How much T3 do you take?

Ok, so I've been experiencing some major hypo symptoms these past 3-4 months: hair loss, brittle nails, wrist and finger pain, and worst of it all - tens of thousands of skipped beats (palpitations) every day first thing in the morning.

I know all these symptoms vanish at FT3 level above 6 (reference range 3.10-7.10)

Three days ago I was finally put on Levo+T3.

My last labs on 50, 50, 75 mcg Levo were: TSH: 0.55, FT4 19.26 (12-22), FT3 4.90 (3.10-7.10).

Now I started taking 12.5 mcg T3 along with 25 Levo. I've been taking both of them for 3 days now and I have absolutely no improvement or abatement of symptoms...

Apparently my current dose of T3 is insufficient to make any difference. I take it at once in the morning, no splitting.

Since I have been googling it a lot, I was convinced that even a dose of 10 mcg would do wonders for me as it does for so many others.

Is it safe to take 25 mcg? Is this too high a dose?

At what dose T3 did you start feeling better?

Endo prescribed only 12.5 T3 but I still feel as awful as before starting taking T3.

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  • YulianaRossenova,

    T3 isn't an instant fix. It works faster than Levothyroxine but still takes some days to get into the cells before it will start metabolising and it can take several weeks to feel any improvement especially as your FT3 level isn't low. It's not true that FT3 6.0 is some sort of magic level where all symptoms vanish.

  • Thank you for your reply, Clutter.

    "...it can take several weeks to feel any improvement especially as your FT3 level isn't low..."

    Did you mean "FT3 level IS low"?

    Well, since I have been browsing very carefully through my labs, I noticed that I didn't have ANY hypo symptoms at FT3 6.60 (3.10-7.10), skipped beats being the most noticeable one, and again I did have quite a few skipped beats at FT3 5.80. That is why I concluded that I need to up my FT3 at least to 6 to feel better, which is the upper 1/4 of the reference range actually.

  • I don't think that's an unreasonable conclusion to reach, but keep in mind the three-dimensional aspect of nutrition + meds. If for instance your iron is low and your t3 is good you could get palps due to anaemia. So it makes it a little more of a guessing game and less of a science, unless you're someone like Paul Robinson who made a scientific study of his health while he plotted his own recovery on t3 only.

  • Thank you for reminding me about supplementing.

    What should my iron level be to not be considered anaemic?

    I mean: Is it enough for it to be within range or it should be higher? Probably above mid-range?

    I have never had any problems with iron. My level has always been in the upper 1/3 of the reference range.

    Right now it is a little over mid-range, however I attribute that to having a baby via s-section 4 months ago.

    Also how much time apart should I take all my vitamins from T3 so they don't interfere with it?

    Is it two hours, or four?

    Endo said it does not matter, I can take all of them even 30 minutes - 1 hour apart, but I have come across quite contradictory information recently and I keep wondering what to do...

  • Ok, I don't mean your iron must be low, that was one example. I just mean there is a lot of variability w nutrients (they can fluctuate) and if something is out of whack you may not feel well even when your thyroid levels seem fine. If your iron is in fact a little lower than it usually is due to your caesarian (I assume you may still be recovering physically as well as dealing w all the demands of a small baby) maybe this could be the cause of the new symptoms - ?

    I'm not sure about specific iron levels, I think it depends on your lab ranges. Maybe someone else can advise.

    I believe iron should be taken well away (4hrs?) from thyroid meds and calcium.

    I usually take my supplements at night so they are well away from thyroid meds and so I don't feel queasy like I do when I take them in the morning.

  • Thank you, puncturedbicycle.

    I am positive that one element/vitamin out of whack can turn everything upside down.

    However, these symptoms are not new at all. I had them well before getting pregnant with number 2. Everything started 14 months after my first baby was born. Then taking 50 levo resolved as if with a magic stick every single symptom (the hair loss, the brittle nails, the skipped beats). T4 made all my symptoms disappear in 2 days. However, Levo cannot do the trick now... since it cannot up my FT3 apparently.

  • It is possible you have stopped converting efficiently. With pregnancy, birth etc things may have changed, or nutritional things have changed or for whatever reason the levo isn't helping to get your t3 where it needs to be.

  • When I was on levo only, I had nothing but skipped beats, pulse at times of 140+,and at others 60 bpb. I had trips to A&E (nothing wrong with heart).

    Sometimes it can be due to fillers/binders in some products. It is trial and error and we cannot always change willy//nilly due to the guidelines.

    Blood tests don't really tell much except where they are at a certain moment when blood was drawn. This is a link and the doctor took blood tests at the initial appointment only, thereafter it was only the patients signs/symptoms which were of importance.

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

  • Shaws, have the skipped beats gone away after switching on a combined T4/T3?

  • T3 made a huge difference but they didn't go completely. When I stopped T4 took T3 only they resolved, I'm glad to say.

  • Glad to hear that. It gives me hope that some day (I pray it be soon) I will be hypo symptoms-free...

  • It is great when it does happen and I hope it's soon for you.

    Also some people have a defect in that they cannot convert T4 properly and can only take T3 and I'll give you a link.

    thyroiduk.org.uk/tuk/testin...

  • Thank you!

  • YulianaRossenova,

    FT3 4.9 is NOT low. Nevertheless, you obviously need it higher to feel well. It will still take more than 3 days for your FT3 level to rise now that you are taking T3 in addition to T4.

  • Clutter, my FT3 is 4.9, however we use a different reference range (3.10-7.10). So my FT3 is not even mid-range, unfortunately. And I do have skipped beats and the other bunch of symptoms even at an FT3 of 5.80...

    I assume that before developing a thyroid condition, my body used to function best at a very high level of FT3.

    At least that sounds plausible to me, since now I experience hypo symptoms even at FT3 of 5.80 which is NOT low at all, it is well over mid-range.

    At FT3 6.60 or even higher than 7.10 (unfortunately I don't have labs with an FT3 lower than 6.60 and higher than 5.80 to see at what level my hypo symptoms start) I don't have a single skipped beat, any hair loss, or any hypo symptoms.

    It will be difficult to keep my levels that steady and that high. Oh...

  • I have noticed a difference in how I react to synthetic T3 and NDT respectively.

    Ten years ago, when I was put on synthetic combo drug Novothyral, I did not feel even remotely human until I took a pill a day (each pill contains 100 mcg of T4 and 20 mcg of T3).

    On NDT, which I have been on for the past five years, I need at least 5 grains daily to achieve that same effect; I don't know if that is because I personally react differently to synthetic T3 compared to the T3 in NDT (if the former is somehow stronger), or if I simply require more thyroid hormone today than I did a decade ago.

    So it's highly individual, both when it comes to how you react to a specific type of T3 (synthetic vs NDT) and how much you need at any given point in time. It's not set in stone.

    I know of some who take 75 or even 100 mcg of synthetic T3 daily and do just fine (those seem to be the people who take T3 only, and no T4). Some take 8-10 grains of NDT daily which means 70-90 mcg of T3 daily without any problems...along with quite a lot of T4.

    I cannot see why taking 25 mcg of T3 daily would be a problem if that is what it takes for you to feel fine and rid yourself of hypo symptoms.

    BTW, when on T3, be it synthetic or NDT, your TSH will most likely be suppressed. It's important not to let your doctor convince you to go off T3 only for that reason. Most doctors seem to freak out at the sight of a suppressed TSH...

  • Thank you, anna69

    That is what I wanted to know.

    I was under the impression that 25 mcg T3 is a high dose. I was wrong apparently.

    I will try slowly increasing my T3 then. Hope to feel human again, almost lost hope...

    Also I've learned the hard way that TSH level doesn't matter at all when a person is on thyroid therapy.

    Endos won't tell us that. They prescribe only T4 and monitor only TSH levels, putting patients' hypo symptoms down to depression...

    It was thanks to this board that I learned not to be constrained by TSH level, not to take T4 (Levo) alone, since it increases my FT4 level, suppresses my TSH, but does nothing for my FT3 level (I don't convert well) and my hypo symptoms.

    Unfortunately, NDT is not prescribed or sold in my country.

    Next month I have an appointment with an endo who has had some experience with NDT. Hope to receive more information on that, as well as on T3.

    T3 therapy is not common at all in my country as well.

    All my friends with Hashimoto's suffer from terrible hypo symptoms, have sky-high, out of range FT4s, very low, almost undetectable TSHs, but feel no relief!!! Nobody has ever told them to have their FT3s tested!!!

    I told them to do that (thanks to this board again).

    I had to convince my endo to put me on T3, which she refused, and that made me look for another endo.

    Finally I found one who would prescribe T3 and believed my symptoms were real and stemming from low FT3.

  • Interesting to read that in your country patients are treated until their FT4 is above range, yet feel no better. :-( I hope they don't suffer atrial fibrillation, and worse.

    I usually take 4.5 grains of Thiroyd NDT, supplying about 157.5 mcg T4 and 37.4 mcg T3. I'm supposed to be on 150 mcg T4 and have reverted to that dose for a forthcoming official blood test. My temperature drops after a day or two, but is more stable, this time around.

    I've tried up to 50 mcg synthetic T3 added to T4, but backed down when I felt over-treated. I have a better pill cutter now, but part of my reason for trying NDT was easier tailoring of the dose -- in my case, to get more than 25 mcg T3.

    Within a few days of starting I was taking a full 25 mcg tablet of T3, and could feel an effect in my legs. Reducing their oedema was one of my aims. The synthetic T3 caused some discomfort in my stomach and torso, shortly after a dose.

    When changing back to NDT or synthetic T4 + T3 after 3 to 10 days on Levo, it takes me a week or two to feel back to where I was (which isn't particularly good).

    I'm "flying blind" and don't have recent results for FT3, but went from 6.8 to 7.6 to 8.4 (normal range 3.5 - 6.5) over the course of 12 weeks before any treatment, and didn't feel bad -- but was acting too irrationally to go back for treatment.

    In Hypothyroidism & Hashimoto's Thyroidistis, Sarfraz Zaidi writes that he is prepared to treat his patient to above-range levels of FT3.

  • Almost no patient in my country knows about T3 supplementing possibility. There is no NDT either.

    I was lucky enough to google it up and then find and endo who was willing to cooperate and acknowledge the importance of FT3 levels.

    Precious information for me! Thank you!

    I am still on 12.5 T3... to no avail. Will be increasing the dose in the course of next couple of days.

  • Thank you so much! I will try increasing my T3 slowly. Hope to feel some improvement soon.

  • A healthy thyroid gland secretes for example 80mcg T4 and 40mcg T3 (Ratio 64-36 according to Diogenes)

    Absorption when taken orally varies but even then the extremely high doses mentioned above should not be needed.

    Ferritin? B12? D? folate? cortisol?

  • Eljii,

    I have never had my cortisol tested.

    My labs from last week are:

    ferritin is only 14 - 4-104

    iron 18 - 6 - 26

    B12 - 282 - 140 -489

    D 48 - 50-120

    folate is just little over mid-range exactly, don't remember the numbers.

    I had my c-section 4 months ago, that's why I think my ferritin might be low. Same might be the case with the other vitamins levels as well, although I am not sure.

    I am D3 deficient. However, when my FT3 was 6.60, my D was only 34, and I had no hypo symptoms whatsoever, no skipped beats, nothing.

    My thyroid went all over the place after I gave birth..

  • It took me 2 years to find the right T4 + T3 combination for me.

    There is no magic formula and you should not assume that blood results are the full answer for alleviating symptoms.

    I gradually increased T3 to 20mcg in 5mcg steps and gradually reduced T4 from 100mcg to 75mcg to notice an improvement, but still not quite there.

    The final step for me was 50mcg T4 + 25mcg T3 to get rid of the remaining remnants of brain-fog. For me, blood results were only useful as a rough guide and fine-tuning was the final step.

    However, the reason for my T3 shortage is unlikely to be the same as yours, so you should not expect to rely on anyone else to tell you the exact doses that are right for you.

  • Thank you, yousurname.

    I know everyone is different, of course. However, it's somehow comforting and stimulating at the same time to hear others' success stories.

    Over what period of time have you been increasing T3?

    Did you immediately feel improvement on 25mcg T3 or it took some time for it to kick in?

  • I spent 4 years trying to find the optimum combination of T4 and T3.

    I felt a significant improvement once I was on 20mcg T3 and I stayed with this for quite a while and adjusted the T4 dose.

    The last step was a combination of reducing the T4 dose from 75mcg to 50mcg and increasing T3 to 25mcg.

    However, there have been unrelated medical complications over the last 2 years. My Iron and Hb have taken a while to recover. I am now experimenting with 20mcg T3, as I just occasionally feel one of the Hyper symptoms (jittery).

    I will probably also try 25mcg T3 and a slightly lower T4 (e.g. 6 x 50mcg per-week instead of 7 x 50mcg).

    It takes a few weeks for any T4 changes to have an impact, so patience is required.

  • Yesterday I increased my T3 to 3 quarters of a pill of 25 mcg which makes about 19 mcg and I had and still have no relief of symptoms (the major one being tens of thousands of skipped beats a day).

    I have had no side effects so far, no hyper symptoms. I think I may need a higher than 25 dose. I thought I might feel at least a slight reduction of my skipped beats at 19 mcg.

    I am on 37.5 mcg T4 and 19 mcg T3. I know it's not a miracle drug but I just seem soo far from MY dose.

    I don't know why I need such a high dose since I became hypo only 2 years ago.

    Since one person here mentioned Paul Robinson... I have read he claims that sometimes T4 can interfere with T3 somehow and reduce its potency to an extent.

    Is that true and under what circumstances?

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