Splitting Sigma 5mcg T3 Liothyronin

[Wired123]

My new endo has suggested taking 5mcg in the morning and 2.5mcg (ie half a tablet) in the afternoon.

Pharmacist advised that tablets without a score line should not be cut.

Sigma doesn’t have a score line.

Who is correct, doctor or pharmacist?

[helvella Administrator Thyroid UK]

Even having a scoreline is not sufficient to indicate that a tablet can, reliably, be split.

Time was the score line was often referred to as a break line. But over the years evidence has accumulated that this should, in general, be avoided.

The break might not be even.

There is the potential to lose fragments.

The amount of active ingredient in each part might not be the same.

If it is a coated or slow release or other special tablet, it might affect absorption.

For some medicines, the Patient Information Leaflet actually says that it can, or cannot be split.

For some medicines, these issues are at the negligible end of the scale. For example, a paracetamol or aspirin or other medicine with a wide range of dosing tolerance.

[fuchsia-pink]

I've split levo and lio with no score-line quite happily using a pill-cutter. Many people here also use scalpels or craft tools to split (particularly into smaller bits than just a half.

I'd recommend finishing the tablet you've cut before cutting another so that if the halving isn't exactly equal you are getting the full tablet's-worth over a minimum period of time - but with lio being much more powerful than levo, do try and get it even

[Wired123]

Thanks for the replies.

Agree on the problems including not cutting evenly so it’s not quite 50:50 and also losing a few small crumbs. Ultimately how much difference this makes is hard to know.

Although Lio is very powerful so I have to be mindful of this.

[helvella Administrator Thyroid UK in reply to Wired123]

I didn't mean to dismiss the possibility, or need, to split tablets. Just point out some of the official views and possible issues.

[Hidden]

I find snapping works (unless they’re really tiny tablets).

[Wired123 in reply to Hidden]

Don’t think that would work reliably and will lead to more uneven splitting. The tablets are pretty small in any case so not really an option.

[FancyPants54]

I can't believe how little T3 they want to give us. 5mcg morning and 5mcg afternoon is hardly a large dose. Fiddling with 2.5mcg is just a pain. What good will that little do?

[Wired123 in reply to FancyPants54]

Depends, doc is experimenting on whether my old dose of 10mcg was too much. So we went down to 5mcg which was not enough. Trying to find the sweet spot by slowing upping it.

I also take 150mcg T4 Levo

[radd in reply to FancyPants54]

Fancypants54,

Some members need just a 2.5mcg dose when introducing T3 with badly compromised adrenals. When large 'whooshes' have been previously felt it can offer confidence to start small and allow the body a more gradual tolerance.

[twizzle303]

I cut mine (morningside) into 3 pieces, half at 5am then sort of quarter at 11am and remainder at 8pm. No score lines. I do notice ups and downs but I am much better than taking 10mcg in one go.Apparently it does come in liquid form or you could ask for 5mcg tablets that way you only split one?

[ShatteredofLee]

I nibble. Like Alice in wonderland at the mushroom.

[radd in reply to ShatteredofLee]

🤣

[Murphysmum]

I used to be on sigma tablets when I first started on T3. I used to split with a pill cutter and while you do lose a few crumbs, I never found it made a difference.

I’m now on a much bigger dose but now having to split 20mcg tablets, sometimes with a split line, sometimes not. Now I just break them between my thumb nails - they almost always break pretty evenly and again, I’ve noticed no difference between doses.

Hope this helps ☺️

[radd]

Wired123,

We do what we have to do.

The 2.5mcg T3 dose has become known by some on the forum as the 'speck of dust' measure. A highly fine & intricate measure when stuck on the end of a finger 😁.

[HappyHealthyGirl]

Hi Wired123,

I've been splitting all types of Thyroid tablets: T3, T4, & NDT, with a pill cutter for over 15 years. Sometimes I've even needed to take 1/8th of a tablet, which means splitting it into quarters & then nibbling part of that quarter!

Some have a 'guide line', & some do not.

Some break cleanly, & some do not.

The pharmacist may be concerned that a tablet without a line perhaps indicates some sort of coating to slow the release. However, I've seen in some inserts that for some tablets any line may be classed as purely 'decorative', and intended only as an aid for identification of that particular Brand, & that a line should not actually be used as an indication that the tablet can be split.

I think that common sense is the answer! And since you have an endo with enough sense to advise you to try it, I would follow his advice.

There is excellent advice in the replies here to only split one tablet at a time, so that if one 'half' is slightly bigger or smaller than the other 'half', it will even out over the day, or two days in your case, when you're taking it.

I would add that it's good to put the pill cutter on a coloured plate, so that if any crumbs break off you can easily see them & pick them up with a dampened finger.

If I've got crumbs from a split tablet, I try to take the smaller 'half' first, along with any crumbs, & then take the slightly bigger 'half' as the next dose.

Also, if you feel a bit 'rushy' from the afternoon half tablet the first few times, you can always begin by only having the half every other day? And remember, you may need to build up the dose, so you may not tolerate 7.5mcg every day at the start, but as you become acclimatised to the increased T3, you may find that you do need 7.5mcg per day.

Also, try everything s.l.o.w.l.y.! Give your body time to adjust.

Also, make sure that you stick to the same brand while you're doing the adjusting.

I hope that your fine-tuning goes well, & that the sun is shining on you this Bank Holiday weekend!

[username9]

Tiny doses. You can approximate. Cut, nibble, use a scale, etc. I take ~6-9 mcg doses w/food.

[wellness1]

I'm curious whether you ended up splitting 5mcg Sigma Pharm Liothyronine tablets in half and if so, how you found it.

[Wired123 in reply to wellness1]

I did for a few months as an idiot Endo brought down the dose, now back up to 2 x 5mcg so no issues.

It’s fiddly to cut with a pill cutter, it never perfectly halves and sometimes breaks into crumbs which is really annoying.