HELP T3 guidance before doctor appt tomorrow.

[okaykay]

I started on 5mcg of T3 a month ago. I feel better and have no anxiety. I take 100mcg of levo also. What I have noticed is that my heart rate (which has been high for years) drops after I take the 5mcg of T3 to about 78-90 and 5 hours later it jumps back up to above 112-127. I take the liothyronine at 6:00am. I am going to ask for the doctor to increase the T3 and am looking for some guidance as to what I should increase it to? I have not had labs yet and am going to wait until we increase it to do labs. Should my levo dose be lowered? Should I do a split dose and go up to 12.5mcg 2x daily or add 5mcg to take in the afternoon? I have a better appetite, but I’m still to thin ::/... A month ago my labs were

free T4 was 1.4 NG/dL (.9-1.7)

Free t3 2.68 pg/ml (2.57-4.44)

TSH 1.63 iu/ml 0.27-4.20)

My free T4 on 75mcg of levo was

1.5 NG/dL (.9-1.7) back in May.

[humanbean]

What I have noticed is that my heart rate (which has been high for years) drops after I take the 5mcg of T3 to about 78-90 and 5 hours later it jumps back up to above 112-127.

This is what often happens when your body runs out of the T3 you've taken. If you get prescribed more T3 then I would suggest taking a second dose about half an hour before your heart rate normally starts rising again. Be aware that you may have to experiment occasionally to find out when that rise in heart rate occurs. When doses change other things change too.

I've read of people taking all their T3 at once. Some divide it into 2 doses, 12 hours apart. Others take the first and second dose 6 hours apart then go 18 hours without taking any more. There are no rules. You just have to experiment to find out what works best for you.

[okaykay in reply to humanbean]

Would you recommend spitting 25mcg or should I ask to add 5 mcg more?

[humanbean in reply to okaykay]

Sorry, I don't know enough about you, your health or your doctor(s) to say. You could ask the doctor for 25mcg (although if you live in the UK prescribed tablets are 5mcg or 20mcg), but don't be surprised if they refuse to offer a higher dose of any kind. Doctors are scared of T3.

[okaykay in reply to humanbean]

Thank you for your reply. I’m in the US and I did get an increase to 25mcg. I will ween it up. 😊

[humanbean in reply to okaykay]

I'd suggest going up by 1/4 of a tablet at a time, and leave anything from 2 - 6 weeks between raises, depending on your reaction to it. It's very easy to go up in dose too fast and miss your sweet spot. And that gets very confusing because being overdosed can share some symptoms with being under-dosed.

When I have become overdosed I've found that I become absolutely exhausted, and I know I'm not alone in this. This reaction is surprising to many patients, and many doctors simply don't believe it.

[okaykay in reply to humanbean]

Thank you!

[Judithdalston]

You have only been on 5 mcg dose of T3 for 1 month with 100 mcg levothyroxin, and not done a blood test...I would stay on same dose now for further 2-4 weeks and take bloods, or change dosage and wait another 6-8 weeks on that one change. 25 mcg of T3 is a huge jump up, you'd need to increase by perhaps as little as 1/8 th of one of these pills at a time say every 3/4 days. I added T3 earlier this year: many advised dropping T4 by 25 mcg for every 10 mcg of T3 added, so I added 25 mcg T3 slowly to 75 mcg levothyroxin over a month, waited 6 weeks then on that dose but experimented with timings. I took my T4 and half my T3 together at 5-6 am, with second half T3 about 5 pm,, but tried at bedtime, and 3.30 pm etc - experiment. My trouble was trying to get two lots of thyroid 'meds', other drugs, supplements and food and drink into 24 hours with necessary gaps after for eg taking iron. I had palpitations, high pulse and Bp, then as reached 25 mcg T3 dose nearly month in these dropped/stopped overnight and every thing became normal. What amazed me was my blood tests after 25 T3/75 T4 showed my FT3 dropped a bit, FT4 went down 10 points and TSH declined by almost x10. Forum members advised adding levothyroxin back again, so for last month gone back up to 125 mcg levo and 25 mcg T3. Symptoms mostly back to what they were before starting T3 15 weeks or so ago, accept I can walk and do 10,000 steps daily, but still ache all over and fall asleep/ nap during day. So doing a lot more exercise probably means I am using up more T3, but whether this should be from taking T3 direct or more from converted T4/levothyroxin ( I was always a poor converter) is to be seen. I certainly need more of something, but I have been hypothyroid for 12 plus years, and have had numerous related health problems including a fibromyalgia diagnosis....my advice is everyone is different, be patient and go slowly. Remember once you add T3 bloods will become somewhat meaningless, only FT3 will be relevant, but how you feel will take precedent- hope your doctor knows this! Hope your Vit D, B12, folate and ferritin were at optimum levels and became no maintained.

[SlowDragon Administrator]

You may need to split dose, certainly to start with

Once T3 dose is high enough, and body has got use to it, say in 6-9 months, you may be able to take in fewer doses

But initially divided dose is likely best.