First results after moving to T4/T3 combo treat... - Thyroid UK

Thyroid UK
101,150 members115,305 posts

First results after moving to T4/T3 combo treatment

Just received the results for my first blood test after incorporating T3 into my regimen:

100mcg T4, 18.75mcg T3


FREE THYROXINE 16.700 pmol/L 12.00 - 22.00

FREE T3 5.55 pmol/L 3.10 - 6.80

Here's the result from June on T4 only:

150 mcg T4


FREE THYROXINE 20.500pmol/L 12.00 - 22.00

FREE T3 4.44pmol/L 3.10 - 6.80

Any comments on the above ? Should I try adding a little more T3 to get it up to an even 25mcg tablet ? Or should I up the Levo to 125mcg ?

In terms of symptoms I do feel more normal but I have found T3 a bit of a rollercoaster at times - the biggest issue has been how to dose it.

I started trying to split it throughout the day but I was left feeling dead earlier on (air hunger, tiredness) so I've started taking it all in one go. This was a bit intense initially as I feel like I was on speed almost but it seems to have settled down.

In any event I can see why doctors are anxious about prescribing T3 - it's a much trickier treatment than T4 that's for sure.

14 Replies

T3 dosing isn't more difficult than T4. You don't need to split doses of T3 as some members do. It is recommended that a T4/T3 combination of 3:1 or 4:1 has found to be beneficial. You can take the combination dose together with one full glass of water and wait an hour before eating. Always take temp/pulse when introducing a new regime as sometimes we can feel quite hot but we find out that temp is around the same as before. If temp or heart rate increases too much, reduce dose slightly.

We feel great when we have a dose that makes us feel well again.

1 like

Thanks for the advice Shaws !

I'm still not sure which to increase though - the levo or the T3.


Shaws would you recommend the same advice regarding temperature and heart rate for T4 only?


Hiya whatevs,

I'm curious: what is prompting you towards an increase of any kind?


Hi roxanaleah,

Just some residual symptoms - like right now for example I've had my T3 this morning but I still have that 'spaced' feeling, like someones hit you in the face with a frying pan ha.

That comes and goes however and perhaps I just need to give my current dose more time i.e. 8 weeks maybe ?

I never have cold hands anymore though, so the T3 is definitely doing it's job there ! ha.



Do you feel warm?


Not overly no.


I agree that T3 is more difficult to dose than T4, but I suppose we are all different. I find that taking T3 in split doses helps me to refine dose across the day. Sometimes, rearrangement of the dose within a day is enough to bring an improvement without changing the daily dose. I wouldn’t increase to get up to a full tablet unless your instinct is that you need the extra. I wouldn’t increase Levo either. Follow your instinct, is my advice. I wonder if your air hunger will return if you split dose now? If you do, you may have to increase T3. Perhaps you need slightly more T3 but in split dosing?

Good luck


Hi Aurealis,

Yes I think it's definitely much trickier - the upside is that any effects are much more immediate vs T4.

I'll just play it by ear and perhaps try an additional 6.25 mcg of T3 then if I get any hypo symptoms.

Also I haven't been on T3 that long, only a few weeks really, so I may need to give it more time on my current dose.


Forgive the ignorance, but what is air hunger?

1 like

Shortness of breath effectively.


Thank you!

1 like

i have tried all different ways, and for me taking my t4 and t3 together in the a.m , then my second dose of t3 four hours later works best, i work 3-11 evening shifts, i have had a tt last October 2017, i would give your current dose more time as your labs aren't too bad , if your feeling better at this point.

1 like

I can’t say for you whether it’s better to add t4 or t3. But I will say I tried all sorts of different ways of dosing t3. What I found is when I’m on the correct dose I can take it all in the morning and have enough energy till the night. Splitting it made no difference when the dose was correct.

The rollercoaster thing subsides as your body gets used to it, but you’ll always tend to have more energy in the morning anyway.

Here’s my non-doctoral guess: if you’re able to take it all in the morning and you’re not getting tired in the afternoon, you’re not struggling to stay awake, you’re nice and sharp throughout the day, then try adding T4 to see how that works. If your body converts t4 which it seems it does, then it will be easier on you as you will convert it later in the day as you need it and it stores in your body for much longer.


You may also like...