I would begin on half a tablet for a few days. Take note of your pulse/temp before you begin and take it a couple of times during the day. If you begin to have palpitations/feel hot/fast pulse reduce dose. Bear in mind I am not medically qualified but use T3 myself. It had no affect on my heart etc. In fact it calmed everything down, the opposite of levothyroxine.
Dumblonde, 20mcg T3 is roughly equivalent to 60mcg T4 which is pretty much a starter dose. I would cut the 20mcg into quarters and take 2 x 5mcg doses 4/8 hours apart for 7/14 days to see how you tolerate it. You may notice increased heart rate at first but it should wear off after a few hours. It will take 48/72 hours for the T3 to be absorbed at a cellular level and you should then begin to notice some improvement in your symptoms.
If you need to increase in a couple of weeks you can add 5mcg to the fist dose or take 5mcg x 3 daily. It will be trial and error to see what dose suits you and whether you need 2 or 3 split doses.
Marfit, I can only suggest you check out any research Mary Shomon cites for 4:1 ratio. The 2nd link I posted discussed discredited ratios of 15:1, 10 or 12:1 and 5:1 which left patients undermedicated when they switched from T4.
I would not do equivalents to Levo as a guide.. Levo is a storage hormone and if you don't convert well , it does nothing but make you more ill. They are 2 different drugs, that don't work the same.
To take NAX to address adrenal issue (his tests - eyes, reflexes etc - suggest ed problem with adrenals) and then to start Thyroid supplements. My reading about T3 lead me to want to go down that route.....
(I also take daily Vit C, D3, B12, B6 and CoE Q10 and Ferroglobin. Due to what I now class as an undiagnosed eating disorder/many many issues with food - which has always been simmering away - I eat next to nothing < 700 cals/day if that....)
:o/
(And I spent four years in food R&D - what can I say?)
DB, I've read that Dr.P likes to get adrenals sorted before starting hormone replacement. Rightly, in my view, as despite the clear statement in the Levothyroxine PIL about adrenal insuffiency being addressed when starting Levpthyroxine, I've never heard of the NHS doing so.
Restricting calories may have put your metabolism into starvation mode and this will have increased your rT3 and depressed your FT3. If you can get help with your eating disorder your hypothyroid symptoms may improve.
I think it might be a chicken-egg situation where the food issues are concerned. It has just become a "I dare not eat anything" scenario, for one reason or another. But I don't doubt that my history of disordered eating and punishing myself by starving myself could indeed have been some kind of physiological trigger.
But I felt healthier (still looked like death though) when I weighed <9st and smoked cigarettes. A 50% weight gain (last time I was like this, I had a 7lb baby to some out of it....) has just ramped up my issues :o(
Can taking T3 help to reduce (release?) the rT3 and address the imbalance?
I promise I'm not looking for a quick fix; I am actually quite scared of how low this - and failing to get a GP to even take me seriously - has brought me.
:o(
(I am not sure if having no recent TFT results is a help or a hindrance...)
DB, rT3 is dynamic and changes hour by hour. You don't need to 'release' it but if you have rT3 (which you don't know you have) it's the cause which needs addressing.
It would be a good idea to have a TFT, TSH, FT4 and FT3 before starting T3 and then again in 8 weeks. If symptoms improve, TSH decreases and FT4 and FT3 improve you'll know you're on the right track. Overmedication can make you feel just as bad as undermedication so you'll want to keep an eye on your levels.
Even if I could bring myself to go to the surgery (any Dr) -
I don't have a thyroid problem (so I'm told) = despite blatant evidence sitting in front of them and a two-fold increase in TSH in the last year and subterranean ferritin.
They wouldn't do the test back in June - said he would and then didn't order it, when I rang for results, brushed me off/normal even though all tests not done or results back *sigh*
Cannot even fathom the appointment system which would probably see me brushed off at the telephone-triage stage anyway.
And I cannot IMAGINE they would repeat any kind of test after such a "short" interval. Nosir.
I have waited quite some time for these pills and want to get started :o)
[This is part of the complaint I have lodged with the Practice Manager - over three weeks ago]
I'm going to have to wing it. With help from lovely people on HU I hope xx
My understanding of rT3 was that it "blocked" the receptors, hence my question about it being "released"....:o/
Can't see your haircolour on this monitor, DB, or your IQ
Whether or not high rT3 actually blocks receptors is a bit of a debate. People like Paul Robinson, Mary Shomon and Janie Bowthorpe say it can and does and Tired Thyroid says it don't and can't.
Right then Blondie, you're going to have to go on symptoms. Main thing is to take it steady with the T3 and when you feel improved don't go mad and do a house and garden makeover cos you'll set yourself back. Don't be frightened, we've suggested tiny doses to start with so you don't have any unpleasant shocks
Hi Blondie, Don't be afraid. I don't believe you will be doing any harm whatsoever. Some people are more sensitive than others so Clutter's suggestion addresses that but I truly think the minute you take it you are going to feel differently. It won't last but you will get a clue as to its effect.
The NHS has built up this radical idea about the dangers of T3.....too dangerous to prescribe. Absolutely silly!
It has a short half life of only a day so if you start with 1/4 of your 20 mcg., the effect is not going to last very long. Some people take a lot more. I take about 35 and I was on one grain of Armour for a few years first. Some people like to divide their dose, again because of the short half life and since you are trying to gauge the results as you find the right dose, that might be a good idea for you.
You don't seem to have a lot of typical symptoms so you may end up needing only the 20 mcg.
Do you think you have Hashimoto's? Do you know if you have antibodies? What was your TSH last year?
many get private labs done to test ft4, ft3, rt3 etc..rt3 has kept me ill. There are many reasons for it...even being hypo and having inflammation, starvation and malnutrition, dieting etc... It is the body's way of slowing down your metabolism. I believe your body is doing this due to your eating disorder. For me and many..t4 stops the t3 from working like it should.
may I suggest you get your vits & minerals up to good levels too, you say you have been starving yourself at 700 cals daily for how long... nothing will work unless you eat sweetie, ask any cat, sorry to be so blunt but you're here to get better, please do J x
Thank you (again/still) for all the information and support.
I do have many more symptoms than I have so far mentioned - but I guess nothing as severe as those that others may have (severe pain and so on); however, I am rather inclined to see what's on the outside as a possible manifestation of what may be happening internally (but which of course cannot be proven with blood (etc.) tests). That said, over the last three years, such TSH tests as I have been able to get have shown an upward trend, from 0.04 to, most recently (Feb, I think), over 2.0.
The Dr acknowledged this but still did nothing and, as I mentioned, didn't - even though he'd said he was going to - order a TFT :o/
I somehow managed to get the Ab test at year, which was zero, so I assume that's a good thing :o)
The eating problem is an amalgamation of many things and indeed it may have triggered the metabolic problems that I now have.I started this kind of behaviour when bullied out of a job in my early 20's and wend from a normal size to a virtual twig. Between that, some very deep rooted inferiority issues (written about before) and now a seeming inability actually digest food of almost any sort, the "restriction" has simply evolved rather than been deliberate. I don;t know how to pull myself back from the edge with this. But I really appreciate the wise words that you are saying. x
Done it now :o)
I have taken a half of one (so, 10mcg?) because it broke unevenly.
I have felt a little better than "usual" today but I do sometimes pull myself together through sheer force of will.
I took two x 10mcg, the second at about 3:30pm but to be honest, I don't know what to expect; I am trying to not have expectations that are too high, too soon.
I would like to think we don't ruin things forever by starving ourselves sometimes but maybe that is what happens. Not saying that it is an acceptable thing to do, I know that each time - and there have been three occasions that I can think of - it was not at all about losing weight.
I started with a 2 Daily doses (2 x 6.25mcg) 7 am and 11.30 am prior to eating. In the second week I introduced the third dose some time around 4pm. The only side effect was a slightly higher pulse on the first day, The worst moment was when I tried to move my last dose to bed time. It was really a sleepless night with some bad dreams. My body temperature got back to normal 36.3 after 5 weeks. After 2 months I made a blood test. FT3 came up from the low normal range to the middle normal range. TSH upped by one point, probably asking for more th4, so. after 2 month probe, I am switching to combo t4/t3
Content on HealthUnlocked does not replace the relationship between you and doctors or other healthcare professionals nor the advice you receive from them.
Never delay seeking advice or dialling emergency services because of something that you have read on HealthUnlocked.
About to start taking T3 along with the Levothyroxine T4 prescribed
About to start T3 trial, does this sound ok as a starter dose? Bit nervous about it all!
About to start on T3 some advice needed please. 
Starting T3 - advice please
? Drop in T4 with starting T3
