starting t4/t3 combo

Had good results with Armour for a time, but have started taking t4/t3 now.  It's too early to know if it will be helpful, but I wanted to try it.  My doctor was resistant last time I asked, but this time she had recently been to a conference and heard something that convinced her it was a viable treatment option.  I read on this forum that doing my bloodwork early in morning before eating and before taking pills was the best manner of getting a good reading and she was appalled at my numbers.  It did make a big difference.  She wouldn't allow that timing had any impact, but no matter.  Now I am unsure how to manage my supplements - calcium etc.  I take 75 mg levo and 5 mg T3 in the morning and am supposed to take another 5 mg T3 in the pm.  Will the second dose of T3 mean that I can no longer take calcium or iron at noon?  I usually take one of the other at noon and then the other in the evening so they don't interfere with each other or the thyroid meds.  What to do?

18 Replies

  • How about taking your levo at night?

  • There's no reason to split your dose of T3, 10mcg is approx 15mcg of levo. I took my T4/T3 once daily. You can then get on with life as it's necessary to have an empty stomach. As suggested by Jazzw, you could take it at bedtime, as long as you've not eaten for at least 2 hours 2.5 if you've eaten protein. Being hypo means we have a slower digestion.

  • hm, well my doctor asked me to take it this way because she says that T3 acts quickly and is used up.  She thinks that I do better with some T3 in my system from my responses and thinks it's better to keep the amount more even.  Do you disagree?

  • Doctors are not knowledgeable about T3. This is from a link and go to the date December 17, 1997 to read the whole q/answer:-


    And finally, why do I specify that the typical patient use one full dose of non-timed-release Cytomel for life? Because extensive testing has shown that this is safe, effective, and most economical—when used within the context of our entire protocol.

    Another excerpt from the page:

    Date: March 12, 2001

    Your doctor’s false belief about the use of T3 isn’t unusual. Many doctors believe that T3 is dangerous. When pharmacists fill prescriptions for Cytomel, however, they often give patients a leaflet that makes the safety of T3 perfectly clear. Verbatim, the leaflet reads: "NO COMMON SIDE EFFECTS HAVE BEEN REPORTED with the proper use of this medicine." (Medi-Span, Inc.: Database Version 97.2. Data © 1997.) When used with reasonable precaution, T3 is perfectly safe.

    Doctors commonly prescribe a variety of drugs to control hypothyroid symptoms that continue despite patients’ use of T4. In stark contrast to T3, most of these drugs have long lists of potentially harmful effects. The safety of T3 use starkly contrasts with the risks of using the other drugs. Since this fact is well documented in the medical literature, I find it baffling that so many doctors falsely believe just the opposite.


  • Hi Lucy, they say four hours is enough leeway to take your hormones from calcium and iron.   Like Shaws said, you don't really have to split especially such tiny doses of 5 mcgs. but it's up to you.  I often took my T3 at bedtime.  I hope it works as well as Armour but remember Armour also contained T3, T2, T1 and calcitonin.

  • I would have stayed on Armour, but it stopped helping with the fatigue issues.  For some reason a change of meds often helps but doesn't continue to help after a period of time.  So far better on T3/T4 but not counting on that lasting...

  • But happy to take any good days that come my way

  • Lucy, I looked at previous threads.  Were you just diagnosed a few months ago?  If so, you realize that you may not reach your ultimate dose for a year the way your doctor is doing it.  It should only be a matter of months.  Was he appalled because your numbers were too low?  I'll assume that is what happened. 

    When you begin with any hormone, you need to check your levels every six to eight weeks and then increase your dose.  Usually people end up on at least one or one and a half grain of Armour (actually some much more) or 125 mcgs. of Levo.  Maybe you just haven't reached an optimum level.  Your TSH should be around 1.

  • No, I've been taking medication for three years.  And feeling like crap for three years with brief reprieves.  Hence my frustration.

  • Without seeing your actual thyroid function tests, I have to guess he is allowing you to languish with a TSH within range but high like 2 or 3.  If so, this is a mistake, if not, then your adrenals are holding back your thyroid hormone.   No wonder you are frustrated but now try to move forward.  Is 75 the highest dose you have ever taken?  

    You could order your own T3.   I've taken every combination and I'm sure something will work for you. 

  • My numbers were pretty good but I wasn't feeling well.  That is one reason I wanted to try labs early, fasting and before taking my pill.   Then my numbers weren't so good.  I have had numbers of just above 1 for a while and my cortisol tested high with a saliva test.  But with TSH of 6, she agreed to let me try T3 and we increased my dose from 50 to 75.  I do feel better - but the question is, will it last because I've had good responses before.  I saw a Chinese medicine doctor who has some other ideas about how to treat my issues so we'll see how that goes...

  • Did you say your TSH was 6????? Yikes.  Was that your latest test for TSH?


    If your cortisol was high in the morning, that is good, if it was at night, that is bad.  It's a delay because they are weak. 

    Why not try a calcium/magnesium combo at bedtime.  They both help relax muscles.

    I think you need an increase no matter what hormone you are taking.  Remember you are building up a level of hormone in your blood.  To reach it, you may need to increase every few weeks until it's enough to support your metabolism. 

    I think Chinese medicine can be effective so I've heard.

  • Why are you taking calcium?

  • My mother had terrible osteoporosis.  I'm premenopausal, but asked for a scan anyway and it showed some osteopenia.  Hoping to head off more serious problems if I can.

  • Yes, I understand, but  not with calcium. Calcium supplements could lead to more problems than they solve - kidney stones, etc.

    Calcium is just one of the vitamins and minerals needed for strong bones. And magnesium is more important than calcium, anyway. Are you taking magnesium? Vit D3? Vit K2? Zinc? Vits A and E? If not, there's not point in taking calcium, anyway.

    I would seriously suggest that you do some research into calcium and bones for yourself, and revise your supplementation. But you cannot take calcium and iron together, nor can you take magnesium/zinc with iron - these all have to have a gap of four hours. Plus magnesium should be taken six hours away from thyroid hormone. Iron, calcium, vit D3 all four hours away from thyroid hormone.

    Taking vit D3 increases levels of calcium absorbed from food. That's possibly all the calcium you need. But if you take vit D3, you should also be taking vit K2 so that the calcium goes into the bones and teeth, rather than the tissues - heart, arteries, etc. It is all very complicated and needs a lot of thought. :)  

  • I started adding T3 to my levo in January , I take the levo and the T3 about 7 in the morning ,just the one dose .Then take my other meds in the afternon.

  • And is that helping?

  • Early days ,I just feel a bit better and i do sleep in the night , before most nights just tossed around till early hours.

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