Success stories with T3 and T4 combination - Thyroid UK

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Success stories with T3 and T4 combination

Starlight1976 profile image

I've got Hashimoto's, diagnosed in January and take 100g Levo. My blood levels look great, don't seem to have a conversion issue etc. However, I feel the same as when I was diagnosed (albeit it with a brief spell of three weeks in February of feeling ok). I have fatigue, low energy, brain fog, weight loss resistance and low Basal body temperature. With each dose increase, I've noticed no improvement. Seriously if this is all Levo is doing for me I might as well not be taking in. Anyway, a couple of weeks ago I posted my results on here and it was suggested that I may benefit from a small, 5mcg dose of T3. With some help on here, I've managed to source a supplier and hoping to start when it arrives, hopefully, end of this week. I see lots of success stories with NDT (Stop the Thyroid Madness seems to love NDT) and also T3 only therapy but was wondering if anybody on here had any positive stories about adding a little T3 to their Levo. I know everyone is different but it doesn't half lift the spirits! :-)

14 Replies
SlowDragon profile image

There are many people on here on mix of mainly Levothyroxine plus small dose of T3. Often as 2 or 3 divided doses per day

Suggest you start with 5mcg waking and 5mcg mid afternoon. Retesting bloods after 6-8 weeks

Your vitamin D is still rather low.

GP will only prescribe to bring vitamin D up to 50nmol. Aiming to improve by self supplementing to at least 80nmol and around 100nmol may be better .

Once you Improve level, very likely you will need on going maintenance dose to keep it there.

Retesting twice yearly via

Vitamin D mouth spray by Better You is good as avoids poor gut function.

It's trial and error what dose each person needs.

Hi Slow Dragon, thanks for the reponse. I don't think I put the measurement for the Vitamin D, is is actually 77ng/ml, not sure how much that is is nmol. It was 11ng/ml when I was diagnosed. Eeek!

SlowDragon profile image
SlowDragonAdministrator in reply to Starlight1976

So that shows exactly the importance of putting the unit of measurement

77ng/ml is 192nmol

You need to reduce your vitamin D dose. You don't want level going higher

Conversion website

bessygo profile image
bessygo in reply to SlowDragon

Would too much D interfere with sleep? Just started 25 mcg T3 and I already have horrible insomnia. Dont know when to take it. Have been taking 25 mcg t3 and 75 mcg t4 at 11pm since I drink cappuccino at 7 to 8 a.m. plus a protein shake made from all veggies that has calcium etc. Was taking meds at 4am but thought that might be contributing to insomnia knowing I had to take my thyroid meds and waking up at 2am. I used to take meds in a.m. not knowing that food and supplements interfered. Yet maybe that's better since I feel taking thyroid meds at night may be contributing to insomnia.

SlowDragon profile image
SlowDragonAdministrator in reply to bessygo


Many of us need SMALL 5mcg dose 3 x per day

Not 25mcg in one dose

Every person is different

Personally I can't tolerate T3 in single or even two doses per day. I have to take as three doses per day at 8 hour intervals

I take 10mcg T3 at 7am and 5mcg at 3pm and 5mcg at 11pm

I found taking SMALL 5mcg dose at bedtime improves sleep. Many others on here say similar.

Vitamin levels need to be optimal

Low vitamin D and/or low B vitamins can contribute to insomnia

bessygo profile image
bessygo in reply to SlowDragon

I take 1/2 of a 5 mcg so .25 not 25 mcg at 11pm with T4, I am very sensitive.

SlowDragon profile image
SlowDragonAdministrator in reply to bessygo


Just read all your previous posts....can't see any vitamin results

You need vitamin D, folate, B12 and ferritin tested

These need to be optimal. Add results and ranges if you have them

bessygo profile image
bessygo in reply to SlowDragon


Ferritin ????

don't know

Iron73 (37-145)

B12 892 (232-1245)

Vit D 39.3 (30-108)

Zinc.7 (37-145)

Selenium216 (109-218)

Am increasing Vitamin D, decreasing selenium and my

Iodine: 234 (range 75-500)

SlowDragon profile image
SlowDragonAdministrator in reply to bessygo

So what supplements do you take ,

Do you supplement magnesium as well as vitamin D?

Magnesium can help improve sleep

B12 looks good

Ask GP to test ferritin at next test

Always take Levo on empty stomach and then nothing apart from water for at least an hour after.

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

Many take Levothyroxine early morning, on waking, but it may be more convenient and possibly more effective taken at bedtime.

Many people find Levothyroxine brands are not interchangeable.

Once you find a brand that suits you, best to make sure to only get that one at each prescription. Watch out for brand change when dose is increased or at repeat prescription.

Many patients do NOT get on well with Teva brand of Levothyroxine. Though it is the only one for lactose intolerant patients

bessygo profile image
bessygo in reply to SlowDragon

Thanks. Yes I take 200 mg of NeuroMag (Albion forms of magnesium found in OptiMag 125 plus Magtein ™ (magnesium L-threonate), the only form of magnesium proven in animal studies to cross the blood-brain barrier. ) plus there is 100mg of magnesium in my daily supplement. I have never seen ferritin on any of my blood labs. What is it? If my iron is within range isn't that indicative of ferreting? So I cannot have espresso with low fat milk 1 hr after taking medication? I'd have to wait 4 hours? Or is that just for supplements ? I fear my insomnia might be worse taking it at 11pm. Why I'd rather try in the am which I did for many years, taking it when I woke up then drinking coffee, eating breakfast and taking supplements. I had no clue. Would a vegetarian protein skake that has natural food based vitamin supplementation be something I could have 2 hrs after synthroid or would that need a 4 hr. buffer as well? The shake provides 15% calcium, 50% niacin, 6% biotin, 50% iron among others since it is made from spinach, kale, chard powders etc plus, carrot juice and other fruit extracts. I'd have to wait 4 hrs after to drinkn this? Bummer.

SlowDragon profile image
SlowDragonAdministrator in reply to bessygo

Probably a small amount of milk in coffee an hour after Levothyroxine is ok,

But perhaps the reason so many fund taking Levothyroxine at bedtime is more effective because its away from foods

If you do take in morning, make sure you do same routine everyday.

Shake with iron and calcium in, would likely be better four hours away

bessygo profile image
bessygo in reply to SlowDragon

Even if the iron and calcium are from FOOD sources? Oh well. Thanks

SlowDragon profile image
SlowDragonAdministrator in reply to bessygo

Yes, calcium especially

There are some foods and drinks that don't mix well with levothyroxine.

Drinks containing caffeine, like coffee, tea and some fizzy drinks, can reduce the amount of levothyroxine your body takes in. Leave at least 30 minutes after taking levothyroxine before you drink them.

Calcium-rich foods, such as milk, cheese, yoghurt and broccoli, can reduce the amount of levothyroxine your body takes in. Leave at least 4 hours between taking levothyroxine and eating calcium-rich foods.

Soya in food and supplements may stop levothyroxine working properly. If you regularly eat soya or take soya supplements your doctor might need to do extra blood tests to make sure you're getting enough levothyroxine.

Kelp (a type of seaweed) can contain high levels of iodine, which sometimes makes an underactive thyroid worse. Do not take supplements containing kelp if you're taking levothyroxine.

Many people on Levothyroxine find being strictly soya free including all soya lecithin, is beneficial

bessygo profile image
bessygo in reply to SlowDragon


Zinc is .7 and range is .5 - 1

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