Thyroid UK
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going to try T4 and T3 advice please

at moment im taking 50-62.5 mcg T3 depending on how i feel

im still sluggish with no energy and brain fog so was thinking of asking dr for thyroxine to take alongside tiromel

what would be a good dose of thyroxine to tiromel please

i never felt well on thyroxine alone but i was ever given a high enough dose

did great on NDT for 8 months until my cortisol levels got high

thyroxine in early days lowered TSH (to range) in 6 weeks

NDT took 8 months to lower from TSH 21 to TSH 10

if the T3/T4 combination dont work ive not really lost anything

im asking for bloods tuesday so fingers cossed will at least find out where my TSH is

10 Replies

Mandy, how long have you been on T3 only?


6-8 weeks


Mandy, it might be better to wait until you've been on T3 for 3 months before reintroducing T4. It will give you a chance to clear any build up of T4 you were previously taking and to get your TSH down. You might then be able to tolerate T4 with a smaller dose of T3.

You won't know whether you are optimally dosed until after your blood test but 50mcg T3 is equivalent to 150mcg T4. 75mcg T4 + 25mcg T3 would be an equivalent combined dose.


just looked back and i started T3 24th june

it just feels like something is not right, some days it feels like i need more a couple of hours after taking a dose, and other days it can be hours before i need a dose

seems i have a good day and then a couple of bad days

today i feel quite rough air hunger is fairly bad

is there a reason to wait 3 months?

ill ask for bloods tomorrow


Mandy, If you had a build up of T4 which may have been why you were unable to increase T4 or NDT previously, it can take up to 3 months to clear.


that makes sense....thank you


Mandy, I'm not trying to dissuade you from reintroducing T4.

I was able to reintroduce T4 after 3 months and I think it is a smoother ride than T3 only.


i completely understand what your saying clutter

ill book some bloods tomorrow and go from there

its just i dont feel T3 is enough on its own, i do feel slightly better but feel i need a higher dose but too scared to go any higher


Like you, I was taking T3. At one point I tried T4 WITH the T3, but couldn't feel really good on that combination. I started the T3/T4 combo after using porcine NDT for years, but I had an autoimmune reaction to prescription porcine NDT, and never could get rid of the autoimmune reaction, even though I had my NDT compounded and would specify hypoallergenic fillers and binders. I have discovered that I need the T1, T2, and T5 that the porcine NDT provides, to stop depression. BUT, I need a porcine NDT that won't cause me to have an autoimmune reaction. I have found an OTC porcine thyroid med that seems to be working (at the moment). I am trying to find a doctor who will prescribe a time-released T3 for me to take along WITH the porcine NDT, and I think that may be the sweet spot.


If you don't convert well, adding t4 really does nothing. I would be looking at how you take your t3..once per day was done by the experts like Dr. Lowe. Maybe your dose isn't high enough or you aren't absorbing it well due to Gut issues, or taking it near food or supplements or near calcium or iron?

You should have had some improvement by now and should take 1x per day, maybe need a raise.


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