Is there any time released T4, T3 available? I take Novothyral, a combination of T4, T3 but towards 6 o'clock in the evening I crash completely. Thank you.
Time released thyroid hormone T4 and T3 - Thyroid UK
Time released thyroid hormone T4 and T3
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ITHY
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You can sometimes get slow-release T3 but it isn't always a good idea. I've never heard of slow-release T4 and doubt it's necessary because the half-life of T4 is seven days. The half-life of T3 is about 24 hours, but what gets into the cells stays there for about three days. So, your six o'clock slump isn't due to the hormone 'running out' or being used up. More likely that you're just under-medicated. When did you last have a blood test? Do you have a copy of the results?
Thank you for the information.
I also have an adenoma of the parathyroid (have but 1 left after total thyroidectomy for papillary-follicular cancer 20 years ago), so too much calcium in the blood at times. Maybe there is a relation?
Also there are ana tithers that are too high (160, max is 80, but lots of people have that problem without presenting with an illness)Last blood work (15th April 2021): TSH: 2.04, T4: 15.7, T3: not determined. In February T3: 2.8 (min should be 3.1). Maybe not enough T3?
I don't know anything about parathyroids and calcium, so can't comment on that.
High ANA means that you have an autoimmune disease of some kind. Did you ever have your Hashi's antibodies tested?
TSH of over 2 is much too high! When on thyroid hormone replacement, it should be down to 1 or under, so you are very much under-medicated. You don't give a range for that FT4, but it's probably too low.
As for the T3, if 3.1 is the bottom of the range, then it's much, much too low! I'm surprised you're still functioning! Didn't your doctor make any comment on that reading? Your result should be up near the top of the range, not under-range. So, there's the root of your problem.
Thank you for your feedback!
I had high antibodies at the time of my cancer diagnosis (20 years ago), there was thyroiditis, but now those parameters are under control (after total thyroidectomy) but still ana tithers, speckled are elevated, yet the specialist told me there was no underlying disease.
I had to take less thyroid hormone in order to 'save my bones', the endo told me high doses of thyroxine can cause osteoporosis (but I also have recurrent hyperparathyroidism, which causes osteoporosis and needs you to be careful with vit. D repletion).
I have recently requested thyroid hormone with T3, because I am so tired. The endo was not too happy, 'T3 can cause osteoporosis', but I read T3 can have a good effect on osteoporosis. It is maddening...
I do not want to take bisphosphonates (they cause the disease, make bones more dense, yes, but also more brittle), even after having broken a hip and a wrist (on impact, osteo is -4.2) I do not want to take that 'medicine'.
You have helped me a lot with this post, I am at a loss what to do. Ever since the total thyroidectomy I have never felt ok again, always tired, jittery, a steam train without steam. Rhodiola (adaptogen) was a miracle for a while, but does not work anymore.
Maybe if you are lactose intolerant ( recently diagnosed) there is interference with the thyroid hormone? I just read an article on that. I hope I can have energy again to live, it has been horrendous, but the endo just does not pay attention.
I had high antibodies at the time of my cancer diagnosis (20 years ago), there was thyroiditis, but now those parameters are under control (
You can't control Hashi's. Although, as you no-longer have a thyroid, the Hashi's antibodies have probably gone. But, that could be why your ANA is still high. I don't really know.
I had to take less thyroid hormone in order to 'save my bones', the endo told me high doses of thyroxine can cause osteoporosis
I really don't think that's true. T4 is a storage hormone. It doesn't do anything much until it's converted into T3. Besides, it's not the size of your dose that counts, it's the levels in your blood, and how much gets into your cells. Your FT3 is so low, that will probably be doing terrible things to your bones! I don't really think your endo knows what he's talking about.
I do not want to take bisphosphonates (
I don't blame you! I wouldn't, either. For good bones you need good levels of FT3 and vit D. Magnesium, and many other nutrients, too.
Ever since the total thyroidectomy I have never felt ok again, always tired, jittery, a steam train without steam.
Because you're under-medicated. You can only replace a hormone with a hormone. So, not surprising Rhodiola 'doesn't work' anymore. It did what it could and now it can do no more. You need a minimum of an increase in levo, but ideally you need T3 because you don't convert very well. You also need a new endo! One that has a clue about thyroid.
Do you think spreading the thyroid hormone dose during the day might improve the fatigue?
No. That helps people who find it difficult to tolerate increases in levo doses. It cannot possibly help someone who is under-medicated and doesn't convert very well, which is your case.
I am in the process of reading your story with the thyroid and yes, at times I wanted to self medicate too, feeling so lousy and not being taken seriously or even listened to. In a university clinic you always encounter different medical students under the supervision of a professor who just signs off a report (with plenty of mistakes in it).
Is there any benefit in taking ERFA, desiccated thyroid that contains T4 and T3?
I have tried what in Belgium is called Novothyral (synthetic with T4 and T, but maybe not long enough or maybe there is not enough T3 in it? Yet I can feel a push (from T3) which then falls back again. The heart can race a bit too.
It could be that caffeine (no more than 3 cups during the day, but I need something to help) in the morning and Kefir (contains lactose) in the morning might interfere with the absorption of the thyroid hormone. Maybe strict avoidance of these can help? Food intolerances can mess up the whole process.
I never get a restorative night's sleep and need to nap during the day, but naps do not help either. There is massive brain fog at times and I feel so edgy it is all frustrating. There was a time shortly after the thyroidectomy (2001) I had to take 200µg levothyroxine to avoid the cancer returning, that was very difficult too. Now that I take a lot less, I lost weight which is rather atypical for hypothyroidism.
I also went to a more 'alternative' doctor (not an endo) who advised me not to eat gluten and dairy, I'll see what that can help.
Thank you for all the information.
Is there any benefit in taking ERFA, desiccated thyroid that contains T4 and T3?
For some people, yes, there's definitely a benefit. But, like everything else, it doesn't suit everyone. However, the only way to find out if it suits you is to try it.
I have tried what in Belgium is called Novothyral (synthetic with T4 and T, but maybe not long enough or maybe there is not enough T3 in it?
As far as I know, Novothyral contains 100 mcg T4 and 20 mcg T3. Erfa, I believe contains 38 mcg T4 and 9 mcg T4. These ratios don't suit everyone. How much T4 and how much T3 people need is a very personal thing. But, when self-treating, one can experiment with adding extra T3 or T4 until one finds the right balance. Doctors rarely allow that kind of experimenting, I'm afraid. They try to shoe-horn everyone into the same mould.
There wasn't enough T3 in either NDT nor Euthyroid (French version of Novothyral). And there was definitely too much T4! I'm much better off on T3 only. But, we're all different.
It could be that caffeine (no more than 3 cups during the day, but I need something to help) in the morning and Kefir (contains lactose) in the morning might interfere with the absorption of the thyroid hormone. Maybe strict avoidance of these can help?
You probably need that caffeine because your cortisol is low in the morning. Has anybody ever tested your adrenals? And, having such low FT3 won't help. But, if you have your coffee at least one hour after your levo, it shouldn't have too much effect on absorption.
I don't think lactose affects absorption, it's the calcium in milk that can have an effect.
I never get a restorative night's sleep and need to nap during the day, but naps do not help either. There is massive brain fog at times and I feel so edgy it is all frustrating.
That's because you are so under-medicated.
I also went to a more 'alternative' doctor (not an endo) who advised me not to eat gluten and dairy, I'll see what that can help.
Giving up gluten and dairy won't necessarily help anything. It's usually people with Hashi's that need to give up gluten if they either have Coeliac Disease or gluten-intolerance. I gave up gluten, dairy, sugar, alcohol, but didn't feel in the least bit better. And, when I started consuming those things again, I didn't feel worse. It doesn't work for everybody. But, you'd be right to try, at least, see if it helps. 
Thank you!
I had thyroiditis prior to the papillary-follicular cancer, so maybe not eating gluten and dairy can help.
There is also the problem with hyperparathyroidism which I have not been able to solve yet (it can only be helped by resecting the adenoma, that would be a 3rd operation, opening up the throat, which is really difficult with 50% chance of success and resulting in a new disease, HYPOparathyroidism)
Here is the article about factors disturbing thyroid hormone uptake, I just recently read it on the internet, looking for possible answers: pubmed.ncbi.nlm.nih.gov/281...
Another question: can you mix synthetic and desiccated thyroid hormone?
About cortisol: I also have very low Co-enzyme Q10 and have now started taking a supplement.
It's true, you coud be gluten or dairy intolerent. But only cut out one at a time, otherwise, you won't know which one makes a difference. And, it's important to know because there's no point in cutting out any nutritional group if it's not going to help.
I'm afraid I know nothing about parathyroids.
In that article it says that lactose intolerence can affect absorption, not the lactose itself.
Yes, you can mix synthetic and dessicated thyroid hormone. And, plenty of people do.
Co-enzyme Q10 has nothing to do with cortisol, I don't think. Are you taking statins?
No, I do not want to take statins and never have, although HDL is 'too high'. A deficiency in co-enzyme Q10 can point to a problem with adrenals.
Are you getting the adenoma removed ? Left untreated the hypercalcemia will cause you long term problems.
I had an adenoma too 20 years ago, that was the reason for the first op. During that operation, they resected half of the thyroid (thyroiditis and struma)too where subsequently a cancerous tumor was found.
Second op = total thyroidectomy and loss of 2 more parathyroids.
Now again adenoma, but no localisation after several scans.
Third op in that region is tricky and risky, especially without localisation. Also it means going from hyperparathyroidism to hypoparathyroidism, this last state is the less bad one, apparently, but I am not convinced. Thank you for your reply!
I had thyroid op then years later parathyroid op, yes it is more difficult going in again and my adenoma didnt show on any scans, my surgeon thought he had removed my last para gland as my calcium crashed afterwards but there must be a tiny bit left as calcium did recover after a couple of months.Are you on Cinicalcet meds to treat it ? problem with doing nothing is the high calcium causing other issues ! I'm left with kidney stones and calcified arteries.
Personally I would rather deal with hypo than hyperparathyroidism.
According to the website Parathyroid.com Cinacalcet should only be taken for primary hyperparathyroidism. By the way dr. Norman (of parathyroid.com) who runs a clinic where only parathyroidectomies are performed in Florida, has been fined for fraud. It makes you wonder about the integrity.
My endo advised against it because it can make you nauseous. I do realize hyperpara is a bad state, but I do not know how life without parathyroids will feel like.
I was told living without a thyroid is no problem at all, well it was not. Some people do not fare well without parathyroids constantly looking for an equilibrium, supplementing with calcium, vit.D.
I have seen 5 surgeons in my home country, Belgium. Two do not even want to operate. The others give a 50 procent chance of finding the adenoma, it is disheartening. No kidney stones, do not know about the arteries? How to check that?
My late husband had secondary hyperparathyroidism and was on Cinacalcet for quite a few years, it did keep his levels in check and he had no side effects.I'm not a fan of Dr N so not surprised about the fine ! When I ran the parathyroid forum we had a few members go over to his clinic for surgery and none went well, all about speed and $$$$.
Have you had your bone density checked ? or kidneys scanned ? I didn't know I had osteopenia, stones or calcification until the scans were done.
justice.gov/usao-mdfl/pr/ow...
In the above link you read about dr. Norman.
I have severe osteoporosis (-4.2), have broken a hip and a wrist (both on impact) but do not want to take bisphosphonates, they make the bones more dense but more brittle too, not stronger.
Supposedly, vit. K2 can help against calcifications.
For secondary hyperparathyroidism (kidney related) Cinacalcet can help, it is not normally used for primary ( = adenoma) hyperparathyroidism.
I do not know how to find out if arteries are calcified due to PHPT.
Thank you for you post!
in reply to greygoose
Unfortunately, many doctors who prescribe T3 and NDT claim that T3 is all used up in 4-6 hours (depending on source) so needs to be multidosed. That is not an absolute truth as many patients are doing absolutely fine taking T3/NDT once a day. I have become more wary also of alternative practitioners lately as some of them are too categorical and seem to think that there is "one size fits all" solution....and it´s THEIR solution. If it were true that T3 gets "used up" very quickly, then you would also need to take some during the night, right...? Also, there would T4 around for conversion in patients taking both T3 and T4, so not sure how logical it is to claim that you run out of T3 if you don´t multidose it.
greygoose in reply to
You don't 'run out' of T3. It has a half-life of about 24 hours in the blood, but what gets into the cells stays there for about three days. So, if you're topping it up every 24 hours with your daily dose, then there's no danger of it 'running out'.
The reason some people do better splitting there dose is that they don't like the peaks and troughs you get with taking it all at once - especially on a high dose. They find that splitting the dose gives them a smoother ride. But, we're all different.
I don't know anything about time release thyroxine, I would love to find some of that. I take NP thyroid name brand of natural desiccated thyroid, porcine. It has t3 in it and t4 and three other hormones. The trouble I've had with natural desiccated thyroid is there have been many recalls which cause you to go hypo and you wondering why and then you find out a month later that your pills were under potent or over potent and so your emotions are all over the place and it's very disturbing to say the least.
Very doubtful that NDT has 'three other hormones'. I imagine you mean T2, T1 and calcitonin. But, the thyroid makes very little T2 and T1 because it mainly comes from conversion. And, there's no real proof that they actually do anything anyway. If there were measurable quantities of T2 and T1 it would be mentioned on the label saying how much. As for calcitonin, it's doubtful that that would survive the pill making process. So, proably not much of that, either. The makers of NDT never claim their product contains these things, so we shouldn't really count on them being there, even though NDT is made from pig thyroid.
in reply to greygoose
I found this pretty interesting, although there is not enough evidence to back the claims up:drchristianson.com/t2-the-u...
greygoose in reply to
I didn't say that the thyroid didn't make any T2, but that it didn't make enough to be meausred. Otherwise, the content would be noted on the label, like T4 and T3.
But, seems to me - and I have no scientific proof of this, just logic - that if you are adequately medicated in terms of T4 and T3, you are going to have enough T2. Because all the T3 and T4 you're taking is going to be converted into T2 eventually. And, logic says that you wouldn't need more T2 than T4 and T3 - you certainly wouldn't have in a euthyroid state. So, I really don't know if its worth worrying about.
I am happy to believe in the importance of T2. But not that desiccated thyroid is a significant and reasonable source.
At one time, the potency of desiccated thyroid was assayed by measuring iodine content. The amount of iodine closely matched what is known of its T4 and T3 content. There simply isn't enough iodine left to indicate a significant T2 or T1 content.
in reply to helvella
Speaking of iodine, even if it´s a bit OT in this post: in the foreward to the Stop the thyroid madness II book, Dr. David Brownstein, MD, writes: "One item that is crucially important for thyroid function is iodine. After testing over 6.000 patients, I can state that over 96 percent have tested low in iodine. In fact, the vast majority have tested extremely low".I cannot help but wonder if this is in hypthyroid patients; that is, people NOT on thyroid hormone replacement? I have read elsewhere that thyroid hormone contains enough iodine for most people´s needs, and that iodine deficiency is rare in industralized countries, and that iodine deficiency is rarely the cause of hypothyroidism. However, since this doctor is in the US, I found this statement very surprising. Many thyroid support supplements contain huge doses of iodine, but they are usually not recommended for people with Hashimoto´s.
ITHY,
Just split your T3 dose.
Many members do this to prevent rapidity of onset and slow duration of T3's action. It helps avoid that common late afternoon low energy slump. Many also say its helps with their sleep although I haven't noticed this. Also kinder on the adrenals if you are sensitive to thyroid hormone.
There's no point in splitting T4 dose because of its long half life.
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