Method for first retest on T3/T4 combo?

[FancyPants54]

Hello T3 users.

I have been on a combo of T3/T4 for 6 weeks next week and need to retest.

I currently take 100 Levo + 6.25 T3 when I get up and 6.25 T3 at 4pm.

I know to leave off Levo for 24 hours before the test. What should I do with the T3? It's 8 hours before the test isn't it? But do I still split the dose the day before and take the usual 6.25 from 4pm and move it to around midnight for an 8.30am blood test?

It's the split dose T3 that is worrying me.

The test can't come soon enough. I am on my knees, worn out and suffering. I felt a lot better at first though.

[SeasideSusie Remembering]

Last dose of T3 should be 8-12 hours before blood draw.

I take my T3 all in one dose early morning with my Levo, but the day before the test I split my dose and alter the time. I take the second dose 8-12 hours before the test. You could take your second dose anywhere between about 9pm and midnight.

[FancyPants54 in reply to SeasideSusie]

Brilliant. Thank you SeasideSusie . Hopefully I'll be back by the end of next week with fresh results for advice on what to add and where.

[jimh111]

Ideally the blood take should be about half-way between thyroid hormone doses to get a reasonable approximation of your average hormone levels. As an aside I've found the bedtime dose of L-T3 more helpful than the daytime one, so I would try switching to morning and bedtime doses. If you have to have the blood taken at 8:30 am then take your second dose just before bedtime and add maybe 10% to your fT3 result to get a better idea of the 'real' numbers. In any event it's important to monitor your response and not focus too much on the numbers.

[FancyPants54 in reply to jimh111]

Because of working hours we eat late in the evening so bedtime dosing isn't going to be possible on an empty stomach for me. But as I progress with doses and recovery, I might add in a small amount of T3 at bedtime irrespective of stomach situation, just because I would quite like to see if it helped me sleep better (i.e. quality of sleep rather than insomnia).

Response right now is at sloth level. It was much better at first, but I need to see what my T4 versus T3 levels are doing now to see what needs increasing. I reduced my Levo by 25 when I added in the T3. I'm feeling like that was probably a retro step at this point. But should be able to compensate with T3 hopefully.

[jimh111 in reply to FancyPants54]

Liothyronine is very well absorbed so you don't need a totally empty gut to absorb it. I don't think there have been any clinical trials in this area but I would have thought a couple of hours after a large meal is enough. Patients used to advise taking liothyronine with meals in order to delay absorption but I'm not sure whether this worked. You could also take liothyronine one hour before eating if this works out better for you. I take my liothyronine with breakfast (and bedtime) and this works.

[SlowDragon Administrator]

Moving the afternoon dose to 9pm for blood test 9am following day

I found out that dose nearer bedtime helped improve sleep because of adjusting my split dose timing day before blood test.

Use to do split dose at 6 am, noon and 6pm

I find it much better to do 7am, 3pm and 11pm

Once you get your results back, you may be able to add in 3rd split dose in evening

[FancyPants54 in reply to SlowDragon]

Oh gosh I hope I don't have to go to 3 split doses! I am finding the second dose very difficult with my lifestyle and it's causing me stress. Another dose would just be depressing. Because I feel so unwell and so weary all the time my working day has shifted to afternoon/evening when I might feel a bit better. So dinner is later and bed is late. I long to feel better than this. But I appreciate that I'm only on a small dose of hormone still. I'm hoping I can take it all in one dose of a morning eventually.

[SlowDragon Administrator in reply to FancyPants54]

Some can do single dose, but some can't

I found it essential to dose every 8 hours.

Waking dose is easy

Mid afternoon dose just means delay in afternoon cup of tea.

Bedtime dose ideally 2 hours after food

If sticking on only two doses, they may need to be 12 hours apart

[FancyPants54 in reply to SlowDragon]

It's a lot more impactful than delaying a cup of tea in the afternoon for me. I need to eat at 3.30 but can't eat until 5pm. Then dinner is late evening so usually less than 2 hours before bed. It didn't used to be like this but this is what being ill has done for me. I don't want to eat before about 11.30am for breakfast. If I eat before I just can't get moving. If only it were just a cup of tea.