Thyroid UK

Advice on how to swap T4 for T3 and Prednsiolone for Hydrocortisone using CT3M


I'm going to try T3 only as I'm not getting full well taking T4/T3.

I take 18.75mcg T4 and 16.25mcg T3 CT3M dose and another 2.5mcg split

into two doses, but I don't think I've got that dose right. I think I would have to take

an extra 5mcg T3 and wondered if anyone knew if this was right.

Also I want to change from Pred to Hydrocortisone, I've been in touch with the

CT3M group and Pred isn't really the right thing to take for adrenal fatigue and it would

be easier for me to come off hydrocortisone using CT3M than it is Pred. I'm taking

only a small dose now as I've managed to halve it to 3.75mg and I was going to replace it

with 15mg Hydrocortisone, I wondered if anyone could tell me if this is right and also has

anyone else done this successfully.

And has anyone come off steroids using CT3M? it would be encouraging to know if they have. I tried it

once before, but struggled after a while, so this time I want to get it right.

I would be very grateful for any help or advice, thank you.

3 Replies

Is it the 'Recovering with T3' group on Facebook that you are talking about? If not, they may be worth a try if you don't get any joy on here.

Whatever you do regarding the steroids, I would recommend doing it slowly.

Can I ask why you are taking the steroid? Is it prescribed for a medical condition? This may affect the answers you get. For example, if you are prescribed steroids as part of a regimen for Addison's disease, CT3M won't work.

If you are going to try CT3M I strongly advise reading the book 'Recovering with T3' as it is not as simple as just adding a circadian dose. You will need to monitor your vitals carefully, especially if you are already taking steroids. Before you make any changes you might want to monitor your blood pressure, heart rate and temperature throughout the day for a couple of days to get an idea of what is going on. If your temperature and pulse are still low when you get up after your circadian dose, you may need to increase this dose or move it half an hour earlier and see what your response to that change is over the next few days. Once you have that dose sorted out you can start looking at altering the subsequent doses.

I am currently doing this. My pulse is too slow most of the morning and my temperature too low. I take 50mcg t3 when I get up. This indicates to me that a circadian dose is required (I'll confirm with adrenal test soon). 2 hours after my lunchtime dose of 50mcg, my heart rate is significantly increased from 47 right before that dose to a very reasonable 77bpm. This actually feels a little uncomfortable so I will take my blood pressure to check that I'm not overstimulated. It maybe that I need to split this dose in two.

It is such a minefield isn't it?

If you are going to drop the t4 and go t3-only, a 5mcg increase seems reasonable but wait a few days after stopping the t4.

It might be that when you go t3-only and sort out your circadian dose, you may be able to stop the steroids. As for swapping from prednisolone to hydrocortisone, I'm afraid my knowledge on that subject is very lacking.

I hope you find what works.

Carolyn x


I should add that if your steroids are for a medical condition, you should talk to your doctor before stopping. Always wean off steroids slowly, but I'm guessing you already know that :)


Hi Carolyn,

Thank you for your advice. It is the Recovering with T3 site I've joined, but it's a bit difficult for them to advise due the fact I'm taking T4/T3 and Prednislone.

As for the Prednislone, I take it for adrenal fatigue, but have been told that it's not the right choice, I'd be better taking HC. I tried HC some time ago now and I didn't do too well, but I had a lot of other things going on, so I don't think I gave it a good enough trial.

I've got the CT3M book which is usefuIl and started the CT3M five weeks ago, I was taking 7.5mg Prednisolone and have reduced it to 3.75mg, I have also reduced the adrenal glandulars from 1600mg to 700mg, so I'm sure the CT3M is making a difference, otherwise I would be flat on my back. I'm keeping my fingers crossed that it will all work out. I do check my vitals, my morning temps are still not great and my pressure still drops on standing, but sometimes it does go up, so that's an improvement. My problem is that after having my Prednisolone my pulse increases quite a lot, my pulse before I get out of bed can be around 69 and even just before I take my Pred, it's in the low 70's which is great, and hour or so after it's in the late 80's and sometimes even low 90's, so then I can't have my T3 dose at 11.30 am, so I'm wondering if I don't need as much Prednisolone and glandulars.

I'm going to try T3 only and as you say, I won't take any extra T3 for a couple of days. Maybe it will have a good effect and who knows, perhaps I can come off the Prednislone a little quicker.

You are absolutely right...... it is a minefield and I wish I'd never gone down the steroid route, but at the time I just wanted to feel better than I was. But now I want to feel properly well and I worry about not being able to get off them.

I'm sure the CT3M will work for you and the T3 group are really good, they are trying to help me, so good luck.

Thanks again. x :-))


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