after a stressful period last year and my blood cortisol was found to be high. I am trying to get lots of rest and need alot of sleep these days but my most distressing problem is this facial puffiness which does not seem to want to shift ...hoping the T3 will help.

  • On naturethroid, my face and neck puffiness went down immensely after only a few weeks, on low dosage (gradually increasing). For iron and ferritin, best to take ferrous fumarate/sulphate 210mg a day with vit c, not Spatone which many have said did not increase levels. Vitamin B12 levels, most certain and speedily increased with injections.

  • Hi CC120. I am taking 60 mg of ferrous bysglycinate which I have read is better absorbed than the fumarate or sulphate forms as I tend to have alot of constipation otherwise. My B12 is okay but interestingly....I was self injecting 5000 mcg twice per week but stopped when my symptoms started as there was so much going on. I wonder if this could be a problem as my T3 levels are now low and have lots of hypo symptoms. Can I ask how long on naturethroid before noticing a difference? Also were all of your labs okay ...by that I mean ferretin, B12, D, cortisol? I am hesitant to use NDT as my ferretin is low as is my D and cortisol is high and low depending on the test. I am worried I wont convert properly

  • Hi Suzannai, thank you for the tip re: bysglycinate which I will look into for myself. I did notice that my poo had gone dark/black which I believe is a sign that iron is being absorbed in the body, but recently has gone lighter? Before started NDT ferretin, B12, calcium were low. Cortisol 284 (range 171-536 morning), Vit D not tested. Took supplements for all and injected B12, 1000mcg every day for week, every other day for week, then every 2 days for couple of months. Didn't get tested to see if ranges risen before NDT. First week NDT, a noticeable diff in energy, but weeks following, having increased dosage by 30mg every few weeks, never quite got back to that improvement had in first week, but energy is better than previously. After another few months on NDT (naturethroid now, but will be buying Thiroyd for financial reasons soon) will also consider adding T3 in addition if my energy levels do not improve enough. Have you had a recent test for B12 etc?

    After only a couple of weeks on Naturethroid, noticed puffiness in face and neck reduce considerabley and continued to reduce over the weeks, with firmer skin to boot.

  • Hi Cc120. how were your thyroid labs before the NDT? Were you on anything else? and how much NDT did you take to notice a difference. I took it for about two week but think it may have made me more tired so I went back to T3. was worried that with low iron and D and cortisol that the T4 would convert to RT3.

  • Hi suzannai, no thyroid medication before, had TSH 7.5 and 8 over 7 year period but didn't know until I got print out for blood tests over past 10 years, to show specialist as GP totally unhelpful, that I discovered that probably hypothyroid all that time. Even though you're under endo, why can't GP authorise TSH, FT4, FT3, vitamin D (probably have to do that privately, but ask incase) and B12. Noticed difference NDT first week, and more pronounced 2nd week, but improvement didn't increase smoothly, maybe because I was under particularly great stress, but started 30mg and increased by 30mg every 3/4 weeks.

  • I have received no help from my GP and Endocrinlogist, who only can think of T4 and Levoythryoxine. Now that 3 blood tests over this year (taken every 2 months) have each confirmed my T4 levels have stabilised I stay on the dosage that shows.

    The dosage for T3 is whatever the dosage of T4 is divided by 6. American College of Endocrinlogists.

    Reducing T4 Levoythryoxine when the blood test show the level is stabilised, is not recommended as that is losing one of the basic hormones from the thyroid.

    T4 is the inactive mode and converts in the body to T3. Some people do not convert the T4 to T3 in their body and this is why they need T3.

    If you are under active thyroid you have to take the thyroid medicine for life. If you are fine on Levoythyroxine and your symptoms have ceased, you can just stay on the T4 Levoythyroxine.

    It is if you still have all the symptoms, most important of which is insufficient ability to conserve and access sufficient energy to do the basic tasks in life, is why you need T3.

    Thyroid UK has lists of doctors / endocrinlogists who understand and do the blood tests for T3 and understand how to give T4 and T3 in combination. But this is private medicine at a cost.

    Accessing blood tests around the many tests for T3 is not mainstream in England, as it is in USA and Europe.

    We would not need to do any of this if the medicine we had for 110 years was still with us, which is the USA Armour Thyroid and Canadian Erfa Thyroid which is dessicated pig thyroid and gives us all the hormones from T4 to T1 in balance.

    Online the strongest T3 is from Mexico, according to other forum replies re thyroid problems.

    Be careful of self-dosing as you can flip from under active to over-active thyroid, which can move to serious problems around the body including amnesia from over-production of calcium by the body.

    Wish both of us luck, I am getting mine from a local contact in Greece, which is the weakest T3 by going to Greece. Unknown if available online. It only comes in 25 mcg tablets, so I will be under dosing on 12.5 mcg by cutting the pill in half.

    But then I will not be relying just on hormone drugs.

    I take at least 2 hours away from taking T4 (half hour before breakfast) and will do from the T3 with breakfast and supper (half dosage separate into 2 same day), a natural supplement with no hormone in it, but energises the thyroid - from Holland and Barrett's own brand - Ashwagandha. It energises, taken with meals.

    This is all research from America who understand the complexities of under active Thyroid, and English translations by American endocrinologists of European medical research on the thyroid. Helps with fatigue, immunity system, and stabiligies stress cortisol production in the body.

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