T3 3 x a day how do you time it?: I currently... - Thyroid UK

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T3 3 x a day how do you time it?

FancyPants54 profile image
40 Replies

I currently take my T3 twice a day. I want to try splitting it 3 times a day so no single dose is too much and to reduce the swings of peaks and troughs in hormone levels.

But I don’t know what the best timings would be. I’m currently on 40mcg per day. But I need to move to 45mcg and probably up to 50 later.

I take Levo 100 mcg first thing with first T3.

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FancyPants54
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radd profile image
radd

FancyPants54,

If you are already feeling T3 'peaks & troughs' and thinking about increasing dose further you may need to split dose even more (which is really inconvenient considering food/supplements).

Traditionally T3 meds are split around 8 hours but realistically you can take meds when it feels right and avoids those felt peaks & troughs, because if you are feeling them then they aren't doing your adrenals ( & long term health) much good.

SlowDragon profile image
SlowDragonAdministrator

I take T3 three times a day and split my levothyroxine too

Total daily dose

Levothyroxine 125mcg 5 x week and 112.5mcg twice week

Always Mercury Pharma brand

20mcg T3 per day - always Morningside

Strictly gluten free and soya free

Schedule

6-7am

25mcg or 12.5mcg levothyroxine and 5mcg T3

9.30am after breakfast

vitamin B complex (Jarrow) and 4000iu-5000iu Better You mouth spray vitamin D with K2.

Once week selenium and zinc piccolante

2-3pm 5mcg T3

7pm most nights Igennus triple magnesium

11pm 10mcg T3 and 100mcg levothyroxine

in reply toSlowDragon

Do you find it easy to split Morningside T3 please as need to move from Teva as impossible to split.

SlowDragon profile image
SlowDragonAdministrator in reply to

Not ever had Teva

I use craft scalpel to cut up …fiddly but reasonably accurate

Morningside make 5mcg and 10mcg tablets too…. But much more expensive (as only company with license)

SlowDragon profile image
SlowDragonAdministrator in reply to

Currently

Cost of 20mcg T3 x 28 tablets is £92

Cost of 10mcg T3 x 28 tablets is £148

So would be £296 for 20mcg as 2 x 10mcg per 28 days

in reply toSlowDragon

Thanks I know that’s why I need to split tablets to keep the cost down.

jimh111 profile image
jimh111

I take 30 mcg, 10 at breakfast! 4pm and bedtime. This works well. Given fT3 peaks about 3 hours after ingestion I find the bedtime dose helps with better sleep quality. The brain works hard during sleep and seems to need T3.

FancyPants54 profile image
FancyPants54 in reply tojimh111

That’s a good regimen if 10mcg doses work for you. I just don’t seem to get any benefits from 10mcg.

CaroleM-A profile image
CaroleM-A

I’m on 50 mcg a day. I take 25 with my levothyroxine at about 4/5/6am, 12.5 at 12 noon and 12.5 at 6pm. I find this avoids the peaks and troughs.

At one point I took it in four equal doses at 4/5/6am 10am 2pm and 6 pm but for some reason I’m now finding a larger dose in the morning works better now

FancyPants54 profile image
FancyPants54 in reply toCaroleM-A

And you don’t find the long overnight gap a problem? My problem is I don’t seem to get benefits from 10mcg doses, and I’m not yet on enough to split it 3 ways on sensible amounts. I’m doing 12 hour doses of 20mcg each as I reduce Levo. I’m noticing I’m tired before my evening dose.

thyr01d profile image
thyr01d in reply toFancyPants54

Hi FancyPants, not sure if I understand nor if I can be of help but I take 30 mcg daily and find that possible to split into 3 doses. I divide the pills in half, take 10 mcg between 4 and 7 am (according to when I wake), second dose of 10 mcg around 11 am to noon then last dose around 4 pm (as endo says not to take it any later or it may interfere with sleep however given Jim's experience I'm going to try taking it at bed time, though don't know how I'll then fit in iron and magnesium which each need to be 4 hours away from T3 and away from each other). It's not easy is it!!!I too am tired in the evenings but my endo really doesn't want me to take a higher dose even though I take no Levo and my thyroid "barely does anything", my tsh was over 95 in a range of 0.5 - 10). Take care with it.

FancyPants54 profile image
FancyPants54 in reply tothyr01d

Fitting iron in is really hard!

I don't like 10mcg doses. I just don't seem to benefit from them. They need to be 15mcg at least (during the day this is, it's different later on. I take a dose of 20mcg T3 at 7pm at the moment and no trouble with sleep). I might try 20, 15, 10 at bedtime taking my dose up to 45mcg T3 a day because I do need to increase it I think.

FancyPants54 profile image
FancyPants54 in reply tothyr01d

What I meant was that I don't feel T3 benefit if I take a 10mcg dose at a time. I seem to need each daytime dose over 15mcg at least. I cut my tablets up all the time.

thyr01d profile image
thyr01d in reply toFancyPants54

I see what you mean and think you are probably right though I approach it from the opposite end. I aim to remain pretty stable, rather than feel any different after taking a dose because overall I am so, so much better than before T3. Best of luck.

FancyPants54 profile image
FancyPants54 in reply tothyr01d

I don't want to feel different after taking a dose. But I do want to see some improvement overall and to stay awake. Some of us seem to need more of it to flood our cells. I really didn't want to have to take so much, but it is what it is in the end. I need enough, whatever that might work out at. And I need to reduce my Levo as it seems to be negatively affecting me and the way T3 works.

thyr01d profile image
thyr01d in reply toFancyPants54

Yes, that does seem to be other people's experience, the flooding, it's all so individual it takes time for us to find our own place. Very best of luck.

CaroleM-A profile image
CaroleM-A in reply toFancyPants54

I don’t find the over night gap a problem at all. What I’m trying to achieve is to have normal energy and to feel stable all day. What I’m trying to avoid is loads of energy for short periods and then slumps when it runs out. This achieves that for me

FancyPants54 profile image
FancyPants54 in reply toCaroleM-A

I've moved mine back now. 8am, 2pm and 7pm. And as you say, it's OK overnight.

Just wish I knew if the way I feel now is due to too much T3 or not enough! I've reduced from 125 Levo to 75 and am waiting for it to wash out. It's such a guessing game. I hate it.

McPammy profile image
McPammy

My regimen is T3 twice a day and liquid Levothyroxine twice a day. I only need low amounts to keep me full of energy. I don’t know why some need a lot more than others. My blood results always are in range and my latest TSH is 0.64. ( 0.35-5.50).

7.30am 5mcg T3 ThyBon Henning

12.00 noon 35mcg Levo liquid

3pm 5mcg T3 ThyBon Henning

5pm 35mcg Levo liquid

7pm Ferris Fumerate

B12 injection every 3 months.

Get full NHS bloods thyroid and vitamins and cholesterol done every 3 months whilst getting my B12 jab. It’s like clockwork now.

This works really well for myself. I have no issues anymore. Lost over 4st from when I was under treated without trying. I’m full of energy these days. I feel younger and fitter.

My mood is good daily. My cholesterol came down from 6.7 to 4.9 very quickly too. My BMI is now 24.

FancyPants54 profile image
FancyPants54 in reply toMcPammy

Excellent work McPammy! Well done for finding that dosage.

Such a low amount of T3 would do nothing for me. But it is looking like I have a problem with the Levo, it's never made me feel at all well and now it seems to be converting to rT3 by the look of what's happening so having talked it over with my Endo last week and re-read bits of Recovering with T3 book, I'm going to take my Levo from 125 down to 75 per day and increase T3 as needed. I'm down to 100 Levo at the moment and up by 5 T3. But as I'm feeling increasingly tired and demotivated in the second week from the changes, I think it's going to need me to increase T3 another 5mcg.

I think the reason some can get away with so little T3 as yourself and others need 60-70mcg a day is because of other hormonal things going on. I've been left hypo for probably a couple of decades before I was started on T4 and lots went wrong in that time. So now I have insulin resistance going on, poor female hormone production but I'm on a decent HRT regime now, and high cholesterol, high triglycerides etc. It's going to take time to fix all those things.

Problem I find with taking several small doses of T3 a day is keeping it away from eating and drinking. What gap do I need to leave. Try and leave 2 hours after and one before but if I wake up late difficult to do. First dose not usually a problem as take when wake in night. Also does cleaning teeth with fluoride toothpaste affect it please.

CaroleM-A profile image
CaroleM-A in reply to

I find T3 is ok near to mealtimes. I wouldn’t risk it with T4 but it doesn’t seem to affect T3

FancyPants54 profile image
FancyPants54 in reply toCaroleM-A

I've come to that conclusion too. Life gets too hard otherwise.

Eliotf profile image
Eliotf

I don’t understand taking Levothyroxine more than once a day since it’s half life is about 10 days. Earlier it was mentioned regarding not taking any of them with food. To take the T3 proper in the evening requires fasting for the third time. I would be concerned also of the speed effect before bed. I take my T3 about 12:30pm. If you fast, then continue fasting. If you don’t fast, keep that up, at least for self analysis

helvella profile image
helvellaAdministrator in reply toEliotf

I don’t understand taking Levothyroxine more than once a day since it’s half life is about 10 days.

Why not imagine you only took levothyroxine every ten days?

I think it is better to look at what happens in a healthy person with no thyroid issue. Their thyroid releases thyroid hormone in a pulsatile fashion throughout the day and night. I have always thought that the best effect is likely to be by emulating that - so far as reasonably practicable.

Once a day is quite different to that. Twice a day slightly closer. But, pushing in the other direction, is the difficulty of separating things which interfere with levothyroxine absorption.

One additional observation: The peak in T3 which occurs from taking a dose of T4 occurs around 48 hours after ingestion. The less frequently we take T4, the bigger the T3 peak will be. And that is very likely to be a poor approach.

Eliotf profile image
Eliotf in reply tohelvella

Interesting information. I thought each organ and or system takes the T4 on an as needed basis and converts it to t3. So if a person is taking t4 once a day and the half life is 10 days, then it is easy to keep the t4 levels even. being the T3 is so much shorter I would rather take it 3-4 x a day to make up for it being low

helvella profile image
helvellaAdministrator in reply toEliotf

Some organs convert T4 to T3 and use that T3 themselves. Some release some back into the bloodstream. It is a complex, dynamic situation. Otherwise, there would be little reason to consider T3 levels in the blood.

Weekly dosing has been promoted for use by district nurses who only visit their patients once a week - or similar. I have always found it difficult to accept that is should be allowed and a fairly recent papers seems to concur.

healthunlocked.com/thyroidu...

If it were practical, I'd like to experiment with dosing down to hourly or even more frequently. But it isn't when using tablets - would need something like a dosing machine.

Eliotf profile image
Eliotf in reply tohelvella

I don't have the time, wherewithal to do that often. I agree that giving someone the T4 or the T3 doing once a week is horrible. I have been without a few times and it is very lousy feelings

in reply tohelvella

I read that the brain itself makes some T3

helvella profile image
helvellaAdministrator in reply to

Yes - in health, much of the T3 in the brain is converted from T4 within the brain. (It has even been claimed that the blood-brain barrier does not allow T3 to cross - which is untrue but shows the mindset.)

Appears that the brain even manages different T3 concentrations across different parts of the brain.

in reply tohelvella

Wow. I didn’t know my brain was that clever. Best not let the anti-T3 medics know or they’ll cut off our heads 😉

helvella profile image
helvellaAdministrator in reply to

Where's the Red Queen? .👑 🧡

in reply tohelvella

Having breakfast with Captain Farley. (No rusks)

tattybogle profile image
tattybogle in reply toEliotf

I split my levo into 2 doses. I first did it years ago (before i knew what a 'half life' was) i wondered if it would help with the fact that i became useless after 4pm, so i took some at 2pm ish .. i did genuinely think it helped , but with hindsight that could have been placebo. Then i learned about it's half life and stopped bothering for a few yrs . I now do it again , but with half first thing a.m. and half just before bed . It's not a hassle cos i don't often eat after 7pm .

I began to wonder if having less of an unnaturally high peak of fT4 may allow my TSH to remain a little higher ( mine was always 0.05 ish on my dose of levo) . If it does , then that would mean i got better deiodinase conversion of T4 to T3 ... so more T3 from the same amount of Levo.

I don't have enough results yet to tell if the fact that my TSH is now closer to 1 is due to splitting or something else.. but i certainly don't feel any worse for splitting it... and since it's no hassle to do, it just seems to make sense to try and replicate the natural workings of the system a little more closely than one big dump of T4 in the morning.

If i 'd always felt very well with one daily dose i wouldn't bother splitting it .. and of course my GP think i'm nut's ... but he humours me and prescribes it in 2x 50's and some 25's anyway (just to shut me up :) )

helvella profile image
helvellaAdministrator in reply totattybogle

(just to shut me up :) )

It didn't work, did it? :-)

tattybogle profile image
tattybogle in reply tohelvella

nope :)

Eliotf profile image
Eliotf in reply totattybogle

To me this is where and why the T3 comes into play. I have had Traditional Chemo and Steroids and I think it F_ _ _ _ up my body. My blood tests for my T4 and TSH were fine, My T3 was out of wack. So I started just in the AM with T3 at the same time I took my T4. After about 2 months I was going down hill in the afternoon really fast. That is when my endo suggested the afternoon T3. He also allowed me to experiment to find the right time and also if I needed to take an evening T3 (so it would be 3x a day). I get up about 6-7am take my T3 & T4 wait an hour. Have a hearty breakfast. Stop eating anything about 11 or so. Take my T3 at about 12:30-12:45 wait an hour and then eat a lunch. Usually I don't notice an evening problem as I winding down anyway. I feel I am in a good place with my thyroid numbers as well as taking care & timing of my doses

tattybogle profile image
tattybogle in reply toEliotf

I like the sound of your breakfast.. start eating at 8 , stop eating at 11.. i used to know some Germans who did that .... :)

SilverAvocado profile image
SilverAvocado

Hi FancyPants54,

Sorry to comment on your very old thread! But I saw some of your very useful replies and was having a look and found myself here :p

I divide my T3 (and NDT) into 4 doses. It seems I am less precise than other people, because I have always just roughly divided it up based on when I eat.

I have one dose on waking, one between breakfast and lunch, one between lunch and supper, and then one whenever I wake up in the night (which can vary by around 5 hours I think, as I take it whenever I naturally wake up.).

I think breaking into doses, and how large each dose is, is very much trial and error. All you can do is try it, and if you then don't feel a bit of an improvement in symptoms, or in how consistent you feel across the day, then you might want to adjust the size of each dose, or you might want to stop bothering with that extra timeslot. Because every extra dose of course brings more hassle. More timekeeping, more cutting of tablets, etc.

My experience has been that every time I've added an extra dose it has been great, and I wish there was time in the day to break down into more doses, as I feel about 75% confident it would be even better.

Noticeably the night time dose was something I put off for years, because I had terrible terrible insomnia earlier in my illness and I couldn't imagine setting an alarm or something similar because I knew I'd never get back to sleep after. Now I set everythung up the night before so the dose is sitting in a tiny pot on my bedside table with a bottle of water besides it. I can pull the tablets out with one finger and get them into my mouth only half waking up.

At one point I divided my T3 only into two, as my Endo initially suggested. But when I eventually added the third and fourth doses (years apart), they felt like a dose increase in terms of how well I was. What surprised me the most was that I felt more well even much later in the day, after I'd taken other doses. For example the third dose after lunch made me feel noticeably better straight after my waking up dose in the morning.

The only other big thing I've experienced with dose adjustments, is deciding how large to make each dose. Currently I have my largest dose on waking, a middle-sized dose after breakfast and during the night, and my smallest dose after lunch (I say lunch, but I eat this meal around 6pm, and I only really have two meals per day and little snack late at night... I go to bed not super long after this dose, and am only awake for around 12 hours, properly awake for shorter, which is all another story :p). I've adjusted the size of these doses many many times over the years. At times the later dose has been too large, and I've felt myself hanging around like a zombie all morning really waiting to eat and then have that dose two hours later before I can start living. At other times that evening dose has been too small and I've felt myself winding down after a short period of being more energetic earlier in the day. As others have said, it is a matter of trying to get consistency across the day, and just go in prepared to adjust and have your mind changed by how you get on.

I think we have a bit in common as we are both at the thyroid resistant end ( This is my big problem), and also both feel we have too much T4. I was on NDT-only for a few years, taking a high dose. But eventually stopped getting improvement and am now substituting in T3. I think the extra T4 was causing me problems, particularly heart palpitations and possible atrial fibrillation. I've now found I can reduce the NDT by a very surprising amount on a dose of T3 that is high but not that super sky high.

FancyPants54 profile image
FancyPants54 in reply toSilverAvocado

Thank you for this. I'm still looking for the right dose at the right time! But I understand better now what I'm looking for I think.

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