T3 Advice

[AliF]

I started taking T3 back in May. I dropped Levo from 100 down to 75mg ( cutting tablets with a pill cutter) and am taking 10mg Liothyronine ( also using a pill cutter)

I think I am feeling a little better although still not great and have days when I am exhausted - which can last a week sometimes.

I have had the results of a blood test from about a month ago. My endo read me the results over the phone.

T4 12.4 ( range 10.8 - 25.5)

TSH 0.3 ( 0.2 - 4.2)

T3 4.6 ( 3.1 - 6.8)

The endo has suggested I double the T3 and split it twice a day 10mg in the morning and another 10 later in the day. He says that is the maximum he can give. He has left levo at 75. He also said this may tip me over the top but to have another blood test in 6 weeks.

Haven’t started on the new regime yet. Taking it twice a day may be tricky if 2 hours after eating and 1 hour before. Not because I am always eating, just because I have to remember while I am at work, and sometimes out and about!

Any advice, tips or general suggestions gratefully received.

[SeasideSusie Remembering]

AliF

It would be better to increase T3 in 5mcg increments, rather than double your dose at this point.

Also, you might be one of those people like me, and some others on the forum, who need a FT4 level higher in range than yours which is very low. After much tweaking of Levo and T3 doses over many many months, I eventually discovered that I'm best when both FT4 and FT3 are around 75% through range. I couldn't function when FT4 was very low in range.

Don't let your endo dose by TSH, when taking T3 it's the FT3 result that is important, as long as that is in range you aren't overmedicated.

[AliF in reply to SeasideSusie]

Thanks Seaside Susie. I was taking 125mg levo a while back and still felt rubbish. Not sure if my T4 was much higher even then. I think, with the emphasis on think, that I am a little better at the moment. Could just be the summer though.

If I increase 5mg at a time should I take that in the afternoon rather than all in one go in the morning ?

[SeasideSusie Remembering in reply to AliF]

AliF

You'd need to experiment and see what suits you best.

I started off splitting the T3 when I first added it to my Levo. I got fed up of trying to fit the second dose around food, etc, so I started taking it all in one dose early morning. Personally I found it made no difference for me, but other people seem to need to split the dose.

[AliF in reply to SeasideSusie]

I did start splitting it and then, partly because of your advice 3 months ago and partly because I too got fed up of trying to take the second dose at the right time whilst on

holiday in China, I’ve been taking it all in one go and haven’t noticed any difference.

[SlowDragon Administrator]

If you find taking T3 makes you feel sleepy (it does for many of us) you could try adding 5mcg at or near bedtime. If that seems ok after week or so could increase to 10mcg

Keep an eye on FT4 in case it goes too low. Has it dropped since you reduced Levo dose?

[AliF in reply to SlowDragon]

Thanks Slow Dragon. Don’t think it’s the T3 making me sleepy. It’s me feeling cream crackered!

I tend to feel better late at night. But I always feel absolutely dreadful first thing.

Here are my results before I started taking T3 from a Blue Horizons test.

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 )

To the untrained eye ( mine!) T4 doesn’t look very different.

[SlowDragon Administrator in reply to AliF]

Yes FT4 is very slightly lower, but range is slightly different, so possibly not directly comparable.

Next test it would be helpful to get total T4 (presumably that was Medichecks or Blue Horizon)

Feeling worse in morning and better at night is likely adrenal. So keeping relaxed as possible, getting vitamins absolutely optimal, including daily vitamin C is often helpful

You might find trying taking extra T3 at bedtime is helpful

[AliF in reply to SlowDragon]

Thanks SD. I’ve always been more of an owl than a lark. It is a disadvantage in life. But waking up each day feeling like you’ve been run over by a bus, barely able to get out of bed, is no fun with a full time job. Maybe I should do a BH test again and check all the vitamins —again. Just gets v expensive even with the Thursday discounts.

[SlowDragon Administrator in reply to AliF]

Perhaps hang on and increase T3 by 5mcg for 6-8 weeks before retesting thyroid and vitamins

Yes, it all adds up in cost, 3-4 Blood tests per year and multiple vitamin supplements

[LAHs]

Hello Alif, regarding the timing of dosage if you are taking T3 I thought I would jump in because I am juggling this very same problem at the moment. Splitting the dose, most in the morning then a little bit more early afternoon would work best because of the short half life of the T3 (~8hours). However, I cannot do this because of guaranteeing an empty stomach then an hours wait mid day before lunch. This if fine when you first wake since by the time you have showered, fed the cats (and in my case the chickens - and killed the ants) its breakfast time and you don't feel any deprivation. Now the other side of this coin is that T3 can send your blood pressure (BP) up, at least that is what is does for me. As much as I would like to bump my morning dose of NDT (T4+T3+T2+T1) I cannot do this because of the increase in BP. The other effect is that exercise will use up your T3 and the reason I am juggling with this problem is that it is getting hot here (July, often >100 degsF) and it is best to exercise, mow the lawn, do all your gardening/shopping in the cool of the morning, so I am worn out by 12:00pm instead of my usual 4:00pm. So, I guess my answer for your problem is to take all of your dosage in the morning unless it affects your BP, split it or settle for being a bit more tired than you want in the afternoon.

[AliF in reply to LAHs]

I tend not to be too bad in the afternoon but mornings are horrendous. I also find that after I have been for my twice weekly swim I often come home and go to sleep on the sofa ! My bp is usually good and i’ve Just had my cholesterol checked which is also good so I think it may be a bit of trial and error as to when to take the second dose. Think I might start with 5 mg first then increase to 10 after a few weeks.