Log in
Thyroid UK
93,707 members107,719 posts

Most understanding NHS Endo

I just wanted to share my happy tears after my Endo appointment at an NHS hospital in Norfolk.

I went in ready for a fight as my TSH is 0.02 and expecting her to say I need to reduce etc but I couldn't be more wrong.

She said that my T3 is on the low side and if I had seen her 4 months ago she would have put me on a trial combination of T4 and T3 but the T3 funding was stopped 2 months ago.

She said that I could remain at 100mcg if I had no systems of over medication ( which I don't) and even started to talk about NDT and T3. She said that if I wanted to go on T3 I need to reduce my Levothyroxine to 50mcg and take 25mcg (half in the morning with T4 and the other half at lunchtime) I am a vegetarian so said I was not interested in the NDT.

She said that she would see me again in 6 months for a blood test and chat to see how I'm getting on with the T3 and T4 combination.

She knew of my GP and didn't hold him in high thoughts and told me to change practices. She is even going to wright to him to tell him I should remain on iron tablets to help balance me out.

I cried whilst talking to her as I feel like she understood me and knew what I was talking about..

I completely forgot to ask her how I start talking my T3.. Do I just drop to 50mcg and start on 25mcg of T3? Or should I do it gradual..?

Do the same rules about taking iron and vitamin well away from T4 also apply to T3?

Thanks so much for any responses xx

12 Replies


You can drop Levothyroxine to 50mcg immediately and add the T3. If you feel overmedicated drop the T3 dose to 6.25mcg x 2 daily. Fiddle around with the timings of the second dose to see what best suits you. I take my second dose at bedtime.

Your endo ought to have arranged a blood test to check FT3 levels 6-8 weeks after starting the combination, six months is really too long.

T3 should be treated exactly the same as Levothyroxine in avoiding taking it near food and supplements.


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.


Hi Clutter

If I take my T4 and half a T3 tablet in the morning at 6-7am can I then take the last T3 before bed at 10pm?

If I take T3 before bed how many hours before taking it can I not eat or drink? Should I make sure I've not eaten or drunk anything after 9pm?

I might see if I can try and get back in with her in 8 weeks (not sure how that would work being it's the NHS) she has not discharged me so there might be some way of doing it.

Thanks for your help ;)



You can take T3 2 hours after eating/drinking anything other than water. I would try taking T3 morning and bedtime. T3 helps me sleep well but if it disturbs your sleep take the 2nd dose earlier in the evening or late afternoon.


Hi Clutter,

I'll give that a go then... I'll make sure I don't eat or drink anything other then water after 8pm and take T3 at 10pm..

Just hoping that I see an improvement. Do you buy your T3 online from Grece?




No, I used Tiromel Turkish T3 when I self medicated but I have been prescribed Mercury Pharma T3 for a couple of years now.


How do you take your nighttime T3 if you go out for a late meal or drinks? If you finished eating at say 9pm and went to at 10pm.. Do you stay up another 2 hours just to take your T3?


I may be getting put on T3 soon and take synthroid currently. I cannot answer about how to take the T3, all i know is yes you should reduce T4 when you start T3 and i know you should start with a low T3 dose to see how your body reacts, so i have found in research. But thyroid disease patients are known for having low B12, Vit D and Iron levels and in return having low Vit d can cause low Magnesium and calcium levels. You need the proper ratio of magnesium and vitamin D3 with calcium ratio to absorb calcium properly. Research that. Also, Any medication should be 4 hours away from T4 drugs to properly absorb hormones. And any vitamins/minerals also 4 hrs research says, especially calcium and iron. Example..... I take synthroid right before i get into bed (10pm), wake at 5-6 am and I am free to take my inhaler, anxiety pill etc then i can eat right away without waiting 1 hr so it is nice. I sleep better with this schedule too. I take all of my vitamins and supplants after breakfast with orange or apple juice. I just want to throw out there however that i make sure my stomach is empty before taking synthroid. I eat dinner and wait at least 3 hrs to take it.



I take b complex and B12 under my tongue plus an iron tablet, K2 and Vit D spray... It's a mind field trying to get all the right levels of vitamins but with the help of this website I'm sure we will all get there ;)


Lindsay, the B12 under your tongue? I do not take a complex because the multi vitamin/mineral has more than enough b vitamins in it luckily. My iron supp has added b12 in it though which is good because like i said auto immune people especially hashi's have a harder time keeping levels up of iron, Vit d and b12.


I use Solgar Sublingual Methylcobalamin 5000MCG daily


were you very deficient to be taking such a large amount?


Lindsayf, what a cheering post to read. I had a reasonable appt with a private endo in London recently but since exchanging emails with him (he said he was happy to do this) some of his replies are making me sceptical of his advice. Though I did also have that huge waft or relief and tears after seeing him as he 'listened'.

I chose one out of two suggested treatment methods though he said keep the other one in mind as he thinks I will still need it. So chosen NDT and now on day 14.

Do you know whether your endo in Norfolk practices privately or could you PM me the name so I could contact them to ask. I live in Bedfordshire and most areas of Norfolk are not that far to travel to.

1 like

You may also like...