I take 5mcg of T3 at 5:00 am. I take 50mcg of levo at 6:00 a.m. Everyday around 8:30-9:00, I have chills, nausea, and internal shaking. Somedays, it subsides enough for me to move around the house, other days not so much. I spend the day in bed. Thoughts as to why this pattern is occurring? Thanks!
T3 timing question: I take 5mcg of T3 at 5:00 am... - Thyroid UK
T3 timing question
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Coachgeorge
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Oops, I made a mistake. I take them both at 5:00 am. I take my blood pressure med at 6:00. Not thinking clearly today. Sorry
You're taking your blood pressure med too close to your thyroid hormone. There should be a gap of at least two hours. I don't know if that has anything to do with your symptoms, but you are compromising the absorption of your thyroid hormones.
I’ll delay tomorrow. Even on days when I forget to take my blood pressure meds, I still have this pattern. I’m so frustrated
You're probably under-medicated. When did you last have an increase in dose?
The t3 was added on July 12th and my levo was reduced to 50mcg from 75mcg. I’m trying not to be dramatic but I feel like I’m dying. This is awful.
So, you've been on 5 mcg T3 about two weeks. You probably need an increase. I doubt just 5 mcg is ever going to be enough.
We tried to increase to 7.5 every other day but I got worse. I don’t know what to do. There has to be an answer.
No, you can't do that with T3. It has to be a steady, constant dose every day. Try taking 7.5 every day, now, and see what happens.
I've just been looking through your old posts. Are you taking any supplements at the moment? Vit D? Folate? Did you get your B12 and ferritin tested? Are you still taking the CBD oil?
All my vitamins are in the normal range. I just had ferritin done yesterday. I thought my results would be back this morning but I’m still waiting. Also had t3, T4, and tsh yesterday. I take one drop of cbd 2x daily. She had me use cbd for anxiety but now I’m wondering if it hasn’t been my thyroid the whole time.
Anxiety certainly can be a hypo symptom. But CBD oil is not a bad thing to take. However, it won't affect your thyroid, and it won't help with nutritional deficiencies.
Vitamins just being in the normal range isn't good enough. It's where in the range they fall that matters. The ranges are too wide. So, do you have your numbers: results and ranges?
Also, have you ever had your cortisol tested? Internal shaking sounds like an adrenal problem.
I’ll ask about adrenal tomorrow
OK, good.
What is done if it is an adrenal problem? I can’t take steroids
Let's cross that bridge when we come to it. Get the testing, first. 
Thank you. Symptoms are subsiding a bit. It makes no sense
As I said in another of your threads, symptoms come and go. The T3 is probably just taking effect.
Appreciate your help. This is a terrible disease. I previously posted that I used to get up, take my levo, and go on about my day. This was very unexpected. I had no clue
Well, that's the way it goes. It's also a very unpredictable disease. We have to take each day as it comes.
Just found your nutrient results. B12 and folate are good. But vit D is a bit low. You really should be supplementing that + vit K2-MK7 + magnesium.
Okay, I’ll try to get to the health food store tomorrow. I have an appointment with my doctor so I have to go out. How much K2-mk7 magnesium?
200 mcg vit K2 and about 350 mg magnesium. But, don't get magnesium oxide, sulfate, aspartate or glutimate. You want something like magnesium malate or glycinate.
Has your cortisol ever been tested?
Right now I’m back in bed and developing all over body tingling. I’m at the end of my rope
Hi George, I don’t think it’s possible to get well just by adjusting the dose, although that is the main thing, without question. I’d suggest that you establish a regular routine, get up at the same time each day, shower, have breakfast etc. Try to put in something you enjoy. Regular meals, rest, a bit of exercise, whatever you can manage. It’s a lifelong condition, thyroid, and waiting to feel better to resume life, in my opinion is unhelpful. I absolutely understand why you might feel like staying in bed, but don’t. Your muscles will waste away, and you’ll never be able to adjust your thyroid levels to suit a normal lifestyle unless you try to adopt the normal lifestyle (or as close to it as you can achieve) first. Write a list of things that need doing, however small, and do one of them a day if you can, but don’t do too much. I am sympathetic, honestly, but trying to help.
I’ve honestly been trying to do what your suggesting. Some days are better than others. I did a load of laundry this morning but got so sick I could barely stand. I’m so discouraged. It’s been 7 months
Just hang on in there, you will get better. Do something you enjoy every day, however small, to keep your spirits up. It does come right eventually, honestly.
I was hoping to get better and work part time. Doesn’t look like that’s going to happen.
Yes you will. Do you sleep well?
I sleep fairly well. Evenings seem to be my best time. That doesn’t make sense to me either as I take my thyroid meds in the morning. I appreciate all thoughts and suggestions as I try to figure this out.
What happens if you take your Levoat bedtime?
I’ve never tried but worth considering.
Some get better results taking Levo at night. I presume you’re taking T3 at 5am as a circadian T3 dose?
Sorry , what’s a circadian dose?
Why are you taking your T3 at 5am?
Doctor recommended and I was trying to take thyroid meds on an empty stomach.
I wonder if you need to ask to see an endo - I don’t think an endo would suggest beta blockers in your situation; current guidance says T3 shouldn’t be introduced by GPs; your GP may be operating beyond her area of expertise; and you feel really poorly.
I’m pretty fortunate with my doctor. I also have backup. My daughter is a nurse who works for one of the most comprehensive, prestigious medical practices in the US. She stays in touch with my doc and consults with her team weekly. Seeing an endocrinologist requires a referral from my doctor. At this point, I’d like to try and work through this with all of you, my doctor, and my daughter’s team. If things don’t improve with time, I’m going to ask for the referral. Make sense?
Your decision of course. However if she treats every symptom you’ll rattle (as we say on this side of the pond). There’s only one important thing really, how you feel. Good luck
Thank you. It’s a rough journey.
If it were me, I would get an endo. You don’t seem to be doing very well from what you report here. I am sure that your daughter is doing her utmost for you and that your GP is also very helpful. However, you seem to need more than the GP can provide. It may be time to bring in someone else to see if you can feel better. Just my 2 cents for what they are worth. Have a good night and hope you are able to rest .
I’ve been thinking about it this afternoon. I’ll talk to my doctor tomorrow. Thank you
Coachgeorge for what it’s worth, I’ve been hypo for about 15 years. Got up, took levo, got on with it. All fine no issues.
Then two years ago all that changed. But, I’m now about 5 months into trying Levo +T3. I started at 5mcg and no I’m at 25mcg T3.
I felt like you until I started T3. Just very unwell. Shaky, cold, nauseous, dizzy, odd pains, so many different and seemingly unrelated things. But they’ve gone. I now feel well (if a little weak still sometimes) all the time.
So hang on in there. Read everything you can on this forum and keep pushing for increases in meds until you get better.
Which you will 😉
Did you have trouble increasing the T3?
I had trouble starting on it. I had horrendous ice pick headaches so I came off it again after about a week. Then I restarted on a quarter tablet (so 1.25 mcg!!) twice a day, increasing by a quarter every three days until I got to 10mcg per day.
Each time I increased though, I had milder headaches. This lasted until I had stuck on 10mcg for a few weeks. Any increase since then have been fine.
I personally think my body was shocked at the presence of T3! 😂
What are you struggling with?
When I tried to increase, all my symptoms got worse. Forum folks thought I increased too much too soon. After taking 5mcg for a few days I tried 10. My doctor suggested 7.5 every other day but that didn’t work. Symptoms were still unbearable. I had a blood draw yesterday and am waiting on results. I see my doctor tomorrow. From what I’ve learned, my options are to continue at 5 for while then increase, or, back down to 1.25 and hold for awhile. I’m not sure what to do.
Do you have bloods? I’m absolutely no expert but your levo dose is quite low. So it should be you need an increase in both?
I also have found that it takes me 12-15 weeks before my levo settles completely. When I was on levo only, bloods would be taken after 6-8 weeks but I know from experience it took longer for my body to settle into it.
Keep reading here, and asking questions. I have a science background, medical research, so I thought I was fairly well informed until I got here!
Post blood results if you have them, read others recommendations of supplement and get started on them. Your vitamin and mineral levels will almost certainly be low.
Keep plugging away and you will get there.
With regard to the T3, I certainly found I struggled to tolerate it to begin with. And each time I increased I would get really strong heart beats (not really palpitations) for about an hour after I took my morning dose. That’s stopped now, again I think my body is getting used to it and settling down.
Taking every other day won’t work. You can do that with levo to end up with a dose that’s in between tablet sizes, but T3 is pretty short lived. Do you know what your bloods are for your levo? Assuming they’re good, I would maybe try half a tablet, so 2.5mcg twice a day and stick with that for minimum three days (that’s how long it takes to see the effect), then you can repeat up to the dose you were prescribed and stick for a while.
People are right in what they say, if you started on 5mcg and didn’t feel great, then increased after a couple of days, that too much too soon. T3 is very powerful and very quick to act in comparison to levo.
Do you have blood results?
I should get my new bloods today. It’s interesting as I was on 100mcg of levo when this started. My ft4 jumped so she backed me down to 75mcg. Then my ft4 Kept climbing . That’s when she backed me down to 50 mcg and added the t3.
At least you got T3! It’s a much harder task this side of the pond!
Post them once you get them and someone far more knowledgeable than me will keep you right.
I can only give you my experience but you’ll get all the help you need on here.
It’ll take time too - frustrating but you will get better 😉
Time seems to be the constant! Health care is a major issue here, particularly since we have an election next year. I’m pretty progressive in my politics but after learning what happens, in other countries, I’m very concerned about having one health care system. My doctor listens to everything I say and rarely denies me. She looks at my research and also does her own. I might just be lucky with her but I’ve had similar experiences before we moved to this state. I’m always amazed by what you all go through to get your meds. Scares me
I’ve been one of the lucky ones. I went private quite soon after my gp told me I had cfs. “Don’t think so” I thought.
I was lucky to be able to see Dr a Toft here before he retired - he trialled increasing levo and nothing happened. He then agreed to trial T3 and so here I am. I haven’t been back to my new private endo as i feel fine to adjust doses myself. Whether I can get my gp to agree to increasing my prescription is another matter! I’m going through tablets like crazy! Others have had it much harder and continue to. I do realise that.
A year ago I hadn’t yet seem Dr Toft and was down and depressed, watching life go by and struggling to implement the supplements etc recommended on here.
But time flies and here I am, almost back to normal and with a serious grip on my own destiny and a much, much fuller understanding of everything thyroid!
Keep going, you’ll get there 😉
Meant back down to 2.5 not 1.25
And, do you take the 25 mcg all at once?
No. It’s always been split. Now I take 15mcg at about 630am and 10mcg at 415pm.
What problems are you having?
SlowDragonAdministrator
Many of us MUST take T3 as divided dose
Have you tried adding 2nd dose of 5mcg about 8-12 hours after first dose
I find three doses per day at 8 hour intervals has by far best results
Initially I started on just 2 x 2.5mcg. Increased to 2 x 5mcg ....held at this and retested 6-8 weeks later
Dose was increased to 20mcg per day (10mcg at 7am, 5mcg at 3pm and 11pm)
Vitamins must be optimal
But we are all individual and it's only trial and error what each person needs
It appears that several people did the 2.5 twice a day and increased from there. I’ve never understood why I feel better the further I get away from dosing. I’m functional right after I take my thyroid meds in the morning for about 4 hours. Then, the symptoms rear up and I’m pretty sick for a few hours. Then, I improve in the afternoon and can be fairly stable and move around the house. Evenings are best. I’d think I’d be bad the further I get away from dosing. As I’ve posted before, it comes and goes. My doctor doesn’t understand, either. It’s a mess!
Hi coach,
I was having a similar problem. My endo told me you can divide the doses of T3 anyway you want during the day for maximum effect. It seems your body likes its medication all at one time. Are you splitting the T3 dose or dividing it up during the day?
Taking 5mcg all in the am
Why am I better the further I get away from dosing? I’d think it would be out of my system and I’d be worse
I think you’re just not well enough yet. I couldn’t find any rhyme nor reason to it either. I’m still experimenting with doses and will try slowdragon’s method next 😉
Be patient but most of all stick with something for as long as you can. It takes longer than you think to settle into a pattern.
(Listen to me - I’m just repeating what advice I’ve been given on here, isn’t that right @slowdragon, @paula6 and @greygoose! 😜
This is such a great group of people. The knowledge but more importantly, the kindness overwhelms me. Thank you
I think you are getting a lot of advice - and it must be very confusing. You will only know by trial and error.
I suspect that your body probably doesn’t like the initial hit of hormone, and once it adjusts you feel better. Maybe the T3 together with your T4 is too much for you.
What if you were to take your T3 later in the day? I take half of my T3 in the am and the other half at 3 pm - and it seems to help me by steadying out the dose. Also, thyroxine gets stored in your tissue - so it doesn’t really wear out over time if you take it regularly. I think skipping days is not a great idea. Your body may be reacting to the withdrawal of the T3z
However, you are not me - you will need to play with the timing of your meds to see how it works for you. I had to experiment over the course of two months to find the right timing and amount - and I’m still not there yet 5 months post TT.
It really is a slow process and very individual. What works for one may not work for another and so, take it one step at a time. Adopt a regimen and stick to it for a week and see how you do. Write down your symptoms and how you feel and then adjust accordingly . There really is no short cut for this and I know for myself I suffered a lot before I found a formula to almost work. I wish you all the best.
Thank you!!
Try averaging out the T3 total - so if you are on 5 mcg every other day, take 2.5 everyday. That way you have steady state and no up and down. Many people do not do well with alternating doses because the body is always trying to find its set point. My doctor started me on that and I was a mess and couldnt get out of bed not to mention constant crying.
So you set it yourself by keeping a steady dose. Maybe that will work for you.
Here here Greekchick !
Aren’t you a sweetheart! Have a wonderful rest of the day 🤗
You, too!
Cortisol has pronounced diurnal variation
We need most cortisol in morning and levels drop through day
Common to feel better in evening as we need less cortisol
That makes me feel better. If I’m getting enough cortisol in the morning then maybe my adrenals are okay and I just need to stabilize my thyroid meds. 🤞thank you
Improving levels of FT3 should improve cortisol issues
But it can be a bit "chicken and egg" to begin with. Your cortisol is low because your hypo and yet you can't tolerate high enough dose of Levothyroxine/T3 because cortisol is low
So it's common to need to increase very slowly
Daily vitamin C can help support adrenals
Good level of vitamin D important too
Didn’t know about vitamin c. My d is a bit low. Heading to health food store tomorrow for vitamins. Will add C. Thank you!!!!
Recommended to always get best quality vitamins you can afford....
Best options often online and at good price
healthunlocked.com/thyroidu...
Thank you.
Had this, ft3 peaks within 2-4 hours of taking the dose. Your body is getting used to it. My doc asked me increase by 2.5 mcg t3 every 2 weeks if no bad effects. Another Endo told me to go from 2.5 straight to 10 within a week, I felt amazing for a week and then I thought I was going to die with pulse 130 and anxiety through the roof! My ft3 was not even mid-range when I checked then, it was just increasing too fast. Slowly, steady, try not to panic, your body will get used to t3 eventually.
Coachgeorge• in reply to
So maybe, I try adding 2.5 around lunchtime?
• in reply toCoachgeorge
I am not sure to be honest, you need to try and see. For me personally I cannot split the dose, I feel super sick doing it - I crash, get stiff neck, get dizzy, tired, blurred vision. All at once - I feel alive! Add it for a day or two and see if it makes any difference. Some people split, some people take it all at once. But try not to go too fast, especially with any cardiac issues, you need to go ultra slow as your t3 is hitting your heart receptors first and gives you all these feelings.
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