Should I lower T4 as I increase T3?: On Thursday... - Thyroid UK

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Should I lower T4 as I increase T3?

FancyPants54 profile image

On Thursday of this week I will have been taking 125mcg Levo and 6.25mcg T3 for 2 weeks.

I want to increase the T3 at that point. Should I decrease the Levo at the same time or hold it steady?

So far the addition of T3 hasn't made a lot of difference. The first day I felt an anxiety and wired feeling about 15 minutes after taking the meds, which lasted for 1 hour. It wasn't pleasant but it wasn't too bad either. When it wore off I had a little more energy for the day and felt OK. Since then I've not felt it at all. There may be a small amount more energy in the morning, but it's minuscule.

My blood results are listed under my profile.

11 Replies
SlowDragon profile image

Are you going to add second dose of 6.25 as separate dose in the afternoon, say about 4 or 5pm

I think I would leave Levothyroxine at current dose and see how you get on

Then retest full Thyroid and vitamins 6 weeks after this. Before considering adding a third dose

When testing, make sure last dose of T3 is not more than 12 hours prior to test (so move 2nd dose later in day to about 9pm just on the day before test, assuming testing at 9am next day)

I wanted to try adding the new 6.25 to the morning dose. Dosing in the afternoon doesn't fit very well with my work/eating processes.

SlowDragon profile image
SlowDragonAdministrator in reply to FancyPants54

Personally I think that's a very bad idea......most endocrinologists recommend split doses

Initially just 2 doses

As total per day increases - 3 split doses per day (waking, mid afternoon and bedtime) That's a dose every 8 hours

You may eventually find you can take as single dose, but you may not. Many of us need regular small dose

I have been on T3 almost 18months. After a year on 3 split doses, (10mcg waking, 5mcg 3 pm and 11pm) I recently tried reducing to 10mcg just twice was dreadful

I know others on T3 have found the same

So to begin with, split dose is probably best option to try .....yes I know it's a pain to avoid cup of tea etc for an hour after!

SeasideSusie profile image


With these results


Blue Horizon Medicals

Taking 125mcg Levothyroxine a day

TSH 4.04 (0.27 - 4.2)

FT4 18.5 (12.0 - 22.0)

FT3 4.1 (3.1 - 6.8)

If they were mine I wouldn't reduce my Levo. That's because I know that I need my FT4 75% through it's range as well as FT3. You have to find your own best levels so only change one thing at a time. If it was me, I would increase my T3 to 12.5mcg and see how it goes then retest in 6-8 weeks to check levels before changing anything else.

Thanks SeasideSusie. Would you split it? SlowDragon is recommending a split. I had hoped to avoid that. I did Paul Robinson's Recovering with T3 in the past (didn't recover and did become over medicated) and I hated all those small doses. I know some take all their T3 at once. Or is it just better to split it in the beginning?

SeasideSusie profile image
SeasideSusieAdministrator in reply to FancyPants54

I think it's a case of try and see what suits you best.

I started off splitting my dose when I increased to 12.5mcg. I stuck it for a certain amount of time but got fed up of having to time it around eating and a cup of coffee that I started taking it all in one dose. For me I found no difference but some people do benefit from split dosing.

Is the cup of tea/coffee thing just because of the caffeine? I only drink decaf drinks anyway so perhaps that wouldn't matter. More problematic is that I can't eat "lunch" until after the post and couriers have gone each day, so that's about 4.30pm.

SeasideSusie profile image
SeasideSusieAdministrator in reply to FancyPants54

I don't know if it's to do with caffeine, all I know is that Diogenes once mentioned in a post that coffee affects TSH. Unfortunately the search facility isn't very sophisticated so I can't find the particular post.

Just because most endos recommend splitting the dose, doesn't mean it's a good thing to do. Most endos know nothing about thyroid. And, with such a small dose, it will mean that you won't be flooding the receptors, the way Dr John Lowe recommended.

It does depend on the person, of course, and how long you've been hypo. But, if you were hypo for a long time before diagnosis, and you probably were because you got 'diagnosed' wit ME, then a lot of receptors will have been shut down, and won't open again until there's enough T3 in the blood at any one time to flood them.

Myself - I probably have hormone resistance at a cellular level - I take 75 mcg all in one go in the morning. But, I had to experiment for a long time to find that that was what was best for me. And, I'm afraid, you will have to do the same. But, I don't think it's necessarily a bad idea to add another 6.25 mcg to your morning dose, and avoid splitting. You just have to try it and see. :)

Thank you.

I don't think I will split it to start. I think I will try the half a tablet first thing with the Levo and see how I get on. I can always split it if I can't settle on it. I could really do with a boost of energy in the mornings. I'm not too bad in the later afternoon and evenings.

I don't have ME. You are thinking of someone else. But I am pretty sure I've been hypo for years and it's slipped under the radar.

Oh, I'm so sorry! Yes, someone else I responded to said she had ME, I was getting confused. :) It does get a bit confusing sometimes.

Yes, you're right, you can always split it at a later date, if taking it all at once doesn't suit you.

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