Starting T3 - any warnings, tips, advice?

Hey folks

So, if anyone has seen some of my other posts, they'll know that my levels have been catastrophically awful for a while now and I've been really struggling to get hold of any T3.

I finally - FINALLY - have some. Someone local has given me a sheet of 16 x 25mcg and I've managed to buy more, arriving in few days.

So, my main question is whether there are any requirements with taking T3 like there are for levo.

I took one for the last 4 days in the morning with my morning pills (an antihistamine, and an antibiotic at the moment) and inhalers, and then had breakfast and coffee pretty much immediately afterwards. I take my levo at night with my night pills (a breathing aid, an antidepressant, and an antibiotic atm) and inhalers, because waiting before breakfast and coffee just doesn't work with my schedule of having to be up and at 'em quite early.

Should I take my T3 at a different time?

Also, I've seen a lot of people talk about taking just 5 or 10 mcg and seeing how they feel - talking about feeling immediate effects? as in, same day? I've noticed no difference at all with 25 in the morning. How soon should I start to see a difference?

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Always start with a low dose of T3 and by low i mean the smallest you can cut it up to. I use a stanley blade and cut a 25 T3 tablet into 1/8th sizes = 3mcg approx.

A small dose can compliment your system immediately, rather than disrupt the cortisol side of things. Lots of people advocate using much higher amounts of T3, but if you never try out the small doses first you may be missing out on a potential winning ratio.

Dr Blanchard has a book out called functional thyroid and he was a big advocate for low dose T3 usage along with T4.

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i'm not sure i can cut it up more than halves, but i'll try that!

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You certainly can. Get a stanley knife blade and you can easily 1/4 them. Then half them again. It is pretty easy. If you can't do it get someone to help you.

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lol i meant with what i have sorry - i dont have a stanley knife or anything like that

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Arn't you talking about your health though and the fact you are very unwell ? If you want to improve your health you will need to do some research and make preparations. Buying a pack of stanley blades at £1 has to be the easiest thing you can do.

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I mean if you really want me to get into the specifics of why I can't do that right now then I will, but it's probably best to accept it when someone says they can't do something?

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Ideally, you shouldn't take thyroid hormones at the same time as anything else - they work best on an empty stomach. But I realise that might make life pretty tricky!

I think, because you're undermedicated on your levo (how much levo are you on, by the way?), that might be why the liothyronine isn't having as much effect as you thought. You probably need it! Your FT3 was very under range, wasn't it? That - and taking it with other things might be reducing its potency.

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Ah yeah here are my levels:

TSH: 4.1 (0.4-4.0)

FT4: 8.9 (9.0-25.0)

FT3: 0.7 (3.5-7.8)

and I'm on 100mcg of levo

I'm just not sure how to take it on an empty stomach honestly - I get up at 8, breakfast is 8:15, and I'm busy by 9!

argh!

Edit: looks like i'm gonna be setting a 5am alarm to take pills and then go back to sleep. rip my sleep schedule.

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You can take your dose at bedtime, as long as you've last eaten about 2 hours or 3 hours before (if you've eaten protein). Food interferes with the uptake.

You take hormones with one full glass of water on an empty stomach.

If having a blood test in the morning, miss the night dose and take after test. If you've not been able to fast allow a 2 hour gap between eating and taking hormones and night dose as usual.

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Quinq, like you I take a lot of medicines, with different rerquirements for with food, empty stomach, etc. Here are a few possible ideas:

For both T3 and Levo the rule is to fast for 2 hours before the tablets, and 1 hour after. It isn't a rule that either have to be taken in the morning or evening. With T3 the half life is quite small (6 hours), for this reason many people break it into multiple doses (I have 3 doses, as I start feeling rubbish 4 or 5hrs after taking). So ideally take T3 in the earlier part of the day. Levo has a half-life of almost a week, so it doesn't matter at all.

Any time in the day you have a 3 hour gap in eating and other medicines you can take these medicines. For example between breakfast and lunch, or lunch and evening meal. As long as you aren't snacking. You can likely fit them in.

Another thing I do, because I take a few things to help me sleep at approximately 11pm, I take my final dose of thyroid replacement at 9pm (but I could push as late as 10pm if I wanted to) this means I always finish eating by 7pm.

So those are a couple of times in the day you might be able to squeezethings in. You might be able to figure out others depending on when you usually eat. It's a nuisance that I only get a few 2hour periods in the day when I'm allowed to eat, and I have to get the food then or I've missed my chance. But actually I've found it's helped me to organise my days and make sure I always get the food I need.

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Silveravocado,

For maximum absorption Levothyroxine and T3 should be taken with water on an empty stomach which means one hour before food and drink or two hours after food and drink, 2 hours away from most medication and supplements, and 4 hours away from iron, calcium, vitamin D and magnesium supplements and oestrogen.

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Thanks Clutter. I've edited the post slightly so it's more clear the gap between eating a hormones. But I didn't include this detail about other medicines.

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Silveravocado,

You are saying fast 2 hours prior to taking T3 and T4 or 1 hour after. It is the other way around.

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Hi Clutter, I think we're getting confused with different ways of wording this. In the post I try to make it clearer by using the word fasting, but maybe I'm not successful.

I think the bit of my post you repeat is correct, and is the same as what you say in your first comment above?

An example to make it less about fiddly language:

If a person takes their Levo immediately on waking, they need to wait 1hour before eating breakfast.

If a person eats a meal and wants to take their Levo after it, they need to wait 2 hours before taking their tablet.

This could be said as 'fast 2 hours prior to taking' or 'take 2 hours after food and drink'. They both mean the same thing but are said different ways round.

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If you drink coffee within a few hours of taking thyroid hormones it affects the uptake of hormons.

Dont take coffee with thyroid hormones. Allow a long gap as coffee interferes. Neither take anything else with T3 unless you also are taking T4. You can take both together.

First thing with one glass of water and wait for an hour before eating.

huffingtonpost.com/sara-got...

If you are adding T3 to T4 you can take both together and if you take at bedtime, allow a gap of about 3 hours between food and hormones especially if you've eaten protein. Usually our digestive system is low due to being hypo so it takes longer to digest.

T3 isn't instant action, although it is quicker than levo.

25mcg T3 is equivalent to around 100mcg of T4.

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Taking t3 will make your t4 go down considerably. Some people need some t4 to feel well, even if they are getting adequate t3 in the form of medication. I took t3 for a month & a half and it zapped my t4. Currently weaning off of t3 as I add t4 back to build up my reservoirs. I felt dreadful after a few weeks on T3 only. And I agree, start on a low dose and see how your body handles it.

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I shall give you a link re breathlessness and I believe depression can be caused by low T3. T3 is the only Active Thyroid Hormone - levothyroxine is inactive and has to convert to T3.

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

Also you should take your temp/pulse several times a day before you begin T3 and until you feel stable on your dose. If either goes too high reduce T3.

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yeah the depression might well be linked but i somehow don't think my benign lung tumours are :p

thanks though!

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Essential to check your vitamin D, folate, ferritin and B12 are at very very good levels FIRST

Plus if you have Hashimoto's then gluten free likely to help

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I take 100mcg of T3 per day and feel normal again. I was taking 100mcg of T4 and was having worse symptoms than when I was diagnosed (my TSH level was 17.84). On 100mcg my doctor said my TSH, T4 and T3 levels were all normal again and I should just carry on. I was telling him I couldn't do my job most of the time due to brain fog (I get annoyed with people who say, oh yes I get that where I can't remember, they have no idea what brain fog is like, I explain it's like wanting to run but your legs won't work, you just can't get your brain to think, it's so frustrating), was totally depressed, tired, putting on weight which was causing more depression, I stopped socialising as I didn't have any energy to go out, my libido was non-existent, I had muscle pains, pins and needles in my hands and dry skin.

I was so fed-up, I decided to try T3 myself. So I experimented in the beginning, I tried 75mcg of T4 and 25mcg of T3. I suffered horrendous headaches for the first 3 days, I was considering stopping the T3 but I persevered and the headaches stopped. After a month I upped the dose of T3 to 50mcg. I still felt ill on this though, so after another month I stopped taking T4 and took 75mcg of T3. At this level I was not feeling good, although most of the symptoms I experienced before were gone, I was experiencing new side effects such as muscle pain in my legs and feet, I was often experiencing heart palpitations at night, and I was still gaining weight. I had my bloods taken and as expected my TSH level was not readable, and my T4 and T3 had not changed from when I was taking T4. I then increased it to 100mcg and everything changed, I don't have muscle aches, heart palpitations and I have started to lose weight.

I feel great, I take the dosage all at once in the morning. Before this, I split the dosage throughout the day, but it was awkward so I changed to once a day and I feel the same as 4 times a day. I leave at least 30 minutes before I drink coffee or eat breakfast. I feel I have my life back again. I only wish the government would control the price of T3 and stop the greedy licensed manufacturers profiting from the TAX payers.

I think you should listen to your body, don't be afraid of trying a higher dosage, you can always go back down if you experience really bad side effects.

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But please try the LOW doses first. You haven't tried the low doses and went straight in at 25mcg. You have no idea if low doses would help. Everyone seems to start on a big dose of T3. Ideal starting doses of T3 should be 1mcg according to Dr Blanchard in USA.

I think with big doses of T3 you eventually override your natural systems and it can sort of work out, but i think it is better if you can compliment your own T4 production or supplementation and cortisol production.

It is good you have found health on a high T3 dose, but it sounds early days and you will need regular blood tests to make sure you are not getting any of the adverse side effects.

I would say it is early days to say you are out of the woods yet, you need to be stable for 1-2 years on this dose with good bloods in the other areas to say all is ok.

Watch out for muscle weakness, bone loss, hair loss.

Have you read Paul robinson book on using T3 only. He can't tolerate any T4 and he thinks it is due to poor cortisol production and the T4 seems to use up more cortisol in its production/breakdown. You can boost cortisol production by taking T3 in the early hours of the night. This can have the effect of needing LESS T3 overall. He says a typical replacement dose of T3 only is 40-80mcg per day.

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Could you get a thermos or travel cup, & have your coffee & a portable breakfast on the go? Your THs will work better away from food, meds, & supplements. If I have an early appointment or i’m Travelling somewhere, I carry fruit, nuts, seeds, water, & a thermal cup. THs are too important, not to mention expensive & hard to get hold of without shooting myself in the foot by taking them with anything to reduce their efficacy. I learned the hard way 🙄

I never have coffee first thing as it reduces the body’s natural wake up hormones from being produced, so people become dependent on caffeine to perk them up in the morning. I do need a huge cup after 11!

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All excellent advice above. The rule is to START LOW AND GO SLOW. Also take your blood pressure (BP) before you start taking supplemental T3, then keep an eye on it. It doesn't affect everyone but I am one it does, if I overdo T3 my BP increases too much.

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