What is considered a therapeutic dose of T3?
What are the signs you should look for not considering blood test?
I started 5 weeks ago to build up my dosage of T3 and now I am on 50mcg T4 + 15 mcg T3 in the morning and 10 mcg T3 in the early afternoon.
I also take vitamins and minerals.
I don't see a big change in my energy. BP and temperature are always lowish and Heart rate increased just a bit.
I would have expected a better improvement...
The endo I have told me that it would take 6 months to a year on Combo till we adjusted the doses and my body had adjusted. This was because I had been ill for a long time.
Clara62
A month ago you said that you were on 80mcg T4 plus 5mcg T3 and you had these results:
Free T4 15.8 12.0 - 22.0 pmol/L
Free T3 3.71 3.1 - 6.8 pmol/L
I think you have made a couple of errors now.
Firstly, you have lowered your dose of T4. Those results showed that you didn't need to, in fact your FT4 might even have been too low.
Secondly, you have changed two things - T4 and T3 - and we should only change one thing at a time.
Thirdly, you haven't left the full 6-8 weeks between dose change and retesting so your levels wont have had enough time to properly settle.
Some of us on combination hormone therapy need both FT4 and FT3 in the upper part of their ranges some of us are fine with FT3 in the upper part of it's range and FT4 in the lower part, it's a case of taking our time, making gradual changes to see where we feel best. It can take many, many months to find the right combination.
Are you taking your thyroid meds on an empty stomach, one hour before or 2 hours after food, with water only and water only for one hour each side? Are you taking all supplements at least 2 hours away from thyroid meds and 4 hours for Vit D, magnesium, iron?
Thank you SeasideSusie.
My FT4 always lowers when adding T3.
I was told to try to lower T4 and increase T3.
No, I haven't left the full 6-8 weeks between dose change ...unfortunately.
What do you think I should do now? Stick with my current meds for 6 weeks or add back more T4? I was told I can build up T3 every week of 5mcg ...
'' ... it's a case of taking our time, making gradual changes to see where we feel best. It can take many, many months to find the right combination.''
Yes, true.
''Are you taking your thyroid meds on an empty stomach, one hour before or 2 hours after food, with water only and water only for one hour each side? Are you taking all supplements at least 2 hours away from thyroid meds and 4 hours for Vit D, magnesium, iron?''
Yes to all this, except for Vit D, didn't know it should be taken 2hours away from thyroid meds
Clara62
My FT4 always lowers when adding T3.
Yes, it tends to do that for most people, if not everyone, which is why we don't always need to lower our dose of Levo.
I was told to try to lower T4 and increase T3.
There is no one size fits all. It's a very individual thing, we have to experiment and tweak doses to find what's best for us. Through trial and error I found that at the beginning of my combo hormone when I lowered my Levo from 100mcg to 75mcg (and kept the same dose of T3) my FT4 level reduced from 19.5 to 12.8 (range 12-22) and because I still have some conversion (though not good enough for Levo alone) it lowered my FT3 level as well. Subsequent adjustments, test results and how I felt showed me that I need my FT4 at around 60-70% through range, and I also need my FT3 around this level too. So we just have to work out where we feel best by tweaking doses, how we feel and making a note of our levels.
No, I haven't left the full 6-8 weeks between dose change ...unfortunately.
Very important to only change on thing at a time and leave 6-8 weeks for levels to settle. Move too quickly and we can act upon false levels and get dose changes wrong.
Yes to all this, except for Vit D, didn't know it should be taken 2hours away from thyroid meds
Vit D is 4 hours, as mentioned above.
What do you think I should do now? Stick with my current meds for 6 weeks or add back more T4? I was told I can build up T3 every week of 5mcg ...
Personally, frustrating as it is, as you have made changes to both Levo and T3, I would wait 6-8 weeks from when you made the changes and retest. Maybe post results at that time for suggestions on next step.
When you test, make sure last dose of Levo is 24 hours before test and last dose of T3 is 8-12 hours before test, timing is important, so if you have to adjust the time of doses the day before, and split dose of T3, then so be it.
Also, if you haven't had vitamins tested for a while, I'd get the thyroid/vitamin bundle so that Vit D, B12, Folate and Ferritin are tested to see if they are optimal and the doses you are taking are appropriate.
If you take a B Complex or Biotin or iron tablets then leave these off for 7 days before the test. Anything else take after the test on the day.
Thank you very much SeasideSusie.
I will wait the necessary time before making any change this time.
Can I ask you what is your T3 intake? Do you take divided doses?
Clara62
I take 12.5mcg T3 split into 2 doses.
Whilst trying to find my optimal dose, I was taking 31.25mcg at one time, like I said, lots of experimenting and tweaking needed. Fortunately I do my own thing so don't have a doctor telling me what to take, I just get my prescription for Levo and look after myself.
Thank you. I understand you, I am starting to do the same: Levo from prescription and the rest by myself. I just need to be more patient. 
I think you might have increased too fast. It's normally recommended to only increase by 5 mcg every two weeks.
Thank you greygoose. I think I need to be more patient. It's just that I want to feel well ...
We all want to feel well! That doesn't mean we can bend the rules of nature. Increasing too fast is not good for you, it stresses the system, and you risk missing your sweet spot. Go too fast and you'll find yourself back at square one.
I would like to know from your experience what you consider a therapeutic dose of T3. I know there is no one size fits all...
Clara on Combo medication it is not only the correct dose of liothyronine that you need to find but also the correct dose of levo to go along with it. Some folk manage with low ft4 and others need ft4 higher. So it isn't all about the therapeutic dose of t3 when you're on Combo - it is about the therapeutic doses of t4 and t3 combined.
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