Starting Journey with T3 - need advice :)

[lizziee1234]

Hi all,

I have moved my story to my profile

I have just started taking T3 and have questions about dosage.

I research different brands of T3 and manged to find a brand sold in turkey that is a good price. I bought 1 box and started taking them last week. From doing research I realised I need to start off on a small dose. So I bought a pill cutter and have cut the 25mg tab into 8 pieces (very difficult!!) For the last week I have had 1/8th twice a day. So totaling 6.25mg ish and reduced my T4 from 175mg to 150mg. I also take D3 supplement but have now bought some Vitamin B complex and have ordered some Iron tablets and selenium tablets.

So my questions start from here. I have found info on how to start low, but what do I increase to?

Here is my plan for dosage for the next few weeks:

WC 24/02/2020

8mg T3 (3rd of a tablet split over twice a day)

T4 125mg.

WC 02/03/2020

12.5mg T3 (1/2 tablet split twice a day)

T4 100mg

WC 09/03/2020

18.75mg T3 (3/4 tablet split three times over a day)

T4 100mg

WC 16/03/2020

25mg T3 split over 3 times a day

T4 75mg

Does this seem ok?

Also, not sure what to do after this point. Do I stick to this and see how I feel? Or should I increase T3 further? What dose would be good once T3 is established?

So if you have hashimoto and are on T3 do you keep some T4? What are your doses? Do you feel better with no T4?

Thanks all

[lizziee1234]

Thanks, I have added it to my story.

I will use the blood test form that the doctor gave to find out my levels.

[Lalatoot]

I think you may be reducing your levo too far. It all depends on what your FT4 level was before you started the T3.

Some folks can manage with low Ft4 levels but others need them well over halfway through range when on a combo.

If your Ft4 was not at the top of the range when you started then a 25mcg or a 50mcg reduction might be all you need.

My FT4 was only 60% through the range when I added T3. Unfortunately because I was prescribed it by an NHS endo I had to comply with her wishes. She halved my levo to 50mcg from a 100mcg and this made me ill even with 20mcg of T3 added. I am now on 75mcg with 15mcg lio and I think I need to increase levo again and then find out whatever dose of lio I need with that increase.

Your needs are individual and it is only by trial and error you will find out what your doses for levo and lio will be. You need to find your own balance between the two medications. It is not as straightforward as reducing levo by a given amount and adding in a set amount of T3.

[lizziee1234 in reply to Lalatoot]

Thank you ☺️ I will go into doctors and ask them to print out my blood test results. I've had a few in the last year so should have some idea of FT4 in there at least. I know they gave it to me recently but I have forgotten what it was now. Did try to get a print out at the time but you have to pay and they wouldn't accept a note, so never went back for it.

[shaws Administrator]

I take one and a quarter tablet T3 when I get up with one glass of water and wait an hour before eating. Food can interfere with the uptake of the hormones. The following might be helpful for you and read 'Safely Getting Well with Thyroid Hormones' which an Adviser to TUK wrote. He was a scientist/researcher.

naturalthyroidsolutions.com...

[lizziee1234 in reply to shaws]

Thanks. I will check this out

[shaws Administrator in reply to lizziee1234]

This is an excerpt from the above link:

"A trial of T3 therapy is then warranted.During the trial, the patient carefully progresses through metabolic rehab using plain T3. The method of adjusting her dose of T3,and the safety monitoring she undergoes, are based on our experiences with hundreds of resistance patients and our scientificstudies of those patients.[36][38][92][93][94][135][137][188][189][292][403]We want to emphasize that our patients use plain T3—not sustained-release or timed-release T3. They take their full dose of T3 on an empty stomach (one hour before a meal, or three hours after)once each day (see Figure 1).When thyroid hormone resistance patients use T3, therapeutic effects from a newly increased dose may occur within several daysto a week. It’s reasonable for these patients to reevaluate the intensity of their symptoms a week after they increase their T3 dose (see Chapter 3).We can’t give a specific starting dose for patients in general. Itvaries for different patients, depending on their health status, severity of their symptoms, and other factors. Many patients, however, start with what the clinician calculates to be a full replacementdose—one that provides all the thyroid hormone a normal thyroidgland would produce to regulate metabolism. The patient’s doctorshould help her calculate an appropriate starting dose."

[SeasideSusie Remembering]

lizziee1234

You can't know whether you need T3 unless you test TSH, FT4 and FT3 all at the same time. Did you do this?

You can't know whether you need to reduce Levo when adding T3 unless you have tested before adding T3 and know where your FT4 lies. Depending on the result you may, or may not, need to reduce Levo.

You have Hashi's, this tends to lower nutrient levels, even cause deficiencies.

Before adding T3 you need optimal nutrient levels, did you test Vit D, B12, Folate and Ferritin? If so, what were the results?

Your plan to reduce Levo from your original 175mcg to 100mcg on 2nd March and to have replaced with 12.5mcg is flawed. You will have reduced your Levo by 75mcg and replaced with an amount of T3 that is roughly equal to 37.5 - 50mcg Levo.

If you haven't done all this testing, and you may not be able to get it all done with your GP, then consider testing with one of our recommended labs - a full thyroid/vitamin panel with Medichecks Thyroid Check ULTRAVIT or Blue Horizon Thyroid PREMIUM GOLD.

I wouldn't continue with your dose plan until you have these results.

I also take D3 supplement but have now bought some Vitamin B complex and have ordered some Iron tablets

You absolutely must know your Vit D level before supplementing so that you can take the correct dose, too little wont help, too much will lead to toxicity. There are also important cofactors needed when taking D3 - magnesium and Vit K2-MK7 - are you also taking these?

As for iron tablets, you absolutely must know that you need them. Did you test Ferritin and have an iron panel and full blood count? If not you shouldn't be taking iron tablets.

[lizziee1234 in reply to SeasideSusie]

I know my D3 was low at a recent blood test. Doctor never told me how much to take and just said take suppliments. I will get a copy of my last test for this when I go to doctors next

Obviously I am just trying to read up on everything so don't know about all the tests that I should be taking or what needs to be tested. I will make another doctor appointment to ask for all these blood test levels. Yes I'm concerned about the extra supplements so won't take them until I've had blood tests done.

I will continue on the same level of levo and see what the next blood test shows

Thanks

[SeasideSusie Remembering in reply to lizziee1234]

We always advise to get a print out of every test you have, this will include the reference range as well as the result. If you have online access to your results, that should also give the information needed. Make spreadsheet with your results - date, name of test, result, reference range, dose of thyroid meds, how you feel, dose change, etc. This will become an invaluable resource in the future.

If you don't have online access and need to ask for a print out (never hand written or verbal results), don't ask the GP as they don't like us knowing, always ask the receptionist. In the UK we are legally entitled to our results without question or charge, we don't have to give a reason, and it's easier to remind a receptionist of this than to bruise the ego of a doctor who doesn't want to give you the results.