T3 self medicate tips

[roukounasGK]

Hello everyone!

I am thinking on trying T3 medication to reduce my symptoms. However, my Endo is negative to prescribe it to me and am thinking on self medication. I am currently on 1,12 mcg.

So since I don't know anything about it I would like your input on how to self medicate on it.

I am planning on starting the minimum dose of t3 of course, 0,20 mcg twice a week.

But how should I take it?

1. Can I take it along with my levo in the morning? Or should I wait after my levo to take the t3?

2. Should it be on an empty stomach and wait at least 30 minutes to eat anything as in levo?

3. I have read somewhere that it is best that the dose is split in half, one being in the morning and one in the evening. Is this true? And if so do the restrictions (i.e. empty stomach) still apply on the noon?

4. Should I decrease my levo dose once I start the t3, since I have read it is more potent?

5. Do the 4 hour window of other supplements (iron etc) still apply on t3?

6. If I do start it, how long should I wait to review my symptoms? I have read somewhere that it is more quick than levo (which is at least 4 weeks). Is this true?

7. If I do start t3, how will my labs be affected? I assume that the TSH will go all the way down. And the rest will increase.

8. In case I have other symptoms, and it doesn't do for me can I completely stop it or should it be stopped gradually?

9. And will I encounter any issues stopping it? I mean for example, it seems logical to me that once my body gets accustomed to the t3, my thyroid may reduce the t4 to t3 conversion (since it finds it ready and there's no need to convert) so once I start it I may not be able to stop it since stopping it will cause even more hypothyroid symptoms (I have never heard this one before and I am not medical educated so this case may be stupid but it seems logical to me and I am afraid of it).

Thanks in advance for your feedback!

[Lalatoot]

Only start T3 if your labs show that you need it. It is not a quick or easy fix and may take over a year of adjusting doses of levo and T3 until you find what suits you.

You must therefore have a reliable source of T3.

You must take the same dose of T3 every day so you cannot just take it twice a week.

You only decrease your levo before starting T3 if your levo is at the top of its range.

As T3 affects ft4 levels and they take 8 weeks to adjust on average we wait 8 weeks for blood tests.

T3 suppresses TSH and also reduces FT4.

Some folks take it all in one go. Other split it to 2 or 3 doses. We treat the dosing times the same as levo for food and vitamins. T3 and levo can be taken at the same time.

The starting dose is 5mcg per day.

Vitamins need to be optimal ( at least half way through their ranges) before starting to get the best benefit.

It would be useful to know your TSH, Ft4 and FT3 prior to starting to see if you have a conversion issue. You cannot look for conversion issues once you start T3. Knowing if you have a conversion issue is important as this is evidence should you need to discuss taking it with doctors. And as your TSH is likely to be suppressed they will question your levo dose and likely try to reduce it.

[roukounasGK in reply to Lalatoot]

My labs do show that I need it (all labs, tsh, ft3 and ft4 are on the low side. More specifically, TSH is 0,8 on a range of 0,5 to 4,5. Ft3 is 2,8 on a range of 1,8 to 5. And ft4 is 1,31 on a range of 0,7 to 2). It seems I do have conversion issues. But I have been though a case of subacute thyroiditis last year so no one knows if this is the standard of my thyroid now or if this is another step of the subacute and it will go away in some months. not even my Endo knows, since he hasn't met with a case of both hashimoto and subacute previously. That's why he is reluctant to prescribe t3.

Regarding the conversion I am especially interested in whether taking t3 will make things worse or not.

Regarding the dose you mentioned that the starting dose is 5 mcg. But where I am around the lowest dose available is 20 mcg. to my knowledge in levothyroxine whether you take 5 mcg daily or 35 mcg weekly is the same thing.

That's why I was thinking on 1 or 2 doses of t3 weekly. Is this equivalent as in levothyroxine?

Thanks a lot for the rest of the feedback! You have helped clear things out for me!

[Lalatoot in reply to roukounasGK]

No you must take T3 every day. T3 is not a storage hormone in the same way that levo is. That is why some folks need to take 3 doses of T3 daily.

We start on a quarter of a tablet (The tablets are 25mcg or 20mcg). A pill cutter or a scalpel are useful.

However looking at your results you would benefit from an increase in levo first. Your FT4 is only 46% through the range. So it is not even half way through. Your FT3 is 31% through range so it is not lagging that far behind.

[shaws Administrator in reply to roukounasGK]

One of Thyroiduk's Adviser (now deceased) was an expert on the use of T3. He took his dose once daily (in the middle of the night so that nothing interfered with the uptake.

I take my dose, when I get up with one full glass of water and wait and hour before I eat.

When I'm due for a blood test, I have the earliest appointment, don't take T3 until afterwards.

I think Endos are now reluctant to prescribe T3, due to its enormous cost to the NHS. It used to be a reasonable cost. The professionals seem to have ignored the fact that T3 assists many to feel an improvement and even to relieve all of their miserable symptoms. I've no idea why T3 can be sourced abroad at a much lower cost than Big Pharma charge the NHS.

Obviously, profits mean more than relieving people of miserable symptoms.

25mcg of T3 is equal, in its effect, to 100mcg of levothyroxine.

[roukounasGK in reply to shaws]

I know, costs are more than the people whenever private health is involved. Although, here in Greece, where we have national health and the cost is not an issue (T3 costs about 2 euros over the counter) they still are reluctant to suggest it. I am not sure if it is the norm from other countries or there's another reason. On any case, the sheer positive feedback from everyone on t3 should be enough to rethink.

Anyway, thanks for your help! I will keep them in mind once (or if) I am to get t3.

[SlowDragon Administrator]

Before considering starting any T3 you better learn a LOT more about it

First being that it’s absolutely essential to take EXACTLY the same dose every day. Starting on 5mcg (20mcg tablet has to be cut into 1/4’s)

TSH will almost always drop extremely low and then GP/endo tend to freak out

So T3 not an easy option

Before considering adding T3 ...all four vitamins need to be optimal and you need to have trialled increase in levothyroxine first

When were vitamin D, folate, ferritin and B12 last tested

What are your most recent vitamin results and ranges

What vitamin supplements are you currently taking

Ft4 is currently only 46% through range so plenty of room for increase in dose

Helpful calculator for working out percentage through range

chorobytarczycy.eu/kalkulator

First step is to get 25mcg dose increase in levothyroxine

And all four vitamins optimal

[Arlie123]

I would echo the advice you’ve been given. T3 isn’t completely plain sailing and it looks like you could definitely do with a levo increase.

Also don’t underestimate how important optimal vitamins are - they can have a significant impact on efficacy of Levothyroxine and conversion.

[roukounasGK]

Thank you all very very much for your feedback! I will follow your recommendation and postpone the t3 medication and increase levo for the time being and see how it goes. If it does come to that and I need any more info I will come back here!

Thanks a ton!