How long does it take to notice a dose adjustment on T3?

[Agapanthus1]

And how long before the levels settle for a blood test for T3 please? Thanks

[SlowDragon Administrator]

6-8 weeks minimum

Personally I like to wait 10-12 weeks

Recommended on here that all thyroid blood tests should ideally be done as early as possible in morning and before eating or drinking anything other than water .

Last dose of Levothyroxine 24 hours prior to blood test. (taking delayed dose immediately after blood draw).

This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, best not mentioned to GP or phlebotomist)

If/when also on T3, make sure to take last dose 8-12 hours prior to test, even if this means adjusting time or splitting of dose day before test

[Agapanthus1 in reply to SlowDragon]

Hello 👋 and thanks. I have just started T3 and was putting it up slowly 2.5mcg every 3 days until on dose endo suggested. I am now on full 15 mcg divided into 3 but after a week feeling a bit over medicated- headaches, not sleeping well and pulse increased. I think I should drop it and increase it a bit more slowly. Any suggestions on how to decrease? I was thinking skipping 5mcg today then dropping by 2.5mcg every day for a week and see how I feel then? 😊

[SlowDragon Administrator in reply to Agapanthus1]

Suggest you either stick as you are, or (if you must) just reduce last dose by 2.5mcg ......if that doesn't help then reduce to just 2 x 5mcg 12 hours apart

Are your vitamin levels optimal?

[Agapanthus1 in reply to SlowDragon]

Yes thanks, vits are all optimal now and have been for a while. I was starting to feel really well but now just a bit over medicated. Will try what you suggest. It seems to take a week to notice a difference from increased dose so maybe was increasing too quickly? Thanks 😊

[Lalatoot in reply to Agapanthus1]

The advice generally on here seems to be increase by 5mcg every two weeks.

[Agapanthus1 in reply to Lalatoot]

Thank you. 😊 I haven’t done it like that as I didn’t know this at the time. My endo told me to drop T4 approx 40mcg for 7 days before and then start 3x5 mcg. I was a bit wary of doing it that way as I know I can react to new meds, so just increased it slowly every 3 days.

It’s all rather complicated as he is just giving me a trial and said it wouldn’t help me, so I feel I can’t ask him as he will tell me to stop the T3, and I will need to have a test soonish as he said😬

How are you doing on the T3?

[Lalatoot in reply to Agapanthus1]

Like you early days. Am feeling better than I did but long way to go. Only on second increase.. Endo wanted me to drop to 50mcg levo and start 20mcg lio right away. Well she gave no other instructions. So I ignored that. Am on 75mcg levo and 2 x 5mcg lio at the mo. It is a pain cutting the tablets!

[Agapanthus1 in reply to Lalatoot]

Good to hear you are feeling better tho! You are better than me-I’m a bit feeble when it comes to Drs! Have you just delayed having the test until you get up to the full amount? Ha ha yes it is a pain cutting tabs although I have a cheap pill cutter I got on eBay. 😊

[Lalatoot in reply to Agapanthus1]

Yes will delay. Will see how I feel. Might stick on 75mcg and 15 lio for a while and get bloods or will carry on to prescribed dose and wait 6 weeks. I'll explain some of what I've done with the reasoning when I next see the endo. Got to train them up! She's not too bad and she knows I go off piste but can argue why. We'll get there. Going out for cup of tea tomorrow with friends - first time I have done that in 4 months.

[Agapanthus1 in reply to Lalatoot]

Sounds like you have a good endo- did you go private in the end? Have a lovely outing with your friends. It must be great to be socialising again altho I find my well friends really don’t get it! 🙄

[Lalatoot in reply to Agapanthus1]

No I am lucky to live in Scotland so get T3 on NHS. Still isn't easy though as they don't like prescribing it and I had 4 years of struggling first on levo. Then I had to make my case from what I learned on here - I spoon-fed the argument to the GP and Endo. I am luck to have 2 friends that I've known for 40 + years and they get it particularly as they new me in my wild youth!!!! All the best.

[SilverAvocado]

Hi Agapanthus1, if you feel you're a little overmedicated, I would slow right down from how you adjusted before. You don't want to miss that sweet spot. I'd say it takes a week or two to first start feeling the change in dose, and then it slowly develops over the next couple of months. I think you need at least 6 weeks to be confident in how the dose is suiting you, and its better still to have 2 or 3 months. Probably at this point your not yet feeling exactly how you will once this new dose has settled.

My advice for your situation would be to reduce by 2.5 or 5mcg, depending on which you like the sound of, and then stay on the new dose for as long as you can, at least about 4 weeks but ideally 6. Then take stock of where you are and figure out whether you need to adjust again.

Bear in mind that if you've got a new Endo appointment booked and will need to do a new blood test you need to keep on a stable dose for 6 weeks before to have reliable results.

[Agapanthus1 in reply to SilverAvocado]

Thanks so much, this is really helpful 😊. I am feeling totally lost with the T3 thing, had no idea how to dose it, what to expect, or how long it would take to notice an improvement. I know some feel better immediately but I am definitely not one of those, sadly!! It is really helpful to know it can take 6 weeks plus to get the full benefit from a dose. I mistakenly thought that because you take it more frequently, the effects would be much quicker. It feels like my body is reacting quite strongly to it and I was even wondering if it is upsetting my adrenals after something I had read on STTM. Let’s hope not, and that everything will settle down soon. 🤞

[SilverAvocado in reply to Agapanthus1]

Hoefully, as it's been at least 18 days you would already know if you're a person whose adrenals are really going to struggle. But you've increased pretty fast, so I wouldn't be surprised if your adrenals have given a little twinge, because introducing T3 is always a bit stressful on the body.

In my experience with adjusting, almost anything can happen in the first 4 weeks or so of a new dose. Sometimes I've felt very under medicated, over medicated, really good, much worse, completely new symptoms coming up, etc, etc. It's not until I've weathered that chaotic period that I start getting more of a true picture of how I will feel on the dose. If you've felt a little strange at any point, don't worry as it may just be part of the teething troubles.

I definitely recommend reading the forum to get more of a feel for how to dose and what to expect on T3. There is loads of knowledge here, and it's good to pick things up from other's experiences. I just try to read a little every day.

I felt an improvement quite quickly on starting T3, but that was probably still a few weeks after I took the first tablet. It's possible to take a few months to see improvement, as you may need to adjust your dose a few times.

[Agapanthus1 in reply to SilverAvocado]

Thank you so much, this really is very reassuring and useful to know. There have definitely been some strange things happening (eg my heart rate has increased slightly, which makes me a bit nervous as it tends to be in the 80’s), but I am feeling more relaxed about the whole thing now so thank you for that. And yes I am definitely trying to read and learn more about T3 from here. Thank you again and I hope you are feeling well at the moment. 💐