Lovely Endo again and T3 question

[Lindsayf]

Hi all

Just wanted to say I saw the same NHS Endo yesterday and again she was lovely.

I was nervous when I sat down as she had told me to reduce my Levo if I was adding T3.... but I decided to remain on my 100mcg Levo and take 6.25mcg with it in the mornings. After some very good advice on here I started to take another 6.25mcg in the afternoon but felt unwell on it and stop the afternoon dose.

I sat down and the first thing she said was 'how are you feeling?' I explained that I was still tired in the afternoon and then proceeded to tell her my current doses of meds. She said that was fine as my TSH is 0.05 and my FT3 was 3. Something which is still low and outside the normal range. She said she wants me to take another 6.25mcg in the afternoon to try and raise my FT3. She also told me to remain on my Iron tablets as I'm right in the middle of normal and doesn't want me to stop taking them as when I do my Iron goes below normal range and I feel ill. She is also going to test me for Celiac disease.

The question I didn't ask was can I take my T3 afternoon dose under my tongue? I take my Levo and T3 in the morning before 6am and then my Iron tablet at 11am and my B12 vits after lunch about 1... I've read I've got to not eat for 2 hours before and an hour after taking T3 but I'm always grazing and love a Cuppa. If I put it under my tongue does it matter if I've eaten or not? I take Selenium in the afternoon but can take that at night with my VitD and K2 to make sure I'm not taking vitamins near the T3 dose.

Any thoughts really welcome

Thanks

[SeasideSusie Remembering]

Lindsayf It's not a sublingual tablet, sublingual means you dissolve it under the tongue (with no help from you) and it goes directly into the bloodstream bypassing the digestive system. I have read that the molecules of Levo and T3 are too large to be absorbed sublingually and that the tablet should be swallowed with water - either whole or crushed.

I used to split my dose of T3, early morning and late afternoon, and like you it limits when you can take it. I now take my whole dose in one go in the morning and I haven't noticed any difference.

Bear in mind we're all different, what suits one doesn't necessarily suit someone else. Try it and see what works for you.

[Clutter]

Lindsayf,

As Seasidesusie said, T3 shouldn't be taken sublingually. You can take it one hour before food or two hours after.

[Lindsayf in reply to Clutter]

Thanks SeasideSusie, I'll try not eating in the afternoons :/ if I struggle I'll just take it in the mornings. Thanks Clutter, do I have to avoid milk?

[SeasideSusie Remembering in reply to Lindsayf]

Yes, you need to avoid milk because it contains calcium and calcium can interfere with the absorption of thyroid meds, as does iron and Vit D. Take with water only.

[Lindsayf in reply to SeasideSusie]

Okay so no milk for 4 hours after then! Might start using Hemp milk ... thanks again

[Clutter in reply to Lindsayf]

Lindsayf,

Avoid everything other than water for an hour before or 2 hours after you take T3.

[Lindsayf in reply to Clutter]

Hi Clutter...

Okay I'll have to really think about it and plan... don't want anything to stop it working... if I really struggle I might try taking it in the morning with my T4 and other T3

[galathea]

Why dont you try taking it last thing at night? Along with the t4? I tried all the multidosing thing but it was such a palava.... I did fine with an evening dose , but eventually changed to ndt.... Which i also take last thing at night.

Adrenals make cortisone at night when you are sleeping and they need t3 to do that. If you run out of cortisone in the middle of the day, you get the afternoon slump.

Might be worth getting a saliva test for cortisone? Also might be worth trying the evening dosing?

Xx. g

[Lindsayf in reply to galathea]

Hi Galathea

I go to the gym in the evening and have a protein shake which I usually have about 7.30 and I sometimes eat about 8 and then I'm in bed for 9... I might try and think about eating less and try taking my T3 in the evening and change my night vits to the afternoon.

Where do I get this test from?

[SeasideSusie Remembering in reply to Lindsayf]

Genova Diagnostics but as they don't deal direct with the public then we have to go through ThyroidUK who act as our practioner - details here on how to order the test and how to get the results, the test you want is END01 Adrenal Stress Profile thyroiduk.org.uk/tuk/testin...

[Hidden]

I always wait 2 hours after food/drink to take NDT and then 1 hour after to help absorption. Unless it's my morning dose then it's just the 1 hour after. However, it's worth noting that T4 is much more dependent on fasting than T3. Absorption rates change massively for T4 but not T3. Almost all (95%) of T3 is absorbed within 4 hours. But still I always do keep my discipline as NDT has both T4 and T3.

[shaws in reply to Hidden]

This is an excerpt re 'food' :-

One factor is being female. Researchers report that on average, the woman’s stomach empties more slowly than the man’s. In a 1998 study, for example, researchers tested how long it took for half of a solid meal to empty from the stomachs of healthy women and men. The average time for women was 86 minutes and for men was 52 minutes.[1] This result is consistent with those of other studies; it suggests that women may benefit by waiting a while longer than men after eating to take thyroid hormone.

Another factor is the slower movement of food and stool through the gastro-intestinal (GI) tract of many patients who have hypothyroidism or thyroid hormone resistance. Doctors often diagnose the sluggish GI function as "constipation-type irritable bowel syndrome."[2,pp.681-687] Until the patient finds a thyroid hormone dose that relieves her constipation, it may be prudent for her to allow more than two hours—maybe three—for food to clear from her stomach and small intestine before taking the hormone.

Still another factor is food-induced slow emptying of the stomach. If a meal contains much fat, oil, or protein, food will pass more slowly from the stomach to the small intestine. This may be helpful when a person has ingested refined sugar as part of the meal.

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

[Hidden in reply to shaws]

Thanks shaws. Interesting to see the digestive differences between men and women in terms of time to empty the stomach. Do you think it's more relevant to T4 meds? As a lot of people take T3 with/without food and say not a difference in absorption. I don't take T3 with food by the way.

[shaws in reply to Hidden]

It may be more relevant to T4 for constipation as that is the main replacement for millions of people. Food can also interfere with the uptake of all hormones.

The excerpt above is from a doctor who never prescribed levo, only T3 or NDT.

If someone is taking food with any thyroid hormones, I wonder how they can reach a plateau of optimum dose. They might need to take less if there's nothing to interfere with the uptake. Not that I am a scientist or medically knowledgeable.

[Hidden in reply to shaws]

I've read about the uptake of hormones but can't really find anything specifically aimed at T3 uptake. Apart from the Armour PIL that says almost all T3 is absorbed in 4 hours, whereas T4 absorption varies between 48 to 79 percent. The capsule (or presumably fillers for tablets) change the absorption rate massively from 41% to 74%. Hence fasting for T4 as food/fillers/etc affect absorption. Fasting is only mentioned for T4. This was based animal studies.

The only thing I've read regarding T3 contraindications is with iron but not actual food.

I agree that reaching a consistent optimal dose should, in theory, be harder to achieve if taking food with thyroid hormones, but, from what I've read it seems more important for T4 containing meds. Having said all that I'm sticking with my consistent doses away from food

[Lindsayf in reply to Hidden]

Thanks for that... I'm going to keep the second T3 dose away from food and try taking it before I sleep

[Hidden in reply to Lindsayf]

I've moved some T3 to midnight and sleep like a big dog!

[shaws in reply to Hidden]

This may be informative:-

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

[Hidden in reply to shaws]

Yeah I like Dr Lowe Q&As. Some other good info in that article. He seems to refer to sustained-release T3 staying in the intestines for too long that it could become attached to proteins and hence pass through the system without going into the blood. I've never taken time-release T3 but still think it's obviously better not to add another factor into the mix with hormones taken orally i.e. food.

Switching to T3 only soon so just wanting to understand how things work.

[shaws in reply to Hidden]

If you are self-medicating here is some info from Dr L.

web.archive.org/web/2010112...

[Lindsayf in reply to shaws]

Hi Shaws

Well I can believe this! I go to the loo every 3 days maybe 2 days if I'm lucky! I'd love to go everyday but my body doesn't seem able to. I feel like taking this extra little dose of T3 is hard planning 🤔

[crimple]

be aware that a coeliac test is not saccurate, you can get false negative and false positive results. You could try going gluten free for a month or so and see i you feel any different. It is important to be GF if you have thyroid antibodied.