Anyone else on T3 only - with or without adrenal insufficiency?

[Canis2017]

Struggling a lot with dosage and timing! I have both hypothyroidism and adrenal insufficiency and had to switch from NDT to T3 only due to RT3 problems. Also on HC. Would be very grateful for sharing experiences!

[mischa]

Hi Canis:

How much T3 are you on? Usually this is taken spread over the day - morning, midday and early evening with the lowest dose being in the evening. I take my largest dose of T3 with my Levo first thing in the morning and wait an hour or so before having breakfast. My second dose of T3 only is around midday again before food. But T3 can be spread over 2, 3 even 4 doses throughout the day. Leave a 2 hour gap before taking T3 and an hour gap after.

I always know when my next T3 is due because my temperature starts dropping.

Do you have a cortisol saliva test result that shows where your cortisol dips? If you do, you can time your T3 by taking it an hour before the dip. Failing that when you know you are going to "slump" take the T3 an hour before that slump. I hope that helps.

[Canis2017 in reply to mischa]

Thanks so much for answering Mischa! I take 50 mcg spread out on 15 -15 - 10 - 5 -5 from wake up with 4 hours apart - always one hour before meal. I have spent 1 year reaching 50 mcg - and still having hypo symptoms. My saliva test showed low cortisol all over the day and ACTH was also low so that's why I'm on 25 mg Hydrocortisone - 10 -7,5 - 5 - 2,5 also 4 hours apart, but take them one hour after T3 with meal. I usually feel OK until 3-4 pm then I usually start feeling bad.

[greygoose]

What were your problems with rT3? If it was just that rT3 was too high, what were your FT4/FT3 levels?

HC needs to be taken first thing in the morning to do any good. How much are you taking, and when? Your T3 needs to be taken at least two hours away from HC. So, it might be a good idea to take the T3 at night. It's a personal thing, but T3 doesn't always need to be split into several doses. That makes life so difficult because it does need to be taken away from food, etc., just like T4. It's OK to take it all in one go. Sometimes, it's even preferable.

[Canis2017 in reply to greygoose]

Thanks so much for answering greygoose! I had really bad adrenaline rushes and insomnia (did not sleep in 2 weeks) - became so ill that I had to stop all NDT. RT3 was over ref, high FT4 and low FT3.

I take 25mg HC spread out on 10 - 7.5 - 5 - 2,5 with 4 hours apart. OK - so I should take HC 2 hours before T3 that's new to me. Why is that? I was told to take HC with food (for the stomach) so I've been taking it 1 h after T3.

[greygoose in reply to Canis2017]

Well, those aren't rT3 problems, Your rT3 was high because you had too much unconverted T4 in your system.

If you have adrenal fatigue, you really shouldn't be taking it spread out like that. That is for Addison's. With adrenal fatigue, you just just take it in the morning - first thing, and just before lunch. If you take it throughout the day like that, you risk shutting down your adrenals completely. And once they've shut down, unlike the thyroid, they don't start working again.

Yes, you should take HC with food. And, you should also take a high protein breakfast as soon as you get up, which is why I suggested you take your T3 all in one go, at night.

Why should you take HC two hours before/after T3? Because if you don't, you will compromise your absorption of T3.

[Canis2017 in reply to greygoose]

I have secondary adrenal insufficiency, ACTH tested, not AFS.

[greygoose in reply to Canis2017]

OK You still shouldn't take HC with T3.

[Canis2017 in reply to greygoose]

Thanks I thought 1 h apart was enough but will change to 2 h now.

[Canis2017 in reply to greygoose]

Any thoughts on what's best- HC before or after T3?

[greygoose in reply to Canis2017]

You need that first dose of HC as soon as you get up. That's when the adrenals have their heaviest work-load, and that's when they need the helping hand that HC can give - I take it your adrenals are still working. Even if they're not, you need that cortisol to get you washed and dressed and started on your day. That and a high-protein breakfast.

You could take your T3 two hours after breakfast. Or, as I suggested, take it at night.

[Undiagnosed-20-years]

I didnt know I had a problem just got fobed off by GP. this book is very good amazon.co.uk/Your-Thyroid-H...

plus I have a good endocranolagist hes on NHS but ive paid as I got nowhere with them as I say just fobbed off. I have t3 very low & adrenal low but not addison so have to say NHS are hopless.