How to dose daily T3 monotherapy?: Hi! Trying to... - Thyroid UK

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How to dose daily T3 monotherapy?

beaubeau1121 profile image


Trying to once & for all… stay w T3 only as seemingly now allergic to levothyroxine.

Have worked up to 50/55 mcg a day… of liothyronine….aiming for 60

Endo wants me to add levo but 25mcg tabs caused tightness of throat, sinus congestion etc. So… back to T3 only! What else can I do

but curious about dosage schedule.

Best & thx,


42 Replies

The dosage schedule has to be the one that suits you best. For me, it's best to take it all in one go in the morning, but others like to split it in various ways. I'm afraid the only way you're going to find out what's best for you is to try different amounts at different times.

Splitting three or four times can make life difficult if you like eating and take other supplements/medications. Because despite what 'they' say, it appears that for maximum absorption T3 needs to be taken on an empty stomach, leaving the gaps between food/supplements/medication that are recommended for levo. :)

You are always so wonderfully helpful & caring. Is it ok to ask, your dosage?I am trying to reach 60mcg as I was having sinus issues at lower doses after a few days at 40…when switching from 75 mcg levo & 20 liothyronine.

Any helpful hints…. however agreed that all trial & error… w the 25mcg tab of levo a recent disaster.

My dose is a work in progress. I was on 75 mcg for years, but earlier this year began to feel it was too much - trembling hands, etc. So, decreased to 50 mcg. Then, recently, anxiety began, so increased by 6.25 mcg and have been on that for a couple of weeks. I don't know if I will feel the need to increase again, we'll see how it goes. :)

I really don't see what helpful hints I could possibly give, except to listen to your body. It knows what it needs, you just have to learn to interpret the signs. But, I would advise treating T3 like levo, and taking well away from food, supplements, etc.

Thank you! So very thoughtful & helpful as always. Best to you!!!

Thank you for your kind words. You're very welcome. :)

I take mine in one dose in the morning. I take multiple other doses of medication every 3 hours and found it much too difficult to fit in T3 around that.

may i ask what that dose might be?

I take 50mcg a day.

Thank you!!!!

I'm a big baby and take my NDT 3 or 4 times through the day. I take with or with out food - I find I'm more likely to get reflux on an empty stomach. I know when I missed a dose, I get a pain from thyroid gland to one of my ears, it can be left or right. If I take it all at once I feel wacked and just want to have a snooze.

Thank you very much for your help!

If I was you I would follow greygoose and see how you go. I would never take medication with food as also mentioned as chances are you won’t benefit as likely to stop or lesson absorption of your medication. Remember aswell that medication needs to build up to your preferred dose so it can take time to do this so it’s not an instant fix-patience is also needed.

Thank you! Totally agree & knowing it may take a while…. gives me hope the rollercoaster of late will end!

I’m on 60mcg and take 40 in the morning and 20 before bed…. I used to take it all in one go but read something about T3 dropping overnight and cortisol/adrenaline kicking in to compensate. I was getting woken up with a pounding heart and be wide awake for a couple of hours early hours of the morning. I thought I was taking too much even though I have been on that dose for years. Since I have been taking 20mcg before bed that has stopped happening……

mstp profile image
mstp in reply to Pixielula

I've been having trouble getting off to sleep lately. I wonder if you think that might be caused by the morning dose of T3 dropping off and the cortisol kicking in?

beaubeau1121 profile image
beaubeau1121 in reply to mstp

I sleep better than ever spacing the doses! Amazing … as for some friends… T3 not an option at bedtime!

mstp profile image
mstp in reply to beaubeau1121

Sorry, I dont understand. Why is T3 not an option at bedtime? I thought you said you took it at bedtime.

i did not mean bedtime…. I meant T3 only is not an option most endocrinologists will allow

SlowDragon profile image
SlowDragonAdministrator in reply to beaubeau1121

Many many people find T3 at bedtime improves sleep

Pixielula profile image
Pixielula in reply to mstp

I usually get it at around two in the morning but have had nights where it’s happened as I’ve gone to bed. It’s the racing heart and pronounced heart beat. I have been on this dose for 11 years and it’s only recently started happening. But stopped since I split the dose. I had always shied away from taking it at night thinking it would actually keep me awake. For me it is the opposite….

Have you tried liquid thyroxine? I changed over to liquid , best thing I did .

Great idea! Never knew it was an option!Thank you so much!

SlowDragon profile image
SlowDragonAdministrator in reply to beaubeau1121 a patient reports persistent symptoms when switching between different levothyroxine tablet formulations, consider consistently prescribing a specific product known to be well tolerated by the patient. If symptoms or poor control of thyroid function persist (despite adhering to a specific product), consider prescribing levothyroxine in an oral solution formulation.

My wife had the same problem with T4 - she couldn't tolerate it after a while. When she first started on T3, it was 75T4, 20T3. She then progressively reduced the T4 and finished on 40T3 only and then increased that to 55-70 depending on the demands of the day. 55 was fine for a relaxing day but she found she needs to go up to 70-75 if she's going to be more active physically and/or mentally that day. She splits her dose, 25 (Mexican) to start the day, 20 at lunchtime and 10 early evening. This works for her but may not be suitable for you of course. As greygoose says, listen to your body.

beaubeau1121 profile image
beaubeau1121 in reply to tcpace

you are the best! that is exactly the schedule i have been trying now at 55mcg!will stay the course… & be hopeful!


I feel better spreading mine out so usually take 15 mcg in the morning then 10 mcg mid-morning and again at night. Only water for an hour before and after.

beaubeau1121 profile image
beaubeau1121 in reply to Babette

Thank you so very much! So grateful!I will try the same. Must say… being off levo…. my sinus congestion gone, sleep well … blood pressure great! Do not understand the drs not permitting T3 only!

Babette profile image
Babette in reply to beaubeau1121

Good luck. It seems to be trial and error.

I think the reluctance to prescribe is partly down to cost but also that T3 is harder to monitor. I can't tolerate levo either; it makes me really ill. On liothyronine only, my TSH has been up to 50 and I've still been able to work.

SlowDragon profile image
SlowDragonAdministrator in reply to beaubeau1121

Are you lactose intolerant?

Is T3 lactose free

Is Levothyroxine brand lactose free

I take mine in a single dose at bedtime (currently 87.5mcg) this avoids having to work round food and drinks, but this timing won't work for everyone.

I'm afraid it's trial and error with T3, it took me a long time, and several mistakes, to reach my therapeutic dose ...and even now it needs occasional tweaking.

You have to learn to "listen to your body" , as an old medic friend of mine used to often repeat.

I doubt modern medics think this way, they depend too much on computer screen info and overlook clinical evaluation!

Be flexible, there's no quick fix it takes time and patience.

Thank you! So true… just numbers not symptoms!

Listening to your body should not only include symptoms but also taking your vitals (blood pressure and basal temperature) an hour before and 2-3 hours after the dose (or even more often if possible) to see the patterns and avoid tissue overstimulation of too rapid dose rises. It all depends where you start from and what state your body is in so no hard and fast rules here other than slowly and patiently does it best 8-).

beaubeau1121 profile image
beaubeau1121 in reply to samaja

Thank you!

I was on thyroxine for 16 years,then T3 only for 2.Now been on NDT since 2017.When I tried to introduce a little thyroxine(25mcgs)to T3 or NDT,I got an increase in episodes of tachycardia & almost constant ectopics.I have a diagnosis of SVT(supraventricular tachycardia) for the almost double heart rate episodes but have now self-diagnosed Roemheld Syndrome(with help from Sanjay Gupta of York Cardio).I believe there may be a connection with Hashimotos.I never did well on thyroxine,but like you,I believe my intolerance has got worse(I am now 71)

beaubeau1121 profile image
beaubeau1121 in reply to Naomi8

I am 71 too…. & on thyroid meds since my teens!Thank you!!!

beaubeau1121 profile image
beaubeau1121 in reply to Naomi8

Which NDT is stopped T3 only? Thc

Naomi8 profile image
Naomi8 in reply to beaubeau1121

Sorry-please explain what you mean

beaubeau1121 profile image
beaubeau1121 in reply to Naomi8

Typo sorry. Curious which NDT are you taking now after stopping T3 only medication a couple years ago.T3/Liothyronine only is making me so tired even as I increase the dosage.


Naomi8 profile image
Naomi8 in reply to beaubeau1121

The NDT I take is no longer produced.I think African Swine Fever has paid/is paying havoc with NDT supplies worldwide.The chinese have slaughtered millions of pigs.I stocked up at the time it was in the news. I am dreading running out.I do not get ectopic beats on NDT or T3.If I can't get NDT I will go back to T3-only.My SVT is much more frequent on thyroxine.

Naomi8 profile image
Naomi8 in reply to beaubeau1121

Being over-medicated as well as under-medicated can cause fatigue.

shaws profile image

I take T3 only and I take it when I awake with one glass of water and don't eat for an hour. I am well and symptom-free and I followed Dr John Lowe's advice and he was also an Adviser to before his accidental death.

These are some of his links and he himself took T3 in the middle of the night when he awoke to go to the toilet. There are some links within the following that may be helpful for you.

beaubeau1121 profile image
beaubeau1121 in reply to shaws

So encouraging! Thank you. Will read all!

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