Dear All. Thanks to the brilliant advice from people on the forum following my medichecks blood tests I am now using vit D spay, super B complex, magnesium and will be getting lozenges for b12 in order to optimise my levels for absorption of thyroid meds. I have t3 on order and will definitely take gradually (have also bought pill cutter). However I'm a bit scared of tinkering with my meds and need you to hold my hand. Is it best to wait until my vits are optimised? Should I buy a thermometer and pulse checker? And if so what do I need to look out for. Any advice would be much appreciated.
Introducing t3: Dear All. Thanks to the brilliant... - Thyroid UK
Introducing t3
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LiziBG
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Hi I’ve been watching your post waiting to see the responses. I’m really surprised you haven’t had a reply yet, so I thought I’d bump you back up the forum to see if it helps. Keen to see what advice you get. 🙂
I'm going down the route of adding T3 after years on levothyroxin only. I too have gone down the recommendations on forum, re pulse and temperature, and not sure if it's worth it! I have an old traditional glass thermometer for basal morning temperature - at best gone up 0.2 C to 36C (by mouth). Pulse has/does go up ( seen on Lloyd's Pharmacy blood pressure machine had for ages), but then I can feel this physically anyway. I went for gradual approach : lowered T4 from 133 to 100, added T3(Tiromel) by 3 doses of 1/8th 25 mcg pill first two days, then after two days two doses of 1/4 pill. This I do at c. 6am with levothyroxin, then other bit at 6pm. Tiromel is better crushed or bitten in mouth( it has fillers/coatings that hinder absorption) so does not enter digestive system so much. My vit/ mineral levels were reasonable tho need some additions/ maintenance: I also swopped D3, with K2(mark7), to drops again to avoid gut and Hashimoto's problem of comprised gut absorption, and lessened the 4 hour window before taking medication. Take other supplements after breakfast. Feeling better ( felt better first day then returned to aches/pains etc). Just lowered T4 to 75 and upped T3 tiny bit (1/8 pill) at 6am, but now trying to resist tampering till done first blood test. I use a craft knife as pill cutter not good, but keep bits to add up to 1/8 of a pill!
How on earth do you manage to cut a pill into eight pieces? Why not half a pill, or even a 1/4 is it really necessary to introduce T3 so slowly? This sounds really complicated 😭 sorry to hijack the thread!
It's just that the T3 I get from abroad only comes in 25 mcg - too big, so need to at least quarter it, no other choice at mo. The way my heart pumped at first it was a good job!
Thanks I’m hoping I don’t have to try T3 and Levo is suitable for me but I’m in the early stages of diagnosis so trying to learn all I can just in case. Adding T3 sounds like a nightmare!
T3 is the only active thyroid hormone. It is taken once a day, it is not a nightmare and it removed my nightmare of a journey on levo (inactive until it converts to T3 
I have been symptom-free since stopping T4 and taking T3.
Sorry Shaws I meant no disrespect 😭 . I mean sourcing T3 and monitoring my own health without the aid of a Doctor would be a nightmare for me. I think I’m kidding myself believing T3 isnt where I will end up.
I like the idea of having the active hormone rather than relying on all the variables that go with T4. I think I will be seeking your advice at some point in the future. I particularly like the idea of being able to increase the dose at two week intervals as opposed to waiting the mandatory 6-8. Kindest regards 😜
Can I ask why T3 comes in 25mcg if it needs to be divided into smaller doses? Or is that just because you’re on T4? If you were on T3 only would you start on 25mcg?
Fraid my guess is as good as yours rosserk but I would think your guess is correct. As we're already on levo we can't reduce it too much too quickly as this could make us feel pretty ill hence the small amounts of t3 to adjust gradually.
I get it from abroad, cheaply, and without prescription, so not much choice! And at mo I only need a small amount, thus chop up pill, perhaps down the line ( many months....) I might take a whole 25 mcg pill! But it would be cheaper to keep the NHS levothyroxin high, and privately bought T3 lower.
Agh I see didn’t think about cost. How awful we have to resort to this it’s absolutely disgraceful! Good luck I really hope it goes well. Maybe in a few months time I will be asking you how it’s going because I need to introduce T3. 😭
If someone switches from levo to T3, they just make sure the dose of T3 is equivalent to the T4 we were taking - some may prefer a slightly lower starting point.
I have switched from T4 to T3 with no problems and increased according to symptom I then gradually increased dose by 1/4 tablet (which can be done every two weeks) until I felt well with relief of symtoms.
Thanks Shaws that’s really interesting and a life line to someone like me at the beginning of this horrendous journey! Knowing there’s another avenue to explore if things don’t work out with Levo. It’s a struggle waiting 8 weeks at a time to get a dose increase but I’m determined to give it a good go before I take the plunge and switch. I can’t help feeling that had my Doctor started me on a higher dose I would have reached optimal dose much sooner.
I find it really difficult having to wait 6 - 8 weeks for a dose increase particularly when each time my dose has been increased I’ve felt better within a few days. As the symptoms are so instantly recognisable when they return it’s easy to know when I’m under medicated, it’s not a guessing game for me. The low heart rate, chest pain, severe drop in blood pressure and profuse sweating are really difficult to ride out for 4-6 weeks particularly when each increased dose relieved or elimated those symptoms so quickly.
I was diagnosed with extreme postural orthostatic tachycardia and angina three years ago, before being diagnosed with hypothyroid. My blood pressure would drop to 60/40 and at times I was passing out two/ three times a day. I put up with that for three years but after two weeks on a Levo it stopped, the angina disappeared and I was no longer sweating constantly.
T4 is inactive and has to convert to T3 and it comes in various doses.
T3 is the only Active thyroid hormones, so 25mcg is equal,in it's effect, to around 100mcg of levo. Some T3s come in 5mcg but it is easy to split 25mcg T3 into four quarters with a pill splitter.
Thanks Judith. It really helps knowing I'm not alone in this. I'm currently on 100 mcg levo and when I get t3 (cytomel 25mcg tabs) plan to reduce levo to 75 mcg and add a quarter of t3 tab to start with on the advice of greygoose on the forum. My plan is to up it depending on how I feel. Since going gluten free and taking probiotics (yogurt & yakults) I only need to resort to prescribed ranitidine occasionally for my acid reflux.Are you going to get a test for t3 only?
Not sure which test - might depend on what is on offer on Thyroid Thursday from Medichecks- prob do T4 and TSH too as will have reduced T4 by almost half.
Ah good idea. How long after starting the t3 are you leaving it before testing?
Sorry replied elsewhere- 6 weeks.
You’re not alone. My t3 arrived Friday. I’m also going slowly slowly route. Had base bloods this morning. So also did 1/8 of tab(20mcg). My Fitbit monitors resting hr. I’ll take that for few days and then add second 1/8 in afternoon.
My endo says my bloods are fine but conversion never better that 5 to 1.
Good luck.
P.s I had thyroidectomy and RIA.
Thanks Hay and hope it goes well for you.
Hi Hay. Thinking could you tell me what your pulse rate should be please.
Well 100 is thought to be tachycardia, but I suspect it would have to be over 100 lots of the time ie so 99 wouldn't count. Adding my T3 did give the odd 100, quite a few 90s....it's now settled 70s/80s but then years of illness have not made me fit, just added years!
You know that' s the thing Judith. I used to do a 2 mile walk every morning but know get knackered just doing the weekly shop! Thanks for the advice on pulse rate. Wish you well x
I don't believe Tiromel crushed or broken in mouth will be of benefit. The purpose is to get T3 into the stomach, where it will be disperse and has to enter the millions of T3 receptor cells. I don't think it is made for saliva to be in the mix. It should be taken on an empty stomach with one full glass of water.
Taking pulse/temp is just a guide because sometimes we do feel quite hot but taking temp will probably show we aren't too high. The same with pulse.
Also, one dose of T3 has to saturate our millions of T3 receptor cells and then it sends out 'waves' which lasts for between one to three days.
Thanks Shawn. This crushing / biting of Tiromel is what previous users had recommended due to their feeling it wasn't quite working as per dose( due to fillers etc)...one member said the crushing made it work c.15 % better ( I presume from blood tests before and after crushing regime). I don't hold the T3 bits in the mouth like under the tongue B12 etc but wash the bits down with plenty of water on an empty stomach as 6 am/ 6 pm. Yes for me taking/recording temperature / pulse is not really even proving a guide- suppose it's a bit of a comfort blanket for going it alone, feeling like you are being proactive while waiting 6 weeks down the line to get the ( private) blood test to show you are making some progress with T3. Yes heart/ chest does feel different at times ( which is why I prefer the hit of T3 in two smaller doses per day), but my ability to walk and pace myself throughout the day is already so much better - I know the T3 is proving advantageous.
I think we're following each other...our results are quite similar so interested in your journey 😊 Can I ask what you decided to do re telling your GP ( or not)?
Hi Janey . Yes we are following each other. Was at doc for something else last week and did not mention thyroid at all. I decided not to waste my time and energy as they can't prescribe anyway. Going by advice on my previous post the best I could expect would be referral to endo which could take months and even then not likely to get t3. Also looked into cost of private prescription which is too high for me to sustain. Someone very kindly sent me pm with how to source t3 myself. It's flaming ridiculous we have to do this ourselves but I'd rather go down the self help route and fail as not to try at all. It is a bit scary though but I'm so grateful to you all for responding to my post as I definitely don't feel so alone in it now 😘
I think I'm going to do the same...Just got a couple of questions to ask here first (in a new post). I wish you well xxx
Was it easy to get them? Would you pm me details please as keeping options open if it works as prescription from Germany route seems to have closed. There are other prescription routes but hate to feel like I’m begging doctors for script. 😳
Pm.ed you.
Dear All. Thank you so much to everyone who has contributed in this post. It is so good to share experiences with people who have either gone or are going through the same process that being to defy standard medical convention and seek our own help outwith. For me it feels like a very brave step and one that I am not taking lightly. When I was first diagnosed Nov. 2016 I did feel a lot worse than I do now. I hardly had the energy or wherewithall to get out of my PJs and get dressed and the brain fog and headaches were awful. I also put on over a stone in weight over a few weeks. So t4 has helped me but I still tire far too easily, have some quite bad days and I haven't lost any of the weight ( a symptom rather than a vanity thing for me). Thus I decided to get the private blood tests which have proven I have high antibodies, I clearly have Hashis and I'm not converting enough t3. Sorry to everyone for going on a bit if you're still reading but writing this and sharing with you has been very therapeutic for me. Wishing you all well.
It is good you know you have high antibodies. Hashimoto's is the commonest form of hypothyroidism and the antibodies attack the thyroid gland and wax and wane until person is hypothyroid. Going gluten-free can help reduce the antibodies thus the attacks too.
You can try to source your own T3 and add some to T4.
Thanks Shaws. Yes I am currently in the process of sourcing my own t3 and plan to add in gradually while reducing t4 gradually. I have been totally gluten free for 2 months. Also have started supplements to optimise my vitamin & mineral levels & taking probiotic drinks & yogurt. I was taking 2 Ranitidine a day as prescribed by GP & now only take when acid reflux really bad.
Some do fine on a T4/T3 combination. I have just looked at Ranitidine but are you aware that stomach problems are also due to hypo, which may mean we actually have low stomach acid but symptoms are very similar to high and GPs usually opt for high.
Most on the forum take tablets to give our stomach acid. I myself take Betaine with Pepsin tablets with each meal, espcially containing protein.
scdlifestyle.com/2014/08/th...
Some members also take a couple of spoonfulls of Apple Cider Vinegar with meals but I found tablets suited me better. Also if you are out and about it is easy to swallow a tablet.
Well I only became aware that the acid reflux was most likely due to low stomach acid recently after reading posts on this forum and other sites. Also the link to hypo. My GP made no mention of this to me and just prescribed ranitidine. Having now read that we need our stomach acid for absorption of thyroid meds & vitamins/minerals I have been really trying to wean myself off them. I will definately give the betaine a try, thanks. Since cutting out gluten and drinking probiotic drinks the reflux hasn't been as bad. Oddly, my sore, stiff knees haven't been quite so bad either...could there be a link there do you think?
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