Day 3 of T3 trial

[Wired123]

Hi friends, as some of you know I’ve started T3 on Friday. Starting on 5mcg once a day in the morning with my T4 based on the advice from learner members here. Endo wanted me to go straight to 2x5mcg a day.

I’m feeling better immediately, feel warmer, more energised and like I’m not dragging myself through life. All well and good.

Side effects include diarrhoea (which I can live with) but more concerning is a slightly uncomfortable feeling in my chest. My heart rate isn’t much changed since before starting treatment on T3 and I’m otherwise fine. No tremors or shakiness, just a discomfort in the chest.

Anyone experience this? I feel I may need to reduce my T4 slightly.

[SlowDragon Administrator]

Suggest you stick with it for now ...see how it goes

Do you wear a Fitbit or equivalent.....useful to monitor resting heart rate

Don’t rush to add 2nd dose

Wait a week, perhaps

[Wired123 in reply to SlowDragon]

Yes I’m using an Apple Watch (my wife’s pink one!). Also monitoring BP using a home BP cuff.

Will stick to it a few more days as I definitely feel better.

[NWA6]

Some can be sensitive when introducing something new. If you can, divide the 5mcg again and take morning and night.

Your system will settle 🤗

[Wired123 in reply to NWA6]

Thanks, the tablets are too small to be able to divide I think.

May have to drop my T4 slightly and see if that helps.

[SlowDragon Administrator in reply to Wired123]

You can cut tablets into 1/4 tablets and then again into 1/8th using sharp craft scalpel

Personally I started like this. 1/8th morning and 1/8th mid afternoon (yes it was a speck of dust)

After about 5-6 days was able to tolerate 5mcg

Scalpel

amazon.co.uk/Modelcraft-Sca...

[Twitchen in reply to SlowDragon]

I cut my T3 tablets in half so I have 10mcg per day and alternate days 75mcg and 100mcg of T4.

Have been on this dose for ages.

[SlowDragon Administrator in reply to Twitchen]

I take 20mcg now, (as 10mcg at 7am, 5mcg at 3pm and 5mcg at 11pm) but starting was tricky...as body so starved of T3.

Initially 2x 1/8th (25mcg tablets).......then 2 x 5mcg. After retesting after 6-8 weeks, was increased to full tablet - changed to 20mcg tablets

[Wired123 in reply to SlowDragon]

I guess I only need to half them as they are 5mcg, and then take 2.5mcg AM and PM.

Thanks for the scalpel link!

[SlowDragon Administrator in reply to Wired123]

Oh ....very easy to cut then

[NWA6 in reply to Wired123]

Please dont change your T4 dose. Stick with it, we all cut our tiny tablets 🤗

[Wired123 in reply to NWA6]

I always was told by pharmacists that you can only cut tablets which have the line indented into them. Clearly it appears to be untrue?

[helvella in reply to Wired123]

The general view of the regulators (e.g. the MHRA in the UK) is that lines on tablets are not there to facilitate splitting doses. They are to help allow splitting to make them easier to swallow and for identification.

I happen to think this represents a change - and the score lines used to be intended to split doses.

Some tablets might expressly state that their score lines are suitable for splitting doses. In which case, fine.

[Wired123 in reply to helvella]

So are you saying I shouldn’t split my tablets with a scalpel or pill cutter?

I’ve emailed the pharmacy already to get their view but I suspect they will only repeat the MHRA or other regulator’s party line.

[helvella in reply to Wired123]

Just to be absolutely clear, I am reporting what MHRA have said! I don't mean to tell you not to split them.

The arguments include:

The active ingredient might not be evenly dispersed.

The split might not be accurate.

Crumbs from splitting might be lost.

If we consider coated tablets, there are many more considerations!

The Summary of Product Characteristics for one UK liothyronine product says:

3. Pharmaceutical form

Tablets

The score line is not intended for breaking the tablet.

AND

• For doses lower than 20 micrograms, the tablet should be allowed to dissolve/disperse in 20 mL of water for 10 minutes, in a small measuring cup.

• The patient should gently swirl the solution occasionally to aid the dissolution/dispersion. The patient should then swirl the solution for a few seconds prior to using a suitable oral syringe to withdraw the amount of liquid corresponding to the dose prescribed (5mL for a 5mcg dose; 10 mL for a 10mcg dose).

• The patient can then squirt the liquid directly into their mouth from the suitable oral syringe by gently pressing the plunger.

• Any remaining liquid should be discarded.

medicines.org.uk/emc/produc...

[ColinK]

Stick with it, I found it took a few days till my body got used to it. Like Slow Dragon I'm on 20mcg but I take the whole tablet first thing in the morning along with 50mcg of levo.

[jrbarnes]

I've also started T3 this week and have the 5mcg pills. I had to make myself take the Levo in my original dose of 88mcg for almost 4 weeks before adding T3 just to get stable first. Now I find it easier to add T3. For the first two days I took 2.5mcg once daily, then days three and four I took 2.5mcg twice daily. It was then I started having that feeling in the chest you describe. 88mcg puts my T4 at the top end of the reference range and T3 about mid range so on day five I reduced my Levo to 75mcg and took 5mcg T3 in the morning and 2.5mcg at 12 noon. That feeling in my chest went away and I started to feel... normal. I felt relief after reducing the Levo but that's only because I was at the high end and starved for T3 so I needed to make some room to get what I really need.

[Wired123 in reply to jrbarnes]

Thanks, that gives me some hope, I will have to bring my T4 down a bit as I was near the top of the range before starting T3.

I also see my resting heart rate has jumped quite a bit since starting T3 which cannot be a good thing so clearly I’m over medicated now.