I started Tiromel at 6.25mcg about a month ago due to lowish ft3 and extreme cold intolerance and low body temps.
Over this month I now reached 18.75 mcg of which I took my 5th dose this morning (currently once a day no splitting). The last 2 days I felt some difference for the first time. Not that cold intolerant like normally and feeling warmer.
Regardless, my morning body temps stayed unchanged at 36,2 degrees.
Question: Can I up to 25mcg before retesting ? And is it normal to have better days and some bad days with more symptoms again when starting to find your optimal dose ?
thanks
Written by
Philipp_Winsel
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Personally, I would stay on your current dose for now and retest 6-8 weeks after you increased to 18.75mcg.
Have you also changed your dose of Levo?
Remember to do your test as early as possible in the morning, fast overnight (just delay breakfast on the day of the test but you can drink water) and it's important to take your last dose of Levo 24 hours before test, and last dose of T3 8-12 hours before test, even if it means splitting and altering timing of your thyroid meds. If you leave different time gaps you won't have an accurate result of your normal circulating hormone levels.
If you take a B Complex containing Biotin, or Biotin as a stand alone supplement, then leave it off for 3-5 days before test.
So how should I take my T3 the day before the blood test ? If I normally take one dose in the morning that would be 24 hours. If you say I should split the day before that will be hard because my tablets are 25mcg and splitting 18.75 will be not possible really.
I normally take my T3 all in one go, with my Levo, before I get up in the morning. I know I will do my test at around 8.30am. The day before I split my T3 into 2 doses - 12.5mcg and 6.25mcg, it would be difficult to split 18.75mcg into 2 x 9.375mcg. I make sure I take my first dose of T3 and Levo at 8.30am and I take the second dose of T3 between 9pm and bedtime.
One more thing I'm curious about is Vit D3 supplements. Normally I take it with breakfast 1 hour after taking T4+T3. Is it ok or do I need to take it further away from Thyroid Med's ?
As you've only been leaving it an hour, it may be affecting the absorption of your Levo and T3. Follow the guidance and start taking your D3 4 hours away from your thyroid meds. Good reason to wait 6-8 weeks now before retesting as it might make a difference.
And can you explain why I should take T3 12 hours before ? Why not just taking it 24h before so I see where my through levels are ?
Because my blood levels at 8am for example will be lower when taking it once a day normally vs twice a day the day before the blood test so my results will be false ?
Many people need divided doses of T3, they experience symptoms if they go too long between doses, in effect they need a "top up". Some of us are lucky enough to be able to manage without any noticeable symptoms by taking one dose in addition to our Levo, maybe because some of the Levo converts to T3 and we still have some natural conversion even though we're taking T3.
The level of T3 will vary throughout the day, whatever time you take your T3.
T3 peaks in the blood 2-4 hours after ingestion. It has a half life of 24 hours so there will still be plenty in the blood after the peak even though it is beginning to fall off. Taking a second dose adds to the amount that is falling after the peak of the first dose, so testing 8-12 hours after last dose of T3 would be classed as the normal circulating hormone which is why that gap is suggested before blood draw.
But if I normally just take one dose per day and just the day before the blood draw I take two doses my normal circulating hormones will be different on the day of the blood draw vs my normal routine ?
You are not taking 2 doses the day before. You are taking 1 dose divided into 2 halves, that will even out the amount of T3 you take in one day. This is what is generally advised here. Whether you wish to follow that suggestion is your choice. But bear in mind that if some takes one dose 24 hours before blood draw, there will be a false low FT3 result which may mean the person increases their dose of T3 where it's not warranted.
Yes it’s a divided dose of my normal dose but the T3 left in my blood when taking the blood next morning will still be higher than it would be when taking T3 once a day so the blood test result will show a false results/will show more FT3 than I would normally have when dosing once a day ?
the blood test result will show a false results/will show more FT3 than I would normally have when dosing once a day ?
It's not showing more FT3 than you would normally have, you will have the same amount of FT3 however many times you divide your dose of T3. But it will give a more accurate result to base your dose on.
If you take a look at the reply by Singoutloud in this thread (6th reply down)
you will see she is saying exactly the same as I have said here, only the member is taking NDT, and the reason for splitting the dose is because NDT contains T3
Maybe just the day before the blood test you can take split your first to give you a more accurate blood test results.
So you will see that this is the advice generally given, as I said, and again you will have to make up your own mind what you want to do.
Regardless, my morning body temps stayed unchanged at 36,2 degrees.
If you have had a low body temperature for a long time your body temperature may stay low permanently. It is impossible to predict which people with a thyroid problem will have a temperature that returns to "normal" and who won't.
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