Hypo To Hyper With One Tiny 1/4 Tablet Dose. Ho... - Thyroid UK

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Hypo To Hyper With One Tiny 1/4 Tablet Dose. How Do I Find The Happy Medium?

Abi-Abster profile image

Hi All,

I have ME/ CFS, Fibromyalgia, ADD and Hypothyroidism.

For my Hypothyroidism I have been taking 50mcg Levothyroxine T4 and 4 split doses of T3 (6.25mcg x 4 = 25mcg total, which comes as one tablet of Tiromel).

It’s been working brilliantly: no pain, brain engaged, every hypothyroid symptom has gone/ been relieved. Joy!

However, after a few weeks on this dose I begin to feel borderline Hyperthyroid: palpitations, diarrhoea, insomnia etc.

Unfortunately, if I drop down a dose and take one 1/4 less of my T3 pill (so 18.75mcg total) within a day I’m in pain and feeling like total crap.

I’ve tried dropping the Levothyroxine down from 50mcg to 25mcg instead of decreasing the T3, but have the same reaction of going back into Hypothyroidism.

And if I take one higher dose one day and one lower dose the next, it doesn’t seem to balance out: I just feel hyper one day and in pain and hypo the next. It doesn’t feel like it averages out over the 48 hours, especially as I notice immediately when I drop a dose as I’m in bloody agony. It’s so sensitive!

This back-and-forth dosing has been going on for some months as I experiment with finding the right level. Obviously, it’s not good for my thyroid to be yo-yoing like this, and it’s also frustrating to be so close but yet so far!

Perhaps somewhat logically i feel that my ideal dose would be:

1 tablet 50mcg Levothyroxine

3 x 1/4 tablets T3 (so 18.75mcg T3)

PLUS 1/8 tablet T3 (approx 3mcg)

Making approx 22mcg T3 total.

However, there’s no way I can split the already-tiny 1/4 tablets into half again for the 1/8 dose.

This is where it would be helpful to have my GP on board so that I could have a liquid version of T3 for more precise dosing.

But since I haven’t got my GP on board and you’re all infinitely more knowledgeable about the thyroid, have you any recommendations/ thoughts on how to take my meds?

I’m so very nearly there with settling on my ideal dose, but finding it so difficult to get there: I’m either in pain and in bed or pinging off the walls like a Duracell bunny! It’s incredible that such a small slice of tablet can have such a significant effect on my health.

Thanks in advance for your input,


13 Replies


Try crushing 1/4 of a tablet (6.25mcg) and divide the powder into 2 piles so you can take 3.125mcg or 1/8th of a tablet.

I'm not aware that there is T3 in liquid form.

Abi-Abster profile image
Abi-Abster in reply to Clutter

Crushing tablets is an obvious answer that I hasn’t considered. Have you tried this before?

Since my music industry days are long gone I’m assuming snorting the T3 powder is out of the question (joke!). So should I add the crushed 1/8 tablet to water, or just stick it on the end of a finger and lick?

Thank you Clutter. I’ll see if I can make that work for me 😀

Clutter profile image
Clutter in reply to Abi-Abster


I would pick it up with a damp finger, lick it from the finger and wash it down with water.

You really need to be on a stable dose for 6-8 weeks before you test otherwise you won't know what dose the results relate to.

helvella profile image
helvellaAdministrator in reply to Clutter

There is no liquid liothyronine in the UK. But, for completeness, there is Liotir in Italy.

Do you have any blood test results which show how your body is reacting to the tiny changes in dose that you are making?

In other words, when you feel hyper is your Free T3 really high? If it isn't then constantly changing your dose is not the answer, and you need to look at some other solution.

I had similar issues to the ones you describe, and in my case the problem was high cortisol. I was taking 25mcg T3, but my Free T3 was bottom of the range and I felt terribly hypo. When I tried to raise my dose I felt terribly over-medicated.

When I lowered my cortisol (using Holy Basil supplements) I was able to increase my dose of T3 to 2 tablets - 50mcg per day - although eventually I have settled on 1.5 tablets T3 (37.5 mcg per day taken as 25mcg in the morning, and 12.5mcg taken in the evening).

I'm sure there must be other reasons besides the one that I suffered with for the situation you are in. But cortisol levels being too high or too low is a common issue for people who are hypothyroid.

Abi-Abster profile image
Abi-Abster in reply to humanbean

This is very useful info - thank you.

I haven’t had my bloods done because I can’t afford it til next month.

Also, I’m not sure what T3 dose to be taking when I finally do have my bloods done, as I can’t seem to stay on one dose for any length of time.

I have been intending to have my cortisol levels checked due to ME often being related to adrenal fatigue, so thanks for the reminder. I’ll add it to the list!

In the meantime, I think I’ll follow Clutter’s suggestion of crushing pills and see how I get on. See if I can manage that dose until my test in November.

Thanks again 😃

Have you ever tried taking it all in one go, instead of splitting your dose?

Abi-Abster profile image
Abi-Abster in reply to greygoose

No I haven’t; I’d understood that T3 was fast-release so needed splitting throughout the day. Is this not right?

I think I’d be a bit scared to take the whole T3 pill at once!

SeasideSusie profile image
SeasideSusieAdministrator in reply to Abi-Abster

I take all my T3 in one dose early morning, 31.25mcg Unipharma, with my Levo (I might take my Levo a bit earlier some days when I go to the loo in the middle f the night).

I used to split it, got fed up of timing with food, coffee, etc., so tried just one dose. I didn't find any difference.

greygoose profile image
greygoose in reply to Abi-Abster

I've taken 225 mcg in one go, at one point. I don't think there's anything to be scared of in taking 22 mcg. :)

It depends what you mean by 'fast-release'. In fact, I don't think that's a very good description at all. You don't get an instant reaction, it still has to go through the stomach to be absorbed in the gut, just like T4. The only difference is that it doesn't have to be converted, like T4.

Once in the blood, it stays there for about 24 hours. But, the T3 that is absorbed by the cells, stays there for several days. It may be that with such a tiny dose, split into three, you don't have enough to saturate the receptors, so some cells still aren't getting enough T3. By taking it all at once, you get better saturation.

But, it's all trial and error. You have to try different things, to see what works for you. This is just one of the things worth trying. There are no hard and fast rules for anybody, about when you take your hormone, as long as it's on an empty stomach, etc. :)

SlowDragon profile image

No point testing until been on stable dose for 6 weeks minimum

How are your vitamin D, folate, ferritin and B12

Do you have Hashimotos as well

Tried strictly gluten free diet?

All being addressed; Vitamin levels ever improving, vast improvement from June thanks to you guys :-)

Don’t have Hashimotos

Been gluten-free for 15 years :-D

Yes, and that’s another reason I haven’t gone for testing yet, because I can’t seem to stay on one dose. Argh!

I use 1/8th size doses.

I just use a Stanley blade and hold it with both hands and press down on the tablet. It cuts them very easily. The smallest size i can get down to is the 1/8th which is approx 3mcg T3.

Have you tried taking some T3 at 4am ? It works wonders for me and is related to the method Paul Robinson talks about in his T3 book. We are supposed to generate more cortisol this way and so this is more supportive of better thyroid health. I only take 3mcg at this time, but i only use a little T3 anyway. I think Paul Robinson takes 20 T3 at 4am and about 50-60 mug overall per day, but he uses T3 only.

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