Starting T3

[AliF]

Here are my latest results — posted a couple of weeks ago.

I now have my prescription from an NHS endo and will start taking T3 tomorrow morning. I have 20 micro gram tablets of Liothyronine sodium to cut in half and take once a day along with my 100mg Levothyroxine. Any advice, tips or pointers gratefully accepted.

TSH 1.04 ( mIU/L 0.27-4.20)

Free thyroxine 15.3 (pool/L 12.00-22.00)

Total Thyroxine (T4) 93.4 ( nmol/L59.00-154.00)

FreeT3 3.59 (pmol/L 3.1 - 6.8 )

Reverse T3 20 (Ng/dL 10.00 -24.00)

Reverse T3 ratio *11.69 (15.01-75.00)

Thyroglobulin antibody <10 (IU/mL 0.00-115)

Thyroid peroxidase antibodies 12.1 (IU/mL 0.00 - 34.00

[Aurealis]

You’re cutting the T3 in half to take in two doses maybe? Leave about 6 hours between doses.

[AliF in reply to Aurealis]

Cutting in half and taking one dose is the instruction on the pot.

[Aurealis in reply to AliF]

Sorry, i misunderstood

[AliF in reply to Aurealis]

I wasn’t very clear with my original post.

[SeasideSusie Remembering]

I'm assuming cutting the 20mcg tablet in half and taking 10mcg daily in one dose?

If so you might want to split into two doses of 5mcg each, one with Levo on rising (or your normal time for Levo) and the second dose of T3 either mid afternoon or maybe before bed, experiment to see what suits you.

Same rules apply to T3 as Levo - take on an empty stomach, one hour before or 2 hours after food, with a glass of water.

[AliF in reply to SeasideSusie]

That’s correct 10micrograms once a day. Good advice SeasideSusie re taking 2X 5. So one in the morning at the same time as the Levo and then the second 2 hours after lunch. I feel worst first thing in the morning generally with extreme fatigue and lots of aches and pains.

[SeasideSusie Remembering in reply to AliF]

If you start off like that and it doesn't suit, you can always try it in one dose and see if that suits you better. I started off taking it in split doses, got fed up of not being able to have a coffee or biscuit whenever I felt like it so tried taking my T3 in one dose in the morning and it didn't seem to make a difference so I still take it in one dose now.

[AliF in reply to SeasideSusie]

I’ll start splitting I think and see how I go. Quite tricky cutting tablets into 4 equal parts though ! Hopefully i’ll get more expert with my pill cutter!

[SlowDragon Administrator in reply to AliF]

A craft scalpel works ok cutting T3

Which brand of NHS T3 have you got?

Just like T4, each brand is different strength in apparent dose it gives

I still take mine as split dose (3 x 5mcg waking, mid afternoon and bedtime)

But started with 2 x 5mcg as SeasideSusie outlined

[AliF in reply to SlowDragon]

No brand on the pot or label.

Can’t see any name on the tablets themselves.

[AliF in reply to SeasideSusie]

How will I know “ if it doesn’t suit” ? Won’t feel any benefit ?

[SeasideSusie Remembering in reply to AliF]

Just if it becomes a nuisance trying to fit it in with everything else time wise.

[AliF in reply to SeasideSusie]

Ah I see much more practical reason. Working on my ferritin too btw. I’ll test that again in a few weeks.

[SeasideSusie Remembering in reply to AliF]

If taking iron tablets, remember to leave 4 hours between thyroid meds and those, same for Vit D if you take it, any other supplements 2 hours.

[DippyDame in reply to AliF]

In case it's any help....

I take 100mcg T4 + 12.5mcg T3 around 3am when I visit the loo and the remaining 12.5mcg around mid day (lunch then about 1.30pm). Been doing this for a few weeks and things are beginning to settle....but aim to eventually take complete dose at bedtime (easier!) My worst time has been on waking but that is slowly improving.....as are various aches and pains and crushing fatigue. I was barely able to function by the end of last year.

There is no "one rule for all" unfortunately and it seems that trial and error eventually reveals what suits you best.

I've been self medicating and adjusting dosage for nearly seven weeks and now feel my body is gradually accepting my current dosage quite well. Interested to read (somewhere) that splitting initially allows the body to slowly get used to T3 so that eventually a single dose will be fine. True or not I can't say, but, it just underlines the patience and dedication needed to achieve improvement.

You ask, "How many days before I may notice a difference?". I too wondered that and discovered the answer is "weeks or even months". I still get frustrated by slow progress but trusted the advice of the well informed people here and now understand there is no quick fix!

But...fix there is!!

You will also find valuable advice here about the various supplements needed to aid progress...just keep swallowing those and notice the difference!

You will get the best possible advice here ( I don't presume to advise..I just waffle on a bit!!) follow it, be very patient and time will do the rest!

Best...

DD

[silverfox7]

Not added T3 but when I started on NDT was told the main reason for splitting was to get used to the T3. Was very good at splitting as first but then feeling better I started to miss the odd dose as was busy just living so after that became a problem I took it all at one and was fine and never looked back. Plus it makes it easier to fit other things around it. Make an effort though to split and try to keep going on a split does asking as you can first.

[MissFG]

Can I ask how you got a prescription for T3 from an NHS Endo? I’m very interested.

Btw I tried splitting my dose and it just didn’t work as I sometimes graze during the day to keep my energy levels up. I take mine first thing then wait an hour before having my morning coffee etc. I tend to take most vitamins in the afternoon (mainly cos some are quite big so can feel like they stick in my throat with having swallowing difficulties and some at bedtime with my pill.

Remembering to take them all is the pain!

[AliF in reply to MissFG]

It was surprisingly easy to get. Took me about 3 years to get a referral to an endo but once I saw him he suggested I might need some the first time I saw him.

[MissFG in reply to AliF]

Mine did too however it was red lighted so restricted then became black listed so impossible. Although with the new guidelines my CCG said if I have a clinical need I should be able to get it on prescription.

I’m now waiting for my hospital to lift the blacklisting and so I can get it on the NHS.

[AliF in reply to MissFG]

It does appear to be rather hit and miss. I can only get it from the hospital pharmacy. I have a couple of months supply and have to call them when I need more so they can order it in. All I can say is keep pressing if you don’t feel well on Levo and think you may need a little T3. Consultants can prescribe and it is certainly allowed and definitely not banned. It’s just that they don’t like giving it out because it costs a lot more than Levo as i’m sure you know. Mainly because of poor NHS procurement.

[MissFG in reply to AliF]

I’ve been on T3 over a year. Wasn’t converting well hence the clinical need and felt terrible on levo so it gradually dwindled and so me and Endo agreed to just remove the small dose I was on last June.

Unfortunately it’s very difficult to get on the NHS as many on here will agree. Maybe they’ve prescribed it due to the new guidelines published in January.

I’m also on 37.5mcg so potentially would cost a lot more each month approx £483pm and I’m still tweaking my dose. But I agree I will continue putting pressure on but do have a supportive Endo but it’s the hospital who have blocked him from prescribing it which is unbelievable and he’s certainly not happy about this either x

[Aurealis]

You may get no benefit from T3 in 5mcg doses. Some of us feel that it has no impact unless in larger doses, but you’ll be able to see when you start it, and adjust appropriately when you see how T3 affects you.

For instance, 10mcg taken in the morning may resolve your early morning problems quite quickly. You may get a different response to two doses of 5mcg - 5 mcg in the morning may not touch your early morning problems.

[AliF in reply to Aurealis]

Useful to know. I have taken a split dose this morning. Wonder how many days before I may feel a difference ?

[Aurealis in reply to AliF]

Three weeks for me, but it varies

[Stourie in reply to AliF]

7 years ago I saw a Dr Skinner and he said to start on 10 mcg of t3 then after a week to up it to 20 which did. I felt a difference within a few days. Now on t3 only. Jo xx

[Lu-ck]

Pleased for u getting T3 from NHS endo. My TSH,T4 & FT3 are almost identical to yours and I had a struggle to get GP to up my Levo from 75mcg to 100!!

Such inconsistencies in NHS service makes this condition so much more complex for hypo folk to deal with on top of already feeling crap!!😪

[AliF in reply to Lu-ck]

It took me 3 years to get a referral to an endo and it came via a consultant rheumatologist who could find nothing that she could or should treat me for in her field. I tried increasing my dose. No improvement. Keep trying. Ask to see an endo.

[Lu-ck]

Thank u for sharing that info. I increased my T4 myself but FT 3 ( done privately) still only 3.5 (3.1-6.8) in desperation I sourced T3 for myself. 3 weeks on 1/4 tab (6.5) and now taking half tab. Cut with craft blade!! Starting to feel I can get some QOL back. 😄