Working progress adding in T3.....could use some advise again please?

[Gillybean1]

Hi again,

Im 4 weeks in to adding T3 to my NDT (im DIO2 pos + Hashis) have dropped my AM dose of NDT down from 1 1/4 grain to 1 1/8 grain + 2.5mcg T3 keeping my afternoon 1/2 grain dose NDT, im now 4 weeks into this protocol with new blood test results today of:

TSH 0.02 (0.27 - 4.2)

FT3 4.63 (3.1 - 6.8)

FT4 17.4 (12 - 22)

My question is should i wait 2 more weeks to adjust the T3 dose increase? Or do i drop the morning NDT down to 1 grain and add the T3 up to 5mcg ? Or should i keep the morning protocol i have, and adjust the afternoon dose by either reducing the 1/2 grain down to a 1/4 grain NDT and add 2.5mcg T3 or just add 2.5mcg T3 to my existing protocol? If that makes sense......

Bearing in mind when i kicked this off last month by mistake i split the T3 incorrectly into 5mcg instead of 2.5mcg in the morning.......felt awful.......cells probably didnt know what hit them !! I know i am extremeley sensitive anyway, so i am treading very cautiously, still feeling weak and tired from being undermedicated i presume, and foolishly trying to eat more (im starving) and realising sharply that i am trying to run before i can walk....my gut has been depleted for 9 years and i guess my body is naturally slow to wake up, it really feels like 2 steps forward and 3 back at the moment.

BP lowish and pulse a little high some days when i try to do too much, if i can call pottering about too much...... when i take my meds pulse is normal 2 hours later.Temp 36.2 am -36.8 through the day, and a bit all over the place with outside temp fluctuations currently.

Im thinking of closing the gap from a 6hr spacing of meds to a 5 hr spacing between AM and PM doses too, as it really dose feel like someone took the key out of my back 6hrs after morning meds......any thoughts?

Every best wish as always, G.

[silverfox7]

You have confused me a little so possibly confused your body as well. It takes a full 6 weeks to get each new dose fully into your body. So I think it's better that you stick to that testing regime but I feel you are or are risking complicating things more with taking about what else you may do so I think best if you slow down a little and only do one thing at the time or you will never really know or understand what your body is doing.

U.K. Ow and understand that we want to feel and get well quickly but things move very slowly in the Thyroid world and trying to do too many things at once often sends us backwards as it's more difficult to work out which tweak has been successful and what hasn't. So keep to the full six weeks between tests and only change one thing at a time. Better still post you next results after 6 weeks and ask for advice and outline anything you have changed when you started that 6 weeks. It much easier to see then what is works and whether you need another tweak or not. Don't look at it as taking forever but that each step is helping in a positive way plus you are learning to understand your body more. Once on the right track then improvements should follow.

[Gillybean1 in reply to silverfox7]

Hi Silverfox7,

Thank you for your reply, yes reading it back to myself maybe im not being clear , i thought i was being slow, ive done 1 thing,dropped off 1/8 of a grain of NDT and added 2.5mg T3 to my morning regime and done nothing else for 4 weeks and my blood test show my T3 levels have dropped down alot since the last one 2months ago and im feeling exhausted more than before,BUT i note having less of the T4 content in the NDT my skin is less yellow and eyes are brighter (billirubin levels fine) just dont have enough UMMFF ha ha if thats how you spell it, and my gut struggles with the lack of T3 in any quantity in the afternoon dose, hence my question.

Im starving and exhausted (my gut inflammation has always been the key issue and T3 and bone broth help imeasurably)

What i dont understand is some folk on here are increasing doses in 10 days, yet most are advising 6 weeks, im barely existing or coping and im only 4 weeks in and seem to be putting a strain on my adrenals by not being able to eat so much since my overall T3 has dropped in 2 months. Im 6 1/2 stone now.

Just wanted to know whether to add 2.5mcg T3 to my afternoon dose of NDT or whether to reduce that NDT dose down and add in T3?

Every best wish and thank you for taking the time, G.

[SlowDragon Administrator]

Personally I find three doses T3 per day with equal 8 hours gap between each keeps T3 levels steady

Are your vitamin levels optimal?

When were vitamin D, folate, ferritin and B12 last tested?

What supplements do you currently take?

Are you on strictly gluten free diet

[Gillybean1 in reply to SlowDragon]

Hi SlowDragon,

Thank you for your reply. Yes my Supplement levels were all good 2 months ago when i last posted nearer to higher end of range, i had to reduce my B12 a little ACTIVE B!2) as it was massively over and i was starting to get adverse symptoms which have now stopped, i take Fish/Coq10, Mg, B's,D, K, ACES, Zc , ProBio, HCL, stopped Ca as i eat alot of leafy green veg, and stopped my supplement drinks unfortunately back in Febuary due to an allergic reaction to rice.

I can only take low dose (empty half capsule out, stomach acid up 1 year on ,no longer hypochlorhydria) HCL because of gut flares, take bone broth daily (just brilliant) but my weight has plummeted further without supp drinks to 6 1/2 stone...im literally starving. GF 7 years, DF 5years (thinking of starting again) SF 5 years (so many supps contain this or rice...nightmare) Dont drink tap water,eat red meat 1-2 times a week for my iron, when i say eat....i mean v v tiny portions otherwise gut cant cope. I do best with food and digestion in the morning because thats when my T3 input is highest then digestion gets worse and worse, so that anything i try to eat subsequently causes pain/inflammation/nausea/vomiting.....then i cant eat anything next day..SO that was why my question was should i increase my afternoon NDT dose with 2.5mcg T3 to bump it up a bit, ? is it ok to do that now just 4 weeks into protocol,or do i drop the NDT down and add T3?

Im going round in circles, calorie intake 1200 - 1600 on a good day, the starvation is affecting my adrenals and blood sugar, but im consumed with fear as to which way to go or if its to soon, im so weak, my T3 blood test is usuall 5 ish 5 ish+, i admit this timing of trying this is rubbish at present with a current long term ongoing extreme stress on the homefront...but c'est la vie, we all have stuff.

Do you believe there is a cut of point afternoon or evening when you can take T3 ?

With such poor sleep at present, im not taking my 1st Meds till 8.30 -9am and i do much better taking at 7am really

Hoping you can advise,every best wish G..

[SlowDragon Administrator in reply to Gillybean1]

Well I found dramatic improvement when I moved timing of T3 to 8 hours gaps. Seemed to help adrenals

I take my last T3 at 11pm with majority of my Levothyroxine. My Dose regime is 25mcg Levo and 10mcg T3 at 7am. 5mcg T3 at 3pm. 5mcg T3 and 100mcg Levothyroxine at 11pm

It shouldn't make a difference splitting Levothyroxine....but it seems to for me

I couldn't get on with NDT

obviously everyone is different. I don't have such severe gut problems, just absolutely strictly gluten and soya free

Your gut is clearly still an issue

Which brand of T3 do you use?

Is it lactose free?

[Gillybean1 in reply to SlowDragon]

Hi SlowDragon,

The T3 is Thybon its been ok despite the corn starch, no lactose. There is however Lactose in the Nature Throid, but it microscopic trace and to be honest i never had a problem with dairy ever, but chose to give it up with this disease many years ago, i was thinking about introducing it again to get some different fats into me as im wasted, can no longer take coconut,sunflower,rapeseed or many of the nuts, just olive oil and cashew at present.

I guess you cant advise me on dosing or what to try next.... judging by your regime we are all beautifully different and i will just have to go for it and see what happens for me, before my time runs out. Your 8hr spacing re your adrenals is one for me to take note of.

Thank you so much for sharing,everything helps to make it a less lonely experience.

Every best wish, G.

[silverfox7]

Hi. I'm dropping off to sleep but I think you are mixing two things up, my apologiesif im miss understanding-it's been a long day. I think you are confusing increasing a dose with testing results. On Levo when starting out we add in an extra amount then wait 6 weeks to test on this new higher level if levels still show our levels are 't quite in the right place.

When we start out with NDT or Adding T3 to T4 then we need to get used to the T3 as our body isn't familiar with it and can get a bit over whelmed. Now with NDT instruction will probable say increase slowly, may.be by half a grain every two weeks and so in until we feel happy with the response but we aren't the finished article but need to then stay in this dose for 6 weeks and the time check whether is the right dosage or you need more or lesss in one method is in Levo and changing doses retesting every 6 weeks.

[silverfox7]

To go back to dosing I ended up taking all mine at once as I kept forgetting the second dose and didn't have any issues but then I heard a rumour that Thyroid S was slow release plus I've heard that again today plus never felt dose was more or less potent throughout the day so I'm now sure it must be correct so we are always learning as time goes on

[Gillybean1 in reply to silverfox7]

Hi Silverfox, thank you for taking the time to answer. Im like a zombie today with the outside heat increase so may make some typos.

Yes i guess i will just have to get on with it,trial and error for all of us by the sound of things.

As my T3 levels have dropped in 2months despite adding this new synthetic T3 to my regime, that i must need an increase sooner than 6weeks, i feel dreadfull, weak, and all other bloods are good. My skin looks less yellow too since the NDT T4 side is lower.

Thank you so much for replying,its less lonely.

Every best wish G

[silverfox7]

Gillybean it's the checking after you have been stable that is six weeks. You can add when ever you think you need to but don't do it sooner than 10 days after the last one as your body needs to stabilise a little otherwise you can easily end up taking too much. So having done that then wait 6 weeks to test. Remember as well now you are taking T3 that results will look very different. Once on the right dose for you TSH will be suppressed, FT4 can lower in its range but FT3 should be high in its range but never over.

[Gillybean1 in reply to silverfox7]

Hi Silver Fox,

Thank you for your reply. Im completely confused.... i thought before introducing T3 to any other meds (NDT or LEVO) that we tested before we start to get a base line, introduce the additional T3 keeping that dose the same for 6 weeks and retest, then depending on that blood test result ie low FT3 and how we are feeling, add the next small increase of T3....keep the same for 6 weeks and retest and so on ....until symptoms are stable and we are well. I thought introducing it T3 sooner than 6 weeks meant it may not have woken up dormant receptors? And run the risk of adding too much too soon?

Every best wish G

[silverfox7]

I've only ever used NDT besides Levo. I started my thyroid journey on NDT from the NHS and think I started on one tablet but ended up on two but that's nearly 40 years ago now. I then went onto Levo as a strike stopped my NDT in Canada but it's about 4 yearsago now I went back to NDT. I followed the STTM method so I took my lat Levo one day and started NDT the day after with half a grain but I think I was ultra cautious and took a quarter grand for the first two days. Cant remember the exact details now but I unversed at about 10 day intervals by half a grain. So I continued as per instructions inti I reached 2 grains and then I continued in quarter grains/day intill I reached three grains. I'd also had a tendency to forget the second dose so started taking it all at once fist thing.

Something wasn't quite right though. I could tell when my next increase was due but although I felt good I didn't think I was getting to very good but fortunately id started out knowing that if it took a bit long or I got it wrong I would have my Endo visit already booked.

So I went along. I'd been given a blood form to get my bloods done the week before so my Endo knew before I did that I was over medicated which is why I wasn't improving though I had stopped increasing aswell so to have my full 6 weeks on what I thought was my required dose. So he told me I needed to stop for ? days, can't remember exactly what now but then drop to 1.75. I thought that would be too much but he was spot on! I also found out being slightly over feels very much like slightly under! As I only needed a low dose then going from 1.5 grains to 2 I had missed my sweet spot! So that's how I did my switchover. I chose to go back on BDT-two reasons-I'd been on it before but also I didn't fancy adding T3 to T4, NDT sounded much easier to juggle with!

In theory you shouldn't need to add T3 to NDT. it should work as is but I suppose there could be the exception that proves the rule as the old saying says!