T4/T3 morning dose time

[mistygrey]

Hi

I usually take my t4/t3 first thing in morning with another 5mcg dose of t3 around 3/4pm. I spoke to another lady in the Thyroid UK Group who has said she takes her t4 first in the morning then waits an hour before taking her first dose of t3, then the last dose of t3 around 3pm. She was advised by an Endo to do this and said she feels better, but she said she doesn’t avoid food around the t3 morning dose and that it’s an hour away from her t4 dose (so no food with the t4)

Would this be ok try? I suffer with Morning IBS and trying to figure out if it’s my meds. I thought you had to take all thyroid meds t4 and t3 away from any food for at least an hour so not sure how this works for the lady I spoke with.

Thanks for any advice

[MaisieGray]

Paul Robinson and those who follow his protocol believe that you don't need to separate T3 from food or drink. I don't worry too much about it, and it doesn't seem to be a problem for me. I take my T4 at night so generally it's taken away from food. More recent research has shown that the old guidance of taking Levo in the morning isn't necessarily accurate and that in fact there can be benefits from night time dosing. If you have morning IBS problems nighttime T4 dosing might be an option; and as T4 has a far longer half life than T3, and T3 is faster to take effect, there is no need to take them together. But the only person that can judge how you need to take your meds is you yourself, by trial and error.

[mistygrey in reply to MaisieGray]

Hi Maisie Do you take your t4 and t3 separately? And what times? Do you eat with t3?

[MaisieGray in reply to mistygrey]

mistygrey After 9 yrs of taking them together in a single dose, I now take a single dose of T4 at night, and split my T3 x 2 during the day. I can then take 3 other meds in the morning. But I also take a beta blocker 4 x daily which interferes with thyroid functioning, and it's nigh on impossible to keep my T3 away from the first three meds and the four lots of betablockers, as well as avoid food and drink. So I often double up on the betablockers to avoid the T3 as far as possible, and have a relaxed attitude to food and drink. (For my first 30 yrs of mono T4 I slugged it down with coffee and took it whenever - and never felt better lol; but then the menopause came along .....)

[Hennerton]

I never bother about food and T3. It makes no difference how I take it but I always wait about 45 minutes to eat after Levo. When I first started taking T3 and my body was not sensitised to it, the effect was dramatic. I could feel the effect in about twenty minutes, even straight after lunch. Sadly I no longer get that quick hit from it but it is still an amazing help.

[Hennerton]

Why did you change from NDT? I tried it but could not get on with it, which was hugely annoying as I had bought a huge batch from the USA.

[SlowDragon Administrator]

My endo recommends 3 doses T3 per day (certainly is the only way i find works well) - every 8 hours

On 20mcg T3 daily - 10mcg waking, 5mcg 3pm and 5mcg bedtime

Levothyroxine at bedtime

I find Levothyroxine at bedtime much more effective than morning. Changed to evening on endo recommendation almost 10 years ago

verywell.com/should-i-take-...

Other medication at least 2 hours away, some like HRT, iron, calcium, vitamin D or magnesium at least four hours away from Levothyroxine

Professor Colin Dayan also mentions ideally splitting T3 dosing into 2 or 3 doses in this paper

ncbi.nlm.nih.gov/pmc/articl...

[mistygrey in reply to SlowDragon]

Would it be ok to take t3 near to food then do you think? I may trial it an hour after my t4 and see if this helps the IBS in the morning that I have

[SlowDragon Administrator in reply to mistygrey]

I avoid food. T3 waking and cup of tea an hour later.

3pm (2 hours after lunch and hour before cup of tea)

11pm - nothing except water for a hour before

Only change one thing at a time

Perhaps try Levothyroxine at bedtime?

[greygoose]

It's always being said, by one person or another, that it's ok to take T3 with food. I would suggest that it depends what that food is. If it was cheese fondu washed down by copious cups of strong coffee, then I doubt you would absorb any T3. If it's a slice of toast and jam (no butter) and a cup of weak tea (no milk), then there shouldn't be much problem.

We often see people on here saying they take their T3 with food, with no problem. Well, nobody's suggesting their heads are going to explode - which is my idea of a problem - but how much of that T3 are they actually absorbing? Often when you look at their FT3 and compare it with the size of their dose, the conclusion often has to be: not much. You might end up taking a lot more T3 than you would need to if you took it away from food. And, given the price and availability of T3 at the moment, that's no mean consideration.

Just something to think about.

[Hennerton in reply to greygoose]

I understand exactly what you are saying but we all speak from our own experience and we are all absorb thyroid medication in different ways. That is why the whole question of dosing and medication is such a minefield and why we are all here trying to help and give our view. I am very thin, cannot put on weight and a little medication goes a long way with me. Maybe weight has got something to do with absorption ability. Who knows? I certainly don't. Sadly, it is all guesswork in the end...

[greygoose in reply to Hennerton]

Absolutely. But, as I said, it was just something to think about.

[Hennerton in reply to greygoose]

Interestingly I just searched out a leaflet from a packet of T3 and the instructions do not give any specific info on when to take, whereas my Levo leaflet specifically says half an hour before food and another ( Teva) says at least half an hour and preferably an hour. So even they cannot agree but I have looked at various T3 packs in the past and have never seen anything other than the nonsense, discussed here recently, of dissolving it in water if taking a smaller dose.

[greygoose in reply to Hennerton]

I would imagine they don't really know. When in doubt, say nothing.

[SlowDragon Administrator]

If Levothyroxine seems to be causing IBS, are you perhaps lactose intolerant ?

Teva brand of Levothyroxine is lactose free, but many people don't get along with it. Many hate it, a few love it

Or it could be the filler in current brand? Which one do you take?

thyroiduk.org.uk/tuk/treatm...

[mistygrey in reply to SlowDragon]

Hi

I don’t think it’s the brands of meds I am using as I am on both henning lactose free t4 and t3 so it’s really confusing what’s going on!

[SlowDragon Administrator in reply to mistygrey]

Then perhaps try changing Levothyroxine to bedtime. See how you get on.

Just move the morning dose to the evening before

[Dunkenb]

I take my t4 and first lot of T3 together when I get up. I then take T3 every 6 hours as I find it starts to drop off rapidly if I leave it longer.I’d prefer to not take the t4 at all but my Endo nags if I don’t ( I don’t convert it hardly)

[mistygrey in reply to Dunkenb]

How much t3 are you on? Yes I find that it does drop off too