I found I had the same symptoms when taking the regular T3, no matter the dose. Hyper symptoms after taking and crashes in the afternoon. I finally had to go with a compounded slow release T3 from a compounding pharmacy. Also, you had asked in one of your posts if the T3 accumulates. I take 6mcg per day (just tried 4mcg and it wasn't enough), and yes it did accumulate over the COVID pandemic, likely because I sit alot more because I'm stuck in my house in front of my computer. So we are going to be working at getting the right dose for me over the coming months. I will reduce my dose a bit once I hit mid-range with my T3 levels and see if that keeps it from building up too much again.
I have been trying a compound of T4 and T3 because T4 75 gave me all those symptoms I felt I couldn’t live like that, switch to Amour thyroid 60 that gave me cardiac issues, high blood press. Then that was recalled, then I went on Nature Thyroid 75 mcg that got recalled too, low doses. That’s when I switched to compound starting with 30 T4 - 5 T3 every six weeks going up 5 mcg on both. I am not a could converter either my reverse T3 is 14 should be below 15 but so 14 is higher than last 6 weeks, then my RT3 was 13 so now I am T4 50-T3 30 I just started and I feel more energy but I won’t know if this is the right dose for another 6 weeks. It’s exhausting I’ve been at this since 2017 it’s research, supplements, and knowing what works for you thyroid and Hashimotos is not the same for everyone. It’s not a one size fits all. You need to work really hard and learn about your disease and what works for you! Best of luck 🙏
I had blood test before starting t3. Ft 3 was at 4%. After 3 days on t3 I started to feel weird.I found a study about half life of t3 where it said that lio can have a maximum half life of 71 hours...maybe I didn't understand well, I am not an English speaker
Half-life refers to the amount of time the T3 stays in the blood, and that's about 24 hours. But, the T3 that gets into the cells stays there for about three days.
It doesn't have a short shelf-life. 'Shelf-life' and 'half-life' are not at all the same thing. Not to be confused.
It has a very long shelf-life, if the pills stay sealed up they are good for years.
You mean a short half-life, which is the length of time it stays in the blood. And, yes, if it did have a very short half-life there wouldn't be much point in testing for it.
But, as it has a half-life of about 24 hours, we like to test for it half-way through that, about 8-12 hours after swallowing it.
If you want T3 to do what it's supposed to do, then you have to take the same dose every day. The body needs to know it can count on that regular dose.
It's not unusual to have some hyper symptoms at the same time as hypo symptoms - although, as people have said, it can be difficult to tell what are hyper symptoms and what are hypo - because that T3 you're taking isn't divided equally between all the cells. So, some are getting too much, and some still aren't getting any at all, on such a small dose. You have to give it time to build up and settle.
But, if you really feel that five mcg is too much for you, can't you cut the pill in half and take half every day? Or, perhaps try cutting it in half and taking half in the morning and half at night, or something like that.
It doesn't remain in the blood for only 24 hours. I said its half-life is 24 hours, which means that if you take 10 mcg this evening, but tomorrow evening, there will be about 5 mcg left. So, you take your next dose of 10 mcg, meaning that you now have 15 mcg in the blood. And, by the following evening, you will have 7.5 mcg left, and you take your dose and have 17.5 mcg in the blood... And, so on and so on over the days, weeks and months.
These are not exact figures, you understand, it won't be exactly half left after 24 hours, but that's just to demonstrate how a dose can build up. It's the same way a dose of T4 builds up, but on a smaller scale.
Ah, got it. Thank you. Does that mean though that if you have infinite accumulation, that levels get too high? Am I understanding it correctly? I also have a supplements question, may I pm you for that?
Well, I suppose it could, in theory. But, then again, we're talking about what's in the blood, and it doesn't do anything in the blood. And, as I said, those numbers were just theoretical to explain the process, so that when people talk about T3 having a 'short half-life' and 'running out' after a couple of hours, I can show them that's not how it works.
Can you not ask your supplement question on the forum - perhaps start a new thread? Could be I'll know nothing about it, or get it wrong, and then there'll be no-one to correct me.
Thank you. Yes, I understood that the numbers were theoretical
Regarding supplements, I didn't want to ask what to take because this forum's been very helpful with that and I believe I'm taking all I need to. I just wanted to know in which order to take them. I've trawled posts to see if a similar question was asked but there were 500 pages and after three I lost the will to live
I've seen many times before on this forum that you shouldn't take x within y amount of hours of z and haven't really paid due attention
I take:
Metavive
Food grown magnesium complex
B complex with folate
D3
K2
Iron
Vit C
I asked if I could pm you to avoid getting lots of replies but I realise I've interrupted this post so if you prefer, I can start a new one
Thyroid hormone must be taken on its own, two hours away from all supplements and other medication; four hours away from oestrogen, vit D, magnesium, calcium and iron.
Apart from that:
Magnesium, it's said, is best taken at night because it can make you sleepy.
B complex is best taken in the morning, because it's said to be envigorating.
D3 and K2 need to be taken with some kind of fat - they are fat soluble - so take them with dinner, perhaps.
Iron must be taken two hours away from all other supplements except vit C - and you must take vit C with it to aid absorption. So, fit them in when you can.
So, why would you want to keep your available T3 in the blood at 6.6? I can't see the point. And, remember, I didn't say those numbers had any accuracy. It was just a vague demonstration of the mechanics.
Well, I don't think a constant level of 6.6 mcg T3 in the blood would make you feel ok. Remember, it doesn't do anything in the blood, it has to get into the cells. What was your last FT3 level?
I read the story of your hypo life ... I found the brain tumor thing very funny. If I were the doctor I would have been curious to test at least ft3...Interesting that you took such high doses of t3 (and I worry about 5mcg). Have you ever had hyper symptoms? I think you have a very healthy heart
But, no, she wasn't in the least curious. She couldn't understand why she ought to test it.
I have had one hyper symptom, yes. Although I didn't realise it was a hyper symptom at the time: my nails started to separate from the nail bed. Which you might not even notice at first! But I didn't have any tremours or diarrhea or rapid heart beat, or anything like that. Although, I must have looked dreadful! Because people kept coming up to me in the supermarket and asking if I was alright, and if I wanted them to call an ambulance! I don't know, I'm not much of a one for looking in mirrors. lol
My experience with Cytomel is you cannot cut it to 1/2 tablet. Even with the sharpest pill cutter. I fell apart easily and you never can have half a tablet correctly divided. That is the reason, I start to have my evening dose every other night.Any advice?
Had a hard time convincing my PCP to order T3/Cytomel so I'm unable to ask for Tiromel. I initially thought my T3 has absorbed moisture for some reason, that is why it fells apart but with other refills, I'm facing the same issue. May be American form of Cytomel is different. Dose it harm me if I take the evening dose of 5mcg every other day?
OK. Sorry, I somehow got the idea you had 5 mcg tablets. So, I would suggest you just sit it out for while and see if things improve.
By the way, on this forum, to reply to someone, you need to click on the blue 'Reply' button underneath their comment. Other wise, they will not be notified that you have replied.
I wondered myself if to restart my 5mcg T3 I bought over a year ago form US....I built up to 8.5mcg ( very difficult to cut precisely) in the morning ( 7 & 11am) and 30mg NP at 2-3pm.....However I was told it's not good to stay at such a low dose of T3 ; I also acquired a 20 or 25mcg tablet that I had to painstakingly cut; I tested the bloods and free T3 was OK but they made a mistake and didn't test the reverse T3 so I will never know what it was on that dose as I stopped taking the T3 after that....At higher then 8.5mcg I didn't like the fast heart beats and didn't want to continue so went back top just NDT's....So I wonder how high a T3 dose should be for one in order for it to be good for you to take? the T3 did give me a little more energy and less joint pains...It was suggested I drop the NDT altogether and just take T3 .....I however didn't like the idea of hearing my fast heart beats at night as I wear earplugs for sleep ( got used to earplugs when we lived near the Airport and Concorde was flying ) PLus of course the 5mcg Liothyronine that I bought from US is expensive...Thanks
I was going to say : you have a Romanian name and British would pronounce it : Ilenutza ....I am from Banat Former Yugoslavia ( now in Serbia ) And how about you ? ( my name is actually Eleonora ) x
Why would you want to know what your rT3 was? That has very little significance for anything.
I can't imagine who told you it wasn't good to stay on a low dose of T3 - a doctor who didn't want you to take it at all? I've never heard such a thing. If your small dose of T3 was doing you good then there's no reason why you shouldn't stay on it. I've never heard that there's of there being a minimum dose you have to take for it to be good. All our needs are different. You just have to find out how much you need by trial and error.
My results weren't optimal : on 5mcg of T3 in morning and 30mg of NP around 2pm ( now use Thyroid S) Just checked them : TSH : 0.06mlU/L ( range : 0.27 -4.2) free T3 : 4.49 pmol/L ( range: 3.1-6.8 you need to be in the upper part of the range) and free T4 of course suppressed cause of the liothyronine) : 10.100 pmol/L ( range 12-22) . I was told Reverse T3 was very important ( in the Treating Thyroid disease with LDN which I take at night) because it shows if the free T3 is blocked ...ie T4 converts into reverse T3 instead of the active T3 causing you the Hypo symptoms and diactivates the existing T3 ....My temperature problems however were still there and that's one of the main reasons I started taking NDT's ....Thanks for replying ! x
That's the old thinking about rT3. We now know better than that. rT3 does not block T3 receptors, it has its own receptors. And, it certainly doesn't de-activate T3. It is inert, and doesn't do anything at all. It only stays in the body for about two hours, and is then converted into T2 in order to recycle the componant parts.
There are many, many causes of high rT3, and only one of them have anything to do with thyroid, and that is when your FT4 is too high. In order to put a break on conversion, more T4 is converted to the inactive rT3 than T3 - but that has nothing to do with any action on the part of the rt3 itself. rT3 is the result, not the cause. If you were taking NDT + T3, it's hardly likely that your FT4 was that high.
So, testing rT3 - a very costly and long test - gives you no information that you can't get from looking at your FT4 result.
I hope you're right....However as you can see by my results : my free T4 was far from high and hardly ever even middle of range in all my previous tests ( for free T4 that is) so this would not have been a reason for the T4 to convert into the reverse T3 ....I would understand if I had high free T4.... The highest readings that I had were when I was on lower Bio Identical hormones and when I was able to take a lot more NDT : 1 & 1/4 grain ( 75 mg NP) . Actually I built up to 2 grains of NP ( 120mg) when the high free T3 appeared in lab results.... My results were almost hyper although I was still Hypo : Free T3 : 7.44 pmol/L ( range 3.1 - 6.8) Free T4 : 18.400 pmol/L ( range 12-22). Reverse T3 : 14ng/dL ( range 10 - 24) I was told the reverse T3 needs to be as close to 10 as possible....MY TSH atr the time was: 0.0005mlU/L ( range: 0.27-4.2) As I raised the BIH I seem to not like more then 3/4 grain of NDT .....at 1 grain I get strong heart beats at night and takes me longer to fall asleep....I thought 1 grain was going to be the ideal dose but I've gone back to 3/4 grain of Thyroid S ....( was on 75mg of Thyrovanz NZ till 6th of January) I take an ACE 50mg ( by Thorne) around 1pm and 1 Holy Basil at night for cortisol levels since July '20 ... I was thinking of diverting to 5mcg T3 in mornings and 30mg of Thyroid S around 2pm as it's very difficult to cut a tiny grain into 30mg & 15mg....unless one dissolves it and that's too mucg hassle...maybe even raise to 7.5mcg as it's an easier dose to cut ( however as I said 5mcg Liothyronine is expensive to be cutting and making a mess if not being precise and having to use another one...a bit of a nightmare) . My cheaper T3 : Tiromel was 25mcg and again not easy to cut ...you'd have a different dose every day ....I remember trying to figure out what part of it can be considered 6.25 mcg and 2.25 mcg or 2mcg etc....Where do people buy the 20mcg T3 from I wonder ? Thanks for replying...x
I was told the reverse T3 needs to be as close to 10 as possible
Given the number of different causes there are for high rT3:
* Chronic fatigue
* Acute illness and injury
* Chronic disease
* Increased cortisol (stress)
* Low cortisol (adrenal fatigue)
* Low iron
* Lyme disease
* Chronic inflammation
* Selenium deficiency
* Excess physical, mental and environmental stresses
* Beta-blocker long-term use such as propranolol, metoprolol, etc.
* Physical injury is a common cause of increased RT3
* Viruses, such as flu
* Starvation/severe calorie restriction
* Mistreated diabetes
* Cirrhosis of the liver
* Fatty liver disease
* Renal Failure.
* Fever of unknown cause
* Detoxing high heavy metals levels
* Etc. etc. etc.
a lot of people will have high rT3 without even knowing it. If they don't have thyroid problems, I doubt it would ever be tested for.
Also, given that it's perfectly normal for T4 to be converted to part T3, part rT3 on a normal basis (can't remember the exact percentages) it's absolute rot to say that rT3 should be as near the bottom of the range as possible. Why even bother to have a range, if that's the case! Some people lack logic as well as knowledge.
Holy Basil at night for cortisol levels
Do you have high levels of cortisol at night, then? Holy Basil reduces cortisol.
If you're only taking 5 mcg T3, I really wouldn't bother trying to split the dose. And, if you do, it's such a tiny dose that the difference in the two parts would be negligeable. I think you're stressing yourself out for no good reason, there.
Sorry do you mean you would take 5mcg of T3 and 30 mg or 45mg of NDT at same time in the morning ? I was trying to increase the 5mcg T3 at the time as my free T3 was low at 4.49 pmol/L - all I could go up to I think was 8.25mcg ( will have to check calendar for precise amount) ; I was however told it's best to split the dose and take it 2 or 3 times per day as that's how it works better? The reason I'm still using the NDTs is cause I still feel the cold badly but can also perspire easily then feel cold if air aoround me isn't warm enough....so am still trying to solve my temperature problems; In winter I find it difficult to go out ( even worse by car if car is cold) as I have to reduce the temperature in house in order to dress for outside....in summer it's difficult to go out as car is too hot then I perspire and when out of car if it's windy and not hot enough I'd be cold.......I prefer to sunbathe in garden or walk nearby ...My body isn't adjusting to differences in temperature without me adjusting what I wear according to the temperature surrounding me which in England can be more difficult then in hot countries where the temperatures are more stable....if I get cold ( due to perspiring) then I catch colds easily so I have to wear the correct clothing....it's very difficult; And yes my cortisol is a little higher then it could be ( but within bottom of range still) at night time which is why I take longer to fall asleep....I am better since taking CBD oils at night after the Holy Basil .... and still these days I add some Tryptophan or Valerian ( I change from time to time) in order to fall asleep ...PS My lab results were better on the Iodine protocol but my temperature problems were still there which is why I thought NDT's might help; Now I just take 20mg of Lugol's iodine in the morning in a little warm tea with 200mg Selenium then about an hour later I take the powdered C & Mg in a little juice.
it's fine first thing in the morning but not in the afternoon ( again within range) so I take Thorne's ACE ( 50mg) capsule around 1pm...which makes me think that perhaps still better to have a little NDT around 2pm as it will help with energy levels....don't like to take it later then 3pm as believe it might interfer with sleep...The day before the test I do try to have it around 5.30pm as they suggested to test 15 -18hrs after last dose of NDT...Many thanks for your valuable replies ! I will start taking 5mcg T3 soon ( at present am having a little trouble with Glutathione causing me detox issues at 1/2 the dose / strange as taken Glutathione in past but not this flavoured one by Lipo Life); I was told for every 1/2 of grain we drop we can take 12.5-15 mcg of T3....I still think it's best to take both so will stick with 5mcg liothyronine ( whilst I have it, but start at 2.5 mcg as didn't take it since 2019 ) in the morning and maybe 30 mg NDT......then later maybe add 15mg Erfa around 2pm ( and stop the Thyroid S which contains 3 different aluminiums & talc whereas Erfa just talc ! ) Alternatively there's now 65mg Thyrovanz grain free ( made with almonds) ....the 50mg dose has vanished / is out of stock....but my ideal dose for NDT might well be : 30-45 mg which Thyrovanz doesn't provide....What do you think ? I plan to investigate the B12 in August with an MMA test but need to make a break from B12 & B complex from end April for 4 months....Many say ME people have B12 deficiency which won't show in a plain blood test as that only shows what's in the serum....beside thyroid problems that is....BUt as the NDTs alone haven't been successfull in me achieving optimal labs ( a lot cause of reverse T3 really) it may well be I'm lacking in B12 ( if it's not absorbed by the cells properly) ....I take a B12 spray by Pure Advantage for now in mornings and a B complex by Thorne at lunch times....Many thanks
The day before the test I do try to have it around 5.30pm as they suggested to test 15 -18hrs after last dose of NDT
Who suggests that? On here it's usually recommended to take the last dose of NDT 8-12 hours before the blood draw. Otherwise, you will be getting a false low FT3.
I was told for every 1/2 of grain we drop we can take 12.5-15 mcg of T3....
Oh, goodness me! Who's been telling you all this stuff? That's really not set in stone. You can't calculate things like that because there are too many variables. Depends how well you convert. Personally, I would prefer to work my way up slowly and not assume that anything equals anything else. So, if I were taking 1 grain of NDT, I would add 5 mcg to it and see how I felt. Then play it by ear for increasing or decreasing. You're making like incredibly har for yourself with all these calculations.
I know nothing about Thyrovanz. It's a glandular, isn't it? We don't actually know if it contains any hormone.
I understand the free T3 might be lower if testing 15hrs -18hrs later ( I might always have been Optimal in that case) The group I'm with get the info from a DR Izabele Weltz ( or similar) ; However 8-12 hr later would be difficult to do as I'd have to take the NDT at 9pm.....or test in the evenings but I was told mornings are best to test the thyroid or at least stick to same testing times...which is around 9.15-10.15am in my case; You're right about slowly increasing the T3 which is why I'll try 2.5mcg of T3 for a few days with 45mg NDT then increase to 5mcg of T3 but with only 30mg Thyroid S to start with ( or maybe even 45mg but not sure I can cut the Thyroid S properly )... or maybe later add the extra 15mg of NDT ( with Erfa if they have a 30mg this will be possible to divide and take at 2pm). Thyrovanz New Zealand is also an NDT but Bovine and no artificial additives at all...Many thanks x
The group I'm with get the info from a DR Izabele Weltz ( or similar)
I'm not sure it can be Dr Wentz herself, because I'm really not impressed with the information you've been getting.
I was told mornings are best to test the thyroid or at least stick to same testing times...
The reason mornings - early mornings, actually - are best for the blood draw is that that is when the TSH is highest. But, if you're taking NDT + T3, that hardly matters, because the TSH is going to be suppressed, anyway.
However, I do agree that it's important to stick to the same time of day for every test.
I agree with the reason....Just read another post where a functional Dr switched her patient to another NDT ( from Armour) because her reverse T3 was high ( in US) ; Unfortunately it doesn't say on bottle and also heard that it varies in capsules...but 75mg of Thyrovanz (50_+25mg) is similar to 45 - 60mg NDT ( like NP, NT) x
Just read another post where a functional Dr switched her patient to another NDT ( from Armour) because her reverse T3 was high
A) I've never had much faith in functional doctors, they appear to have little knowledge but a lot of funny ideas!
B) I cannot see the relevance of changing brands because of high rT3 - who would that help, even if it were necessary???
C) The more I learn about thyroid care and treatment in the US, the more disallusioned and despairing I become. I had thought the US was streets ahead in thyroid science than Europe. Turns out, they're street behind.
Somebody just asked: 'then why would reducing t4 meds drop it ( drop the reverse T3 ) and stop the issues? Maybe reverse T3 does fight for same receptors? xx
Of course rT3 level will drop if you reduce T4, because the FT4 will no-longer be high enough to trigger the conversion to excess rT3. That's only logical. But, you cannot deduce from that that rT3 does block T3 receptors. That is totally illogical. rT3 is inert and does not cause symptoms whatever the level.
in that same post they mention that the T3 receptors compete with the reverse T3 receptors.....I think they mentioned ( like me) that every time they raise their NDT they get a high reverse T3....even if T4 is not high in the range....xx
Yes, well, they're wrong. Latest research says that rT3 has it's own receptors and does not block T3 recptors.
As for having high rT3 even though the FT4 is not high, I gave you a list, above, of all the things that can cause high rT3. It's not just a thyroid thing.
this is how one explained it : 'say you need 100 gallon jugs to fill up your bathtub.
If reverse T3 is occupying 20 of those by filling 20 of the jugs with sand, you're only ever going to be able to get your bathtub filled part of the way with the other 80 gallons.' xx
I'm sure that's a brilliant explanation of something. But, what on earth does it have to do with rT3? It certainly isn't any sort of proof that rT3 blocks T3 receptors. Because it doesn't.
When you have high FT4, and the T4 is converting to more rT3 than T3, it is the resulting low FT3 that causes symptoms, not the rT3. And not blocked receptors. The truth is, you just don't have enough T3 to fill those receptors.
Have you a link to the latest scientific research that shows reverse T3 doesn't block our free T3 please? Many thanks I just don't understand why if you've not got much free T4 does it convert into reverse T3 ? is it due to a conversion problem ? I completely understand why if you've a lot of free T4 that the body will convert some of it to reverse T3 to help you out / as it's for our benefit .... xx
If there is any T4 at all, some of it will always convert to rT3. That is perfectly normal. But, if you have a lot of T4, a lot will be converted to rT3. Also, is you have a health problem, more T4 than normal will be converted to rT3 in an effort to slow the body down to allow it to health. rT3 is natures safety device.
However as I decreased my NDT to 45mg per day as it caused me strong heart beats at night I think it's best to start low... so can't add 5mcg at once but start at 2.5mcg again.....T3 can cause me fast heart beats when I've raised above 8mcg with only 30 mg NDT and then I was on slightly lower BIH too....and that's what it's usually suggested in the other group I'm in to increase slowly ( like every 10 or 14 days with NDT's) ... Many Thanks x
Yes would start with 2.5mcg of T3 then increase to 5mcg after 3 days but at first take it with 30mg NDT / Thyroid S at present....Would be great if my results were perfect on that amount as don't relish cutting the other 30 mg from the one 60mg tablet in 2 as it's just not precise....Would almost prefer to be able to take 7,5mcg of liothyronine ( or 6.25mcg Tiromel if cutting a 25mcg tablet) then play around with another 15mg of Thyroid S ( not scored at all like Erfa is) Many Thanks x
That's actually not true about rT3. The cells have different receptors for T3 and rT3 so rT3 can't block T3. Only T4 can be converted to rT3. Most people need T3 over 50% of range but not necessarily at the top of the range. T3 doesn't suppress T4 if you are taking some T4 (as you are), but not everyone does well with under range T4, so you probably need an increase in NDT perhaps instead of adding T3.
Sorry...do you mean you'd have stayed at 5mcg T3 in morning and instead of 30mg of NDT take 45mg in the afternoon ? these were results on : on 5mcg of T3 in morning and 30mg of NP around 2pm ( now use Thyroid S) ; TSH : 0.06mlU/L ( range : 0.27 -4.2) free T3 : 4.49 pmol/L ( range: 3.1-6.8 ) and free T4 at : 10.100 pmol/L ( range 12-22). Again, 45mg is hard to cut out of 60mg and maybe a bit much for an afternoon dose unless I take 15mg in morning after Liothyronine ( which unless I buy NP again is difficult to cut out of 60mg ; I could get back to Erfa that I used last year for 1.5 months which comes in 30mg too if they have it in stock at the Customised4u pharmacy ) . At the start of my taking NDT's in September 2018 I raised to 2grains and 1/4 and shortly after I introduced Bio identical hormones at a low dose ( 1.25mg estrogens & 0.75 mg testosterone with Progesterone at night ....as I raised the BIH it seems I needed less NDT's ( or could tolearate less NDT's) MY labs were actually the best whilst I was doing the Lugol Iodine protocol....but temperature problems still there. ( I have mild ME and we have temperature dysfunction which became very apparent after Menopause ) Thanks
Well, half a grain of NDT is a very small dose, so I'd probably have increased NDT by quarter of a grain a day every week until I felt good and dropped the T3 unless my T3 was still low in range after getting to 2 grains of NDT. Often taking NDT in multiple doses works better
Trouble is even 1 grain is too much for me these days; IN 2018 I was able to tolerate 2 grains but now it's not the case....as the free T3 wasn't high enough and had reverse T3 of 16 at the time they suggested I add T3 .....I was OK in 2019 with: 8mcg of Liothyronine & 30mg NDT...however I suspect this is not the case anymore and somehow see myself stuck at 5mcg T3 ( liothyronine) and 30 mg NDT - this is the going trend lately maybe cause I increased my BIH ( estrogen & testeosterone) ....Thank for your suggestion but the route of raising my NDT has vanished at present as it doesn't agree with me.....this also may be due to the fact I've added Quercetin in March last year to help against Corona and as I've trouble with sinuses and am trying to wean myself off Flixonase aqueous spray quercetin is the right supplement ....However , a Naturopath in US commented that it blocks estrogen....sooo maybe although I raised my BIH since March last year it's as if I'm not having much if it gets blocked ....At start of BIH it worked OK with NDT's and was able to raise....So maybe at present the Quercetin is at fault....Whenever I raised my NDT my reverse T3 would go up and they said that it's either due to cortisol or Iron and the easiest solution is to add T3 which I have slowly...I was working on cortisol those days and Iron was OK so didn't understand why...and even then if I raised over 2 grains the palpitations started....( before experimenting with T3 / right at the start of NDTs) This happens now even on 1 grain... At present am not taking any T3......Thanks for suggesting
The half life of T3 is 12 to 24 hours, but that’s not a steady decline from a peak. The true shape of the Free T3 curve has a steep rise and fall in the first 6 hours.This will vary slightly between individuals
T4 has a 5 - 9 day half life
It is important therefore that T3 is taken on a daily basis so that cellular level is maintained. The cells need an adequate and constant supply of T3 to allow the body to function optimally and therefore for good health.
You say you are a poor converter (ft4 63%, ft3 4%) ......your conversion is abysmally low you must be feeling unwell!
Have you tested and optimised vitD, vit B12, folate and ferritin this is essential for good thyroid function.
Too little T3 can also cause symptoms
I suggest that you need more T3 to raise your FT3 ....and perhaps to lower your levo.
I hope this relates to the reply you’ve just given to Iluneca: Would you also say it is important to take T3 separately from T4 ? - I currently take them together with no obvious issues but often wonder if it would be better to separate the doses.
If it works for you then together is fine. We are all different, there are no rules set in stone. It often takes considerable trial and error to find the dose that suits the individual.
Glad you have found the dose that suits you....stick with it!
The important thing is that if you make dose changes only change one thing at a time then give the body time to adjust (about 6 weeks) to that dose before making any further changes.
It could mean that you are needing another dose of lio. Some folks take their lio in one dose but others have to take 2 or 3 doses each day. T3 peaks 2 - 4 hours after the dose and then declines getting low 8 - 12 hours after the dose.Often folks start on 1 morning dose of 5mcg for 1 week and if they are ok with that they add in another dose of 5mcg in the afternoon.
It does take time for the body to settle. It has taken me 15 months to adjust doses of levo and lio. Now I am waiting to see how my body settles longer term after the last dose change.
With your labs/dose I suspect it means that you need more T3.....your " T3 batteries" may have gone flat after 12 hours!
For others it may mean that a split dose is more beneficial
As I understand it you first need to slowly saturate the cells with T3, it will take several weeks for the system to settle. Once we reach this point then we need to maintain an adequate and steady dose of T3 to maintain good health. You cannot take T3 like headache pills....it is a hormone essential to life rather than a drug per se and needs to be taken daily for life
As Lalatoot says, how we manage our dose is an individual thing. I need a large dose of T3 which I take in a single dose at bedtime, splitting didn't work for me.
You say you have "hyper" symptoms.....if you are hypothyroid you cannot become hyperthyroid.....symptoms indicate either under or over medication; not hypo or hyper. I suspect your symptoms indicate undermedication
It would be helpful if you could post the results of your latest full thyroid test, including nutrients and antibodies.
I've just posted this article on the forum you may find it helpful
You say you only started T3 three weeks ago, that is far too soon to draw any definitive conclusions. It can takes many months to find the dose that suits you and along the way as your body adapts you can experience unexpected symptoms.
There is no quick cure....think headache/paracetamol. It takes time and patience....and that can be difficult as I discovered! Leave 6 to 8 weeks between any dose change and test before altering dose.
Like shaws I followed Dr Lowe's protocol, it made complete sense to me. and I also read extensively about T3 and thyroid function because I started out knowing very little about the subject.
I reduced my Levo 25mcg and slowly started to add T3. I had anxiety, insomnia, headaches and weakness. Increased the Levo back up for two weeks and now adding 5mcg of T3 to start. No more anxiety and I'm sleeping better. I can't think of any benefit to skipping days. I need that T3 everyday! I take 2.5 mcg before or after a long walk as well.
I take 5 mg T3 every other day with no adverse effects. After taking it for a few years I developed serious cardiac symptoms, atrial fibrillation, breathlessness, angina pains etc. Cardiologist discovered congenital bradychardia alongside very strong heart and says no treatment needed. I asked for thryoid medication review as T3 is known to have such side effects. My T4 was lowered from 100 to 75mg by endocrinologist who discounted any side effects from T3. Nothing changed on lower T4 dose so I decided to take T3 every other day and within a day all cardio symptoms disappeared never to return. I find I need the T3 to avoid the hideous side effects I was having on T4 alone. I have told my GP about my decision and she is happy to keep monitoring the situation for now although my TSH fluctuates wildly, but then it always has irrespective of prescriptions. I intend to to full blood test as recommended on this site in March when my next NHS blood test is due but for now I have achieved a workable balance.
I din t take the lio yesterday and felt better last night. My cardio symptoms scare me the most. I had some episodes of atrial fibrillation in a holter in the past when i was on levo only
I found the first week or so on T3 I had quite a lot of weird symptoms including high/erratic heart rate and strange chest sensations.
These went after a week or so, definitely persevere with it initially if you can. The alternative would be to buy 5mcg tablet and take half every day and then build up over 2 weeks to the 5mcg dose. You can ask the doctor for a 1 week supply of 5mcg tablet though you then add another complication into the mix if the 5mcg is a different brand.
I know Roseway Labs pharmacy can compound the exact dose for you themselves so you could call or email them and ask, they are extremely helpful. But you will need another prescription.
I would persevere if you can for some more days if that doesn’t work then try speaking to you doctor about reducing to 2.5mcg then raising levels.
Looking back at your previous posts you say you still have a large proportion of your thyroid gland and that your Graves antibodies still active :
Graves is an auto immune disease and as such. it is for life, it's in your blood and DNA :
Graves doesn't just target the thyroid, but it is because the thyroid is such a major organ that this is generally when it's picked up by the medical profession, identified as life threatening, and the treatment begins.
Graves Disease is not resolved by the RAI treatment :
I also read the " science behind the iodine 1-31 dose unclear"
All this does is mitigate the circumstances which generally sees the patient down graded from a life threatening disease, hyperthyroid, to a life limiting disease, hypothyroid.
I believe my thyroid took around 8 years to finally be destroyed and burnt out by the RAI as that was when I became seriously unwell :
I'm sorry I don't know enough to give you a definite answer but I do know I need to maintain my full spectrum hormone replacement everyday and that I now feel much better.
It has taken me a couple of years repairing my body and restoring optimum ferritin, folate, B12 and vitamin D and I also supplement adrenal glandular as I read RAI is taken up - to a lesser extent - by other glands and organs with in the body.
I did trial some synthetic T3 with a lowered T4 dose, but I felt it a bit too powerful :
I then trialled Natural Desiccated Thyroid and found this softer on my body and am now some 2 years into this thyroid hormone replacement and am much improved.
Have you ever looking into the Elaine Moore Graves Disease Foundation website ?
Elaine has Graves and went through RAI bck at the end of the 1990's and finding no help nor understanding with her continued ill health, and being a medical technician, started researching this poorly understood and badly treated auto immune herself. Her books and website have been invaluable to many, though totally appreciate there is a language issue here which I'm able to help you with.
Elaine Moore does offer an open forum, much like this amazing platform, and she also offers to answer questions on a one to one basis, should you prefer to talk to her personally about your situation.
Having just caught up with your thread - it could just be that the ratio of T3 and T4 in the
Novothyral is not the right ratio for you ? The ratio in this product is 1 / 5 - T3 / T4 :
Many people find that they need to adjust both T3 and T4 independently ?
I take Natural Desiccated Thyroid and it's a fixed ratio at around 1 / 4 - T3 / T4 :
each grain containing a T3 at 9 mcg + a T4 at 38 mcg : this suits me - though I read of people adding back in, when they are close to near " perfect " a little T3 or a little T4 :
I now seem ok on 1 + 1/2 grains a day which works out at 57 T4 + 13.50 T3 :
NDT contains all the same known thyroid hormones as a human gland, namely trace elements of T1. T2, and calcitonin plus a measure of T3 and T4 as detailed above.
NDT is pig thyroid dried and ground down into tablets referred to as grains and was successfully used for over 100 years to treat hypothyroidism prior to the Big Pharma launch of synthetic thyroid hormones, guidelines, ranges and blood tests.
I take 5 mcg T3 every day. I split the 20mcg tablet into 4 with a pill cutter. Then I split the daily dose into two. Its tiny but seems to work. Sometimes it crumbles but usually it's possible to salvage it. I used to get 5mcg tablets but they came from somewhere perhaps the US and were expensive, the pharmacy won't prescribe them any more. I also take 100mcg T4 on four days a week, and 75mcg on three days a week. Complicated, but you need to play around with what works for you
I developed atrial fibrillation, which appeared to be linked to taking a bit too much thyroid replacement hormone. I reduced the T4 and stopped the T3. I find a feel better with a bit of T3, and an endocrinologist suggested adding 5mcg of T3 and reducing T4. Taking T3 tends to suppress TSH. Now I make sure that my TSH is measurable (just), and have not had AF since this. He said take it once a day but I figured smaller doses twice a day was better. It's a tiny dose but all I can manage. I'm very pleased that the AF has not recurred because it is a grim condition.
I’ve been reading this thread today... I’m sorry about the AF. Very upsetting and no doubt frustrating for you.... do you find that the meds you now take are enough? Or do you find yourself feeling that you could do with more of it wasn’t for the AF? Just interested to know what you experience is. Thanks.
I'm okay. Actually I realised that I had some earlier symptoms of over- treatment with T4 dose, eg feeling nervy. Quite subtle. I had been reluctant to reduce the dose despite my GP's advice. Turned out they were right. Perhaps the dose needs tweaking at different times in life, in my case the menopause.
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Should I add T3 or wait and see?
Mentally better on more levo, more energy on more t3
Advice about combination of T4/T3
Endo doubts I take my 25mcg levo every day 
