T3 maximum dosage

[Lizzigill]

What's the maximum dose of T3 someone can have? I started low but am continually updosing because my TSH keeps rising......

[Lalatoot]

Are you on t3 only? We would need to see blood results tsh, ft4 and Ft3 before we could comment.

[helvella Administrator Thyroid UK]

The standard documentation reads as if 60 micrograms is the standard top dose. But we have seen quite a number of people who have ended up needing far more than that - certainly 150 micrograms.

I am assuming you mean you are on T3-only?

In anyone who needs a higher dose, it is reasonable to question why. Can you tell us some more?

[Jazzw]

A month ago you were taking 20mcg liothyronine in total. How much are you taking now—and how often are you testing?

Is your T3 from a reputable source (please don’t name your source here unless it’s prescribed)?

[SlowDragon Administrator]

Did you get vitamin D, folate, ferritin and B12 tested yet

As you have hashimoto’s are you on strictly gluten free diet?

[Lizzigill]

Gluten free yes. Havnt had vitamins and minerals tested recently but taking all the supplements. T3 prescribed and from reputable source. Had half thyroid removed in November. Currently taking 35mcg split between three doses. Thank you for your input!

[DippyDame]

Hello..

Why do you need to take T3-only?

T3 only therapy is considered as the last resort.

It is not a quick fix.

It is not the panacea of all ills!

Who decided on this option?

How did you respond to LT4 mono therapy?

Do you have your diagnostic(first) test results that you can post....you are legally entitled to ask your surgery for copies of any labs?

Did you trial T4/T3 combo?

Do you have the Dio2 polymorphism?

20mcg T3 raised to 35mcg in one month if far too fast an increase.

5 or 6.25 mcg (depending on whether your tablets are 20 or 25mcg i.e a quarter tablet) is advised as an increase every 6 weeks. You raised by 15mcg in 4 weeks....see Jazzw above.

Your body would find this amount difficult to process in such a short time!

Maximum dose? It depends on why your body needs exogenous T3.

I have a form of Thyroid Hormone Resistance which requires me to take a supraphysiological dose of T3 (175mcg) that would be very dangerous for most people.

I suggest , as advised above by SlowDragon that you have vits D and B12 and folate and ferritin tested...just randomly taking "all the supplements" isn't the answer.

Hopefully GF is making a difference....but that is only one factor. As someone here once advised me, "you need to get all your ducks in a row". Good advice!

Without having more information it is difficult for members to comment in any detail.

I'm not a medic just another traveller who has had to read, listen and learn along the very long , bumpy and sometimes lonely road that is thyroid treatment.

Good luck

DD

[Lizzigill]

I didn't tolerate T4 and my Endo prescribed T3 in November after parathyroid removal. I have felt much better on T3 although had to drop to 10 MCG in January due to insomnia. I now do a 4am Ct3m dose and am raising that and 8am dose only. Symptoms and vitals all improving just TSH raised. GP feels I am therefore under medicated.

[DippyDame in reply to Lizzigill]

Medics are now taught that TSH is the gold standard thyroid test which research (and historical treatment) has proved not to be the case.

Medics are poorly educated in matters of thyroid disease as members of this forum underline on a daily basis.

This might help-

bmcendocrdisord.biomedcentr...

Clinical evaluation is, we are advised, the way to dose with T3 only...it sounds as if you are more aware of this than your GP! Listen to your body!

I take a large single dose of T3 at bedtime, splitting the dose didn't work for me.....but again we are all different with different needs. Trial and error is the way forward!

TSH is not the issue...how you feel is the critical factor.

[SlowDragon Administrator in reply to Lizzigill]

For levothyroxine or T3 to work well we need optimal vitamin levels

Recommend getting full thyroid and vitamin testing after 6 weeks on constant unchanging dose of T3

If you have Graves or Hashimoto’s then frequently strictly gluten free diet helps or is absolutely essential

For full Thyroid evaluation you need TSH, FT4 and FT3 plus both TPO and TG thyroid antibodies tested. Also EXTREMELY important to test vitamin D, folate, ferritin and B12

Low vitamin levels are extremely common, especially if you have autoimmune thyroid disease (Hashimoto's) diagnosed by raised Thyroid antibodies

You may need to get full Thyroid testing privately as NHS refuses to test TG antibodies if TPO antibodies are negative

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 1/2 or 1/3rd of daily dose 8-12 hours prior to test, even if this means adjusting time or splitting of dose day before test

Is this how you do your tests?

Private tests are available. Thousands on here forced to do this as NHS often refuses to test FT3 or antibodies

thyroiduk.org.uk/tuk/testin...

For thyroid including antibodies and vitamins

Medichecks Thyroid plus ultra vitamin or Blue Horizon Thyroid plus eleven are the most popular choice. DIY finger prick test or option to pay extra for private blood draw. Both companies often have special offers, Medichecks usually have offers on Thursdays, Blue Horizon its more random

If you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 7 days before any blood tests, as biotin can falsely affect test results

endo.confex.com/endo/2016en...

endocrinenews.endocrine.org...

[Lizzigill]

Thank you everyone! You have been really helpful!