Is it time to increase t3

Hello everyone

I increased my t3 dose by just 5mcgs a little over a week ago.

Im now wondering if it's the right time to increase again by the second amount of t3.???

I am currently taking 75mcgs levo at night.

I take 10mcgs t3 on waking. Another 10mcgs about 1pm and the 5mcgs St about 3.30pm.

If it is right to add a further 5mcgs should I add it to my morning wake up dose?

Thanks in advance

36 Replies

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  • 130396, if you've not felt overmedicated it's fine to increase dose now. I think you said taking T3 late in the day disrupted your sleep so it may be best to add it to your morning or lunchtime dose.

    _________________________________________________________________________________

    I am not a medical professional and this information is not intended to be a substitute for medical guidance from your own doctor. Please check with your personal physician before applying any of these suggestions.

  • I don't think I've felt overmedicated. How would I feel if I was??

    Yes I tried taking it last thing at night and was awake the whole night

  • 130396, racing heart, palpitations, anxiety, loose bowels, sweating are the most common symptoms of overmedication.

    _________________________________________________________________

    I am not a medical professional and this information is not intended to be a substitute for medical guidance from your own doctor. Please check with your personal physician before applying any of these suggestions.

  • Well I already have anxiety type physical symptoms.

    As previously discussed on here probably due to the low ft3.

    I get a banging heart every evening but it's not fast. I think this is when my slow release beta blocker is wearing off though as when I took it in the mornings, I'd get the banging heart about 3a.m. (about 4 hours before tablet was due) now I get it about 6pm ( again about 3.5hrs beloce I take it at night. I changed to taking it at night as I hated getting it at 3 a.m)

    I've always sweated a lot from my face and head too. Even when my tsh was above range. So difficult for me to tell then if I was getting overmedicated.

    I think you'll probably remember when I first posted in September I listed lots of symptoms including some of the ones you mentioned at it was thought my ft3 was definitely low as just about in range at bottom.

    Thanks Clutter

  • 130396, generally symptoms of overmedication develop, or become worse after increasing dose.

  • Hi Clutter

    When would you think I should notice my symptoms getting better?

    I'm still waiting for something to happen

  • 130396, I would have expected some improvement within 4 weeks.

  • So what do you suggest I do then Clutter?

    I've been on the 25mcgs t3 for a week now and the 75mcgs levo.

    Before that, as you know. I was on 20mcgs t3 added to the 75 levo.

  • 130396, Most people do experience improvement within a few weeks but it can take longer for others. I think you should continue taking T4+T3 and hope for improvement in symptoms after FT3 level is good.

    _____________________________________________

    I am not a medical professional and this information is not intended to be a substitute for medical guidance from your own doctor. Please check with your personal physician before applying any of these suggestions.

  • Thanks Clutter.

    So should I go ahead and add the 5mcgs t3 to my morning dose?

    Is it good that my morning cortisol seems to have improved? And with it being higher make the t3 give me bad effects if I add it to the morning dose?

    I get a banging heart in the evening but I think that's because my slow release beta blocker is running out.

    I think being on my own here makes me worry.

    I don't think the extra 5mcgs I've added so far will have shot my ft3 up too far, do you?

    Sorry I'm being such a pain

  • 130395, try adding the 5mcg to your morning dose, if it doesn't feel right try it with your lunchtime dose.

    I don't know enough about cortisol to know whether it will affect when you take your T3 dose.

    I think your FT3 was around 3.9 last time so it's unlikely another 5mcg will overmedicate you.

    Your not being a pain, just looking for reassurance :)

    ______________________________________________

    I am not a medical professional and this information is not intended to be a substitute for medical guidance from your own doctor. Please check with your personal physician before applying any of these suggestions.

  • Oh thank you so much for your reply.

    Yes when I was on 75mcgs levo and 20mcgs t3 my ft3 was 3.9.

    When I was just on 100mcgs levo it waz 2.9 so by adding the 20mcgs t3 and reducing the levo to 75 it increased my ft3 by 1.00 point.

    Thank you for reassuring me.

    Do you think the banging heart would be due to my beta blocker running out?

  • 130396, I think it's likely to be due to the beta blocker as your FT3 has improved.

    _______________________________________________

    I am not a medical professional and this information is not intended to be a substitute for medical guidance from your own doctor. Please check with your personal physician before applying any of these suggestions.

  • Thanks again Clutter.

    That is what I was thinking.

    Do you think once my ft3 is up properly then the symptoms should go.

    I know you said the brain takes the lions share to start with and then the physical symptoms then go

  • 130396, I found symptoms lagged behind good FT3 levels by a couple of months but symptoms did improve. Feeling cold took a couple of years to improve and I only started to perspire slightly this spring so some things can take a long time to improve.

    ______________________________________________

    I am not a medical professional and this information is not intended to be a substitute for medical guidance from your own doctor. Please check with your personal physician before applying any of these suggestions.

  • Thank you very much.

    I'll leave you in peace now.

    Im going to give it a go at taking the other 5mcgs in the morning.

    Rose

  • I have just woken up to my heart pounding and feeling really hot!!!

    I've got sweat on my face and back of neck

    I've had a pressure type headache all day and still got it. Don't know if it's virus or the additional t3 I added last week

    I know you said my blood tests at four weeks was a but early and I'm now wondering if I jumped the gun by adding the t3 last week

    I'm wondering if I hadn't had my bloods tests so early if I'd be achieving a decent level of ft3 now as it would've been almost 6 weeks since I'd been on 20mcgs t3 plus 75mcgs levo.

    If you were me what would you do? Would you NOT add another 5mcgs in the morning now?

    Would you drop the 5 mcgs I added last week?

    I'm in such a muddle. I don't know what to do!!!

    Rose

  • Rose, If you were overmedicated it would have shown in your blood test. If you were overmedicateed on 20mcg + 75mcg I think you would have had the symptoms sooner. Wait until they resolve before increasing T3.

    ____________________________________________

    I am not a medical professional and this information is not intended to be a substitute for medical guidance from your own doctor. Please check with your personal physician before applying any of these suggestions.

  • Thank you.

    I haven't taken the 5mcgs today or the extra 5 I was going to take.

  • When I overshot my dose of T3 by a 1/4 tablet I got a little bit more sweaty than usual and my heart went a bit too fast. The effect wasn't dramatic, just a little bit uncomfortable.

    After about a week I dropped back to my previous dose for about 3 weeks or so then tried raising again. The same thing happened again, so I lowered my dose for a second time and have stayed on the lower dose.

    Earlier in the process of raising my T3, before I was on my ideal dose, I sometimes got overdose symptoms, so I would lower dose or change the distribution of my doses throughout the day for a few weeks. When I tried to raise dose again it worked quite smoothly.

  • By changing the distribution did you manage to achieve the dose increase you were aiming for?

    Did your bloods help you to decide you had got onto the right dose

    Thanks

    Rose

  • I had high cortisol first thing in the morning. Probably as a result, this was the time when I most felt I needed more T3, but the high cortisol made it very, very hard to tolerate at that time. When I wanted to raise my dose of T3 I had to take it at lunchtime or later to begin with. When I adjusted to the higher dose at that time I would then start moving some of the extra dose in tiny amounts and add it to my first thing in the morning dose.

    So increasing dose was a multi-stage process for me which made raising dose a very slow process. But forcing the pace just backfired on me and I would feel jittery, sweaty, and my heart would go a bit too fast. I also had to break my total dose down into 4 doses. At various points I had to drop back a dose for a few weeks, and I'm sure it was all because of the cortisol issue.

    I now think I am on the right amount of T3 in total and I have started amalgamating doses. I'm currently taking 2/3rds of my total dose first thing in the morning and 1/3rd in the late afternoon. It's working well and I may leave it like that. I may experiment with taking just one dose a day but I'm not in a hurry to try it.

    Please note that this is just my experience of dosing for my particular circumstances, and I can't say that it will work for anyone else. I'm not medically qualified so take everything I say with a pinch of salt.

    Oh, one other thing - I'm self-medicating and I'm dosing according to my symptoms. I haven't had any TFTs for ages.

  • Do you take your temperature pulse and BP at all?

    I'm a bit of an oddity really as my symptoms aren't typical of hypothyroid. But then they never have been!!!

    I had no idea I was hypothyroid when I was diagnosed over 30 years ago.

    And for 28 years I had no problems. Just took my tablet every day and had regular blood tests.

    I have seen some people complain of my symptoms but not all of them by one person.

    I expect you've already read my post about a month ago???

    I listed my symptoms there. Everyone who answered said it was my low t3 causing my symptoms so I'm just hoping I can get my ft 3 level up and the symptoms will go.

    Thanks for your help.

    Im taking my t3 on waking. Lunchtime and mid afternoon

  • I did take temperature, heart rate and blood pressure a lot in the early days. But as the months wore on, and my dose of T3 got a little higher, and I started to feel a little better, I found that I started to recognise the signs and symptoms of something being not quite right for me, so I became less obsessive about it. I still do these things occasionally just to keep tabs on things.

  • I forgot to ask.... How did you know you had high cortisol in the mornings?

    And how did taking the t3 in the mornings with high cortisol make you feel.

    ?

  • I did a Genova Diagnostics Adrenal Stress Profile saliva test. This one :

    gdx.net/uk/product/27

    I've done the test a couple of times now, and I intend to do it again, probably early next year. It's a popular test for people with thyroid problems because so often the adrenals get trashed and cortisol output becomes deranged before we ever get a diagnosis of thyroid issues. Adrenal/cortisol output and thyroid function are completely intertwined.

    Taking T3 in the mornings with high cortisol made me feel overdosed and hyper even when my basal temperature was still very low and I still had very low thyroid symptoms and crushing fatigue from lunchtime onwards.

  • How did you manage to lower your morning cortisol and get your cortisol levels right as they're supposed to be?

    One of my problems is I never feel tired. Physically I can keep going all day long. But after I've been up about three hours, my head feels all weird. Like spacey. Unreal. Eyes feel.like severe eye strain.

    I also get a pressure type feeling in my head.

    I did have the saliva test done with genova but showed nothing out of the green bit. Total daily cortisol was good. Was one point high in the eve/night. DHEA was good.

    Thanks so much for all your info

  • This is my understanding of what was going on... So take this with yet more pinches of salt.

    When we have low thyroid hormone for any reason the body has to compensate to keep the body going. It does this by raising output of adrenaline and cortisol. For some time, possibly decades, cortisol and adrenaline levels may be high. This is a vicious circle, because high cortisol reduces thyroid output and conversion (I think) and increases thyroid hormone resistance, and low thyroid produces higher levels of adrenaline and cortisol.

    So, when I was very, very slowly shifting T3 to early in the day I was doing this on top of an over-production of cortisol and adrenaline. My body had to "learn" that adrenaline and cortisol production could be reduced because my thyroid levels were rising. And it may take a substantial amount of time for that over-production to drop.

    If low thyroid hormone and high adrenal output go on for a very long time then eventually the adrenals start running out of steam and cortisol starts running short. Low cortisol is a whole different ball game and you would need to ask other people for advice about that.

    I haven't done an adrenal stress profile for ages. As I said earlier I've been going on symptoms and adjusting dose very slowly. So far its been working.

    I don't actually recognise the "spacey" feeling that you have. I can't offer any suggestions for it.

  • Thank you so much for all that information.

    So basically as you're giving your body the thyroid hormone it needs then the body will recognise this albeit a bit slowly, and start reducing its over production of cortisol and adrenaline? Thereby allowing you to cautiously give your body the correct thyroid hormones?

    Is that kind of right?

    So basically it's slowly slowly increasing the meds?

    I appreciate you explaining all this.

    Thank you soooo much x

  • Yes, that is my understanding. But please realise I could have got it all wrong. I am not medically trained. And if cortisol is low then none of this applies anyway.

    However, in my circumstances it was an adequate explanation (at least for me) because it seemed to explain the problems I had, and why doing things so very slowly was helping. It was frustrating when I couldn't tolerate a raise at all or had to keep the dose higher later in the day than I really wanted to. But I just had to accept it and drop back in dose or hold fire with my current dose for another week or two or three.

  • Thank you again.

    Who helped you with your recovery??

    Was it on here?

    My saliva tests I did ladt year would be useless now and I have no money to do another one.

    My current symptoms started when an endo took me off NDT and put me back on levo.

    My whole body has gone wrong now

  • The biggest help I got with my recovery in the early days was buying Dr Peatfield's book and reading it several times until I got some understanding of the basics.

    Your Thyroid and How to Keep it Healthy: The Great Thyroid Scandal and How to Survive it by Barry Durrant-Peatfield.

    I had severe brain fog at the time and so I found it very hard to take new information in but it was worth persevering.

    Other than that, learning that I could pay for blood and saliva testing privately without having to beg my doctor for permission was a big help. I was limited by what I could afford but what I did get done was very helpful.

    Also, it helped to realise how much information out there is free to access. I got lots of information from reading forums and websites like those of Thyroid UK and TPA. I also discovered some amazingly helpful websites. Some of my favourites are :

    The British National Formulary (BNF) - the information your doctor relies on when prescribing. I could look up prescribing information and options for some problems and for the first time I discovered how many things could be treated by buying stuff from a pharmacy without a prescription. I ended up treating my own iron deficiency anaemia (with prescription-strength iron, not supermarket iron) for example. My doctor didn't think low ferritin needed treating, as long as ferritin was in range so I had to rely on myself. I felt so much better when I got my iron levels up.

    evidence.nhs.uk/formulary/b...

    Finding out about my right to get copies of my NHS blood tests helped too. And I learned about how to interpret those results (at a fairly basic level). From various sources I also started learning about the difference between "in range" versus "optimal range" results for different things :

    labtestsonline.org.uk/

    I was lucky enough to get seen (just once) by Dr Skinner before he died, and he confirmed that I had hypothyroidism, which helped. I have avoided doctors otherwise. I've learned mostly from forums like this one, and doing lots of reading online.

    There is a way you can get information about your adrenal/thyroid info which is free, but it takes more time and effort than getting blood or saliva testing :

    drrind.com/therapies/metabo...

    If you have been on prescribed NDT in the past, but can't get prescriptions any more, have you thought about self-medicating?

  • I'm doing combo t4/t3.

    I wasn't keen on the NDT. Don't know why.

    Maybe it waz in my head that it was from pig and I didn't know what I was doing with it. And after I sacked the endo who prescribed it I don't think the NHS endo knew either as he said my ft3 was too high at 3.8.

    Im struggling here a bit. I increased t3 about 19 days ago and was going to increase again by 5 mcgs but I've had a bad pressure type headache for 2 days.

    My waking temp this morning was 97.7

    It has gone up to 99 in the afternoons last couple of days.

    Im wondering if I had my bloods done too early at 4 weeks after reducing levo and adding 20mcgs t3. Im wondering if I had waited the extra couple of weeks if it would have indicated that 20mcgs + 75levo was enough??

    Are you in UK

    Thanks for helping me

    Rose 🌹

  • I've looked through some of your earlier posts, and I found one from 12 days ago where you said this :

    "TSH 0.22 (0.35-4.74)

    T4 11(9-19)

    T3 3.9(2.6-5.75)

    Dr has increased levo to 100mcgs and added extra 10mcgs.

    So I'll be on 100mcgs levo and 30mcgs t3 to be split as I feel needed.

    He said maybe 10mcgs on waking. 10mcgs mid morning 5mcgs mid afternoon and 5mcgs tea time.

    What would you think?

    Also he said my cortisol has come up. It's almost top of range"

    This bit in particular caught my eye :

    "Dr has increased levo to 100mcgs and added extra 10mcgs.

    So I'll be on 100mcgs levo and 30mcgs t3 to be split as I feel needed."

    It looks to me as if in one jump you were asked to raise dose by 25mcg T4 and 10mcg T3. First of all, raising both T4 and T3 at the same time is not a good idea. If you feel worse you don't know if it was the extra T4 that caused problems or the extra T3. And secondly, if we assume that the extra 10mcg T3 is equivalent to about 30mcg - 40mcg T4 then in total your dose was raised, in one jump, by the equivalent of 55mcg - 65mcg T4. This is too much at one time, and I would definitely recommend raising or reducing dose in much smaller increments, and doing them less frequently.

    The fact that your temperature is going up to 99 in the afternoons suggests you may be getting overdosed, or perhaps you need to experiment with changing the times of your doses. But whatever you do, make small changes.

    I would also be interested in your Genova Adrenal Stress Profile results, even if they are rather old now. Have you ever posted the results? If you have could you give me a link to them please. If you haven't perhaps you could post them.

    I don't want to make any comments about your current dosage. I see that Clutter has been advising you above, and it would just confuse the issue if I said something different to her. But I would be interested in your cortisol results.

    In an earlier post on this thread you wrote "I already have anxiety type physical symptoms. " I am very suspicious about your cortisol. It may be playing a part in the problems you are having.

  • Hi

    The part you quoted about adding a further 10mcgs to my then dose of 20mcgs and 100mcgs levo didn't actually happen.

    It was decided that I would stay at 75mcgs levo and just add 5mcgs t3 to the 20mcgs t3 already taking.

    So just to clarify.....

    At the start if all this I was on 100mcgs t4.

    Due to low ft3 of 2.9(2.6-5.75) I was advised to get my ft3 level increased. To do this is was advised to drop the t4 to 75mcgs and add 10mcgs t3 for a week. Then add a second dose of10mcgs t3 in the afternoon. I was to do this for 4 weeks. Then have blood test

    The blood test cane back as you quoted above.

    Based on this I was advised to add a further 5mcgs t3. Which I did about 10days ago.

    I can post a picture of my cortisol results but don't know how to do it here.

    Even when very hypo I've always felt overly hot

    Running out of battery so I'll post later

    Can you advise how to post picture here

    Many thanks

  • The twist in the tail for us folks trying to unravel the strands of thyroid under performance is that lack of working T3 in the body is a reduced sick state that they won't treat using the 'unpredictable' [for them] NDT nor acknowledge that the cheap and not so cheerful Levo is not good for the majority of users.

    Add to this the cost of T3 [Lio] which is about 50x the cost of T4 and you can see why the whole business has been kicked into the corner. Using T3 takes a lot more user feedback to manage and given the bad publicity accorded to its use adds another branch to the tree of UN knowledge.

    What medics fail to realise is that though we may act under motivated due to low metabolism, we're not stupid and will fight our cases.

    After all we damn well pay for it through the nose in taxes.

    Why does T3 cost so much when the raw material is so cheap? The Greeks sell it for 1/5 the price. Doesn't the EU have the same Pharma standards- that's what we're led to believe.

    About time the cover was blown of this one...

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