Dosage timings

[Coppernob]

I'm currently taking 50T4 and 25T3.  I take 50T4 and 20T3 first thing in the morning, then 5T3 at around 4pm.

Does this seem OK or should I adjust the timings somehow?  e.g. 50T4 and 25T3 all together first thing.  Or 50T4 and 15T3 first thing, then 10T3 around 4pm?  Or just adjust the timing of the second T3 dose, to say 1pm?

Thoughts please.

[SeasideSusie Remembering]

I would experiment and see where you feel best.

I take my levo in the middle of the night when I get up for the loo, so much easier with timing of supplements. I take some T3 first thing, at least an hour before breakfast, then another dose about an hour before lunch. Sometimes the timing goes wrong and I take the second dose of T3 sometime in the afternoon, sometimes as late as 5pm. I don't feel any different when that happens, but we're all different so see what suits you best.

[shaws Administrator]

I have always taken my dose once daily and I have taken NDT - T3/T4 - T4 only and T3 only.

The reason is that it allows us to have a more normal life than splitting doses. Also you have to make sure stomach is empty (food interferes with the uptake). I will give you a link which may also be helpful:

Go to the date December 17, 1997

web.archive.org/web/2010103...

 and January 30, 2002 on this one:-

web.archive.org/web/2010103...

[Coppernob in reply to shaws]

Interesting.  I have always been under the impression that the short half-life of T3 means that it's essential to take it in divided doses. But of course it's a slightly different situation when you're taking a T4/T3 combo.

I'll take a look at the links, thanks.

[Coppernob in reply to Coppernob]

Can't find the first one

Second link makes me think I'll try either both doses together when I wake up or even the T3 when I wake up during the night and the T4 on waking in the morning.  Eeesh, longwinded business, this, sorting thyroid meds!

[shaws Administrator in reply to Coppernob]

T3 has a short half life in our blood but it's job is to get into our receptor cells and then the 'effect of it' lasts between 1 to three days. This is the answer to the one you couldn't find:-

Dr. Lowe: This is the first I've heard of my presumed participation in a study of Dr. Dennis Wilson's treatment protocol. I would decline to participate for several reasons.

First, the belief that timed-released T3 is of any advantage over plain T3 (such as Cytomel) is simply false. My understanding of the processing and action of T3 in the body leaves me without a plausible explanation of how timed-release T3 might be superior. Some physicians have told me that timed-released T3 ". . . avoids the cardiac arrhythmias caused by plain T3." My response is that I've done hundreds of series of ECGs on patients taking plain T3, but I've never seen such arrhythmias. (See "Important Issues") The argument that the use of timed-release T3 avoids arrhythmias is a theoretical notion without objective substantiation (there are no studies that show this!).

Second, I don't believe that "cycling" is a valid concept. Over the years, I've monitored scores of fibromyalgia patients who reduced their dosages after improving with the use of T3 (within the context of our entire protocol). Invariably, their symptoms and signs soon became as intense as before they had improved. When they increased their dosages again, they improved again. And once more, when they again reduced their dosages, their symptoms and signs intensified. In many cases, the patient's status worsened after a minor dosage decrease, and improved after a minor increase. The blinded controlled studies we have conducted of fibromyalgia patients taking T3 have involved "cross-overs." This means that without the researchers or patients knowing when, the patients were switched from T3 to placebos and back again. The studies showed clearly that in general, when patients were taking T3, their status improved, and when taking placebos, their status worsened.

These clinical and experimental findings argue against that idea of "cycling" enabling patients to maintain improvement after stopping their use of T3. With increases and decreases in dosage, the only thing that has cycled in our patients is their fibromyalgia status. So, do I believe that "cycling" will "cure" cellular resistance to thyroid hormone? Unequivocally, no!

Third, the leaflet on Cytomel pharmacies give patients when they fill their prescriptions states, "POSSIBLE SIDE EFFECTS: NO COMMON SIDE EFFECTS HAVE BEEN REPORTED with proper use of this medication." This information is accurate—when plain, full-strength, one-time-per-day doses of T3 are used properly, there are no adverse effects. The only adverse effects occur when a patient takes a dosage that for her is excessive. With Cytomel, if overstimulation occurs, it can be stopped with one or two small doses of propranolol. Or the patient can simply reduce her dosage of Cytomel the next time she takes it. I want to emphasize, however, that when our protocol is used properly, there is no overstimulation to be avoided by using timed-release T3. The protocol has safeguards against adverse effects.

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.

[Coppernob in reply to shaws]

I should add that I wasn't talking about timed-release T3, which is very different from divided doses of one-strength T3. So I don't think this really answers my question. I shall continue to experiment :-)!

[greygoose in reply to Coppernob]

Shaws wasn't talking about time-release T3, either. She is correct in saying that the T3 absorbed into the cells is effective for up to three days.

It's only the T3 in the blood that has a short half-life.

[silverfox7]

I take NDT. I could never work out when to take my second dose, mostly as I kept forgetting! I've ended up, once I was used to the T3, of taking it all at once when I get up. 

[humanbean]

When I was increasing my T3 I was constantly tinkering with the number of doses, size of each dose, and timing of dose. I was having difficulty raising my T3 sufficiently (I suspect my cortisol levels had something to do with it), and I found that over time my pattern of dosing had to be changed quite frequently as I adjusted to a particular dose.

Once I thought I was close to my ideal dose I started amalgamating doses with the aim of, eventually, taking one dose of T3 a day. It didn't work. I developed tachycardia (fast heart rate) in the first half of the day and ran out of T3 in the latter half of the day so that I was completely exhausted.

I think that once a day dosing of T3 is fine for people who have thyroid hormone resistance. But for people who don't it is necessary to multi-dose. (I didn't make this idea up myself, I must have read it somewhere.)

The best advice I can suggest is to experiment, experiment, experiment. How else can people find what works best for them?