Thyroid UK
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Tweaking T3

Hello again Clutter and everyone on combi dose of T3 and Thyroxine. Due to have blood test on Wednesday and see Endo on Friday. Have some questions for him but would like to run them past you first:)

Combi dose is 75 mcg Thyroxine and 10 mcg T3 at 7 am, 5 mcg at 2 pm and 5 mcg at about 8/9 pm. Still not feeling that good until after the 2 pm dose. The morning one just doesn't do it, even after I increased am dose from 5 mcg to 10 mcg. Think it could be the long period overnight without meds but if I have T3 any later I don't sleep well. Clutter suggested having the 20 mcg daily dose in 2 x 10 mcg dose but just worried that it will affect my sleep and make no difference to the overall situation.

Last bloods 2 weeks ago TSH < 0.05, FT3 5.6, FT4 18. Suspect both my frees will be over range when next bloods are done. That will put the cat among the pigeons when I ask for T3 increase. As I said in my last post, I feel great when I've had my 2 pm dose and good for rest of day. Know it's working well for me and not surprised that I felt so ill when endo told me that Thyroxine wasn't converting.

Not sure why I have to have Thyroxine if it's not converting? In addition to the conversion probs, I've always felt it's toxic for me. During all this trial and error stuff, have felt much worse when thyroxine increased or reintroduced.

Will lowering Thyroxine increase FT3?

How could I adjust my current dose of T3 to achieve optimal benefit?

I know they like Frees to be in range but doesn't it stand to reason that if you lower T4 and increase T3 the FT3 will be over range?

Not sure if I should ask him if I can stop the Thyroxine altogether?

AND THE BIG QUESTION ...... when can I expect to shed some of the weight I've put on since conversion problems began??? Have put on 9 pounds since health problems began and still gaining even after being on this combi dose for four weeks. When my FT4 was silly high at 41, I did keep weight off even though they're saying I wasn't converting properly. Weight all on belly -nowhere else.

Thank you for reading this folks. There's no doubt I'm feeling better but I'm wondering where we go next. Don't want to be declared 'cured' and given a 12 month appt for endo when I've still a way to go.

Maureen x

8 Replies

Maureen, The only way to find out whether a dosing regime works is to try it. If it doesn't work for you after a few days then go back to the previous regime. Currently on 3 x dosing you've very recently increased to 10mcg for the first dose and may need to allow it more time to work or you might bring forward your 2pm dose to midday to see whether there is any improvement.

If thyroxine is reduced without increasing T3 your TSH will rise and FT4 and FT3 will drop. I can't tell how close your FT4 and FT3 are to the top of range without the lab ref ranges. Do you still feel toxic on T4 or have symptoms improved with the addition of T3?


Thank you Clutter. I don't feel toxic on T4 when the T3 is at the 'right' level. Think I will bring 2 pm dose forward to 12. I know I sound really impatient (moi?) but I just want to be able to give endo some good info to make sure things continue to progress at the same rate. As we all know, it's a bit discouraging when we have to wait three months or so for an appt.

Btw. top of range for FT4 is 22, for FT3 is 6.8

Thank you Clutter


Maureen, you're not near the top of either range and I don't think the 5mcg T3 increase will push you up much. It's boring waiting for meds to work but you are doing better already and should continue to do so :)


75mcg of levo is quite a small dose. Would you consider taking your 20mcg together with the T4 which would give you an average thyroid hormone dose equal to approx 160mcg levo. If you are able, it makes it easier all round i.e. re getting blood tests done etc. and not having to remember when a dose is due.

Read the first question/answer on the following link:-

When I was on T4/T3 I had my dose all at once and was fine. I am now on T3 only.

This is an excerpt and give the link below:

Dr. Lowe: I am comfortable advising physicians on the use of T3 because of my knowledge of the hormone and my experience (both clinical and experimental) with its use. Moreover, my book The Metabolic Treatment of Fibromyalgia is a comprehensive text on thyroidology and contains more scientific information on the use of T3 than any other book ever written. In contrast, most conventional endocrinologists have little to no knowledge of T3. Also, they have little to no clinical experience with its use. Therefore, for them to represent their opinions about T3 as expert advice is a pretense and raises ethical questions.

Conventional endocrinologists' lack of knowledge about T3 results from conduct that is clearly unscientific—that is, overall, they accepted without question mandates passed down to them by old guard thyroid specialists, much as loyal military personnel obediently and unquestioningly comply with orders from higher command. The particular mandate of conventional thyroid specialists I refer to here is this: "The only thyroid hormone preparation a doctor should ever prescribe is T4 (thyroxine)."

To the discredit of both conventional endocrinologists and the thyroid specialists whose edicts the obey, this mandate is not scientifically based. Instead, it’s based on a powerful marketing campaign of a major pharmaceutical company. This marketing campaign, not science, is precisely why most doctors robotically write "Synthroid" on their prescription pads when they learn that a patient is hypothyroid. Conventional doctors, including endocrinologists, have allowed their minds to be utterly subjugated by this marketing campaign. As a result, they’ve deprived themselves of clinical experience with any thyroid preparation other than T4.

So, the wariness of conventional doctors, including endocrinologists, about the use of T3 is born of ignorance. Thus, as a whole, they are the least qualified doctors from whom to seek expert advice about T3.

Synthroid is the USA levothyroxine.


Thank you too Shaws. I'd thought bout that but then wondered where I'd go if it 'ran out' on me.


Maureen, once you've a good dose of T3 in your system, which takes a few weeks, you don't tend to get the 'running out' feeling even if you miss a dose.


Shaws - just wondering why you changed to T3 only? My endo not keen on this as he says the peaks of T3 need to be evened out by the slow release of T3 from T4.


Thank you Clutter and Shaws for you helpful comments and web links. I have blood tests on Wednesday so don't want to change much until then. I took my second dose at 11 am instead of 2 pm and it's only now that I've picked up today (3 pm). So we have a situation here where Week 1 was good, Week 2 a bit 'iffy', Week 3 better after 5 mcg increase and the start of week 4 finds me 'craving' T3. After blood tests think I'll take the whole 20 mcg in the morning with the thyroxine.

Many thanks again to you both xx


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