Apologies, I have been looking back through old posts made to others but haven't found the info I was looking for.
I have been fortunate enough to get a private prescription for T3 (my first time taking it) and I was wondering what the HU advice is regarding taking it? I am getting 20mcg thybon henning, and have been told to start off an a quarter a day. Do I need to take it on an empty stomach? Should I take it at the same time as Levo or not? Should I be reducing my Levo (currently 100mcg daily)?
Last blood tests 20 Sep 21 (I am due another lot soon I guess):
FT4: 17.9 (12-22)
FT3: 4.3 (3.1 -6.8)
TSH: 0.48 (0.27-4.2)
Many thanks in advance
M
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malohant
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I treat T3 the same as Levo, it's expensive and not easy to obtain so I don't want anything to affect it's absorption.
Should I take it at the same time as Levo or not?
Yes you can do. I take first dose with Levo early morning. When you add in a second dose you could take this in the afternoon or some people take it at bedtime. Remember to keep away from other medication and supplements, like you do with Levo.
Should I be reducing my Levo (currently 100mcg daily)?
Did your endo not tell you what to do?
FT4: 17.9 (12-22)
FT3: 4.3 (3.1 -6.8)
TSH: 0.48 (0.27-4.2)
Your FT4 is only 59% through range. No need to reduce Levo. Taking T3 is going to lower your FT4 anyway so add the T3, leave Levo dose as it is, see what your next test shows before deciding what to do next.
I am getting 20mcg thybon henning, and have been told to start off an a quarter a day.
Have you been given guidance by your endo on hour to titrate your dose of T3 and when to test? Remember that when testing last dose of Leve should be 24 hours before test and last dose of T3 should be 8-12 hours before test (splitting dose and adjusting time of T3 the day before if necessary).
Thanks SeasideSusie , I have emailed my endo asking for clear instructions - he did tell me to take a quarter tablet to start with and something else over the phone but I have forgotten half of it already. He didn't say anything about adjusting Levo but I wanted to check with the advice given here - if I trusted everything a medical professional told me re: hypothyroidism I would be nowhere. For example, two things which have demonstrably made a difference in managing my condition have been eliminating trigger foods and taking supplements, boht of which the endo rather pooh-poohed, showing me papers which said there was no connection, which is all well and good but they have definitely made a difference to me.
As I said I need to get blood tests done, ideally before starting the T3, and then he has asked for more blood tests to be done in two months when we will review. I don't know anything about when to titrate up or how long I will stay on 1/4 tab (~5mcg). Or really what to expect when I start taking it - I believe starting T3 isn't supposed to be the smoothest journey but I don't know what that might mean.
See if he has any instructions for titration. If not we often see advice here is to start with 1/4 of a tablet, wait 2 weeks and if all OK add another 1/4 later in the day, see how things go and maybe add a third 1/4 (so 3 x 5mcg 8 hours apart or maybe 10mcg morning and 5mcg later in the day) after another couple of weeks or maybe wait a bit longer. It's a lot of trial and error. You may find 15mcg enough, you may need the full 20mcg, nobody can tell you.
Why is it whoever prescribed T3 has not offered you a clear introduction protocol?
FT4: 17.9 (12-22) - 59%
FT3: 4.3 (3.1 -6.8) - 32.43%
TSH: 0.48 (0.27-4.2)
Your TFT’s don’t look too bad and even if you wished to higher FT3 a little going in at 20mcg T3 seems a lot. Have you tried optimising iron & nutrients for improved utilisation of thyroid hormone ? On these results I would be recommending a rise in Levo myself that would raise FT4 and also FT3 by conversion, which if were not to happen I would be adding 5mcg or 10mcg T3.
However, if you have been prescribed 20mcg T3 on these results then the protocol would be to take 5mcg T3 (a quarter pill) with Levo and a glass of water on an empty stomach each morning.
After two weeks if there are no ill effects add another 5mcg T3 and take in the pm.
After four weeks if there are no ill effects add another 5mcg T3 to the am dose.
After six weeks if there are no ill effects add another 5mcg T3 to the pm dose.
After 8 weeks TFT’s to check FT3 hasn’t risen too high.
If you feel a bump (fluttery heart, anxiety, etc) you can hold dose for longer or reduce increments to 2.5mcg T3 and/or split dose into three times a day, Many members have to do this if adrenals aren’t robust enough to withstand the increase in metabolism. Also many members experience an inner heat and headache after initial dose that clears after about three days.
My endocrinologist has offered me a three month trial of T3 based on my bloods appearing essentially euthyroid but me still having significant symptoms. They were honest enough to say they don't know why T3 works but it anecdotally does work for many of their patients so they prescribe it as a 'therapeutic trial'.
My GP, if anything, has been wavering on suggesting a decrease in levo (which I have strongly objected to, and therefore it hasn't happened thus far) - which is why I went to a private endo, and this was their suggestion. I believe it has largely been prescribed due to symptoms rather than blood results - I was given an option of NDT or T3, but prefer the vegan option (although I'm not vegan).
My FT4 has been at 80% or more of the range since Sep 20, the last test was the first it has been so low in a while. My FT3 has generally been 25-50% through the range over the same period, and my TSH has been consistently below range (which looks good on paper but essentially put paid to my hopes of seeing an NHS endo, or so my GP and local support group said).
I have been working on my blood nutrient profile, my vit D has increased from 4% to 25%; B12 from 218 (300-569) to 713 (>179); folate from 34% to 98%; ferritin from 1% to 17%.
I think the 20mcg tabs were the only ones available, certainly from the supplier the endo gave me details for?
I will have a review with the endo after 2 months.
I take my first quarter 5mcg of T3 ThyBon Henning tablet when I get up. Then my 2nd quarter 5mcg 8 hrs later. I’m on Levothyroxine also and I also split my Levothyroxine dose into two dose. I’m on liquid Levothyroxine. When I first started T3 about 2.5 years ago now, I felt bloody fantastic compared to how I’d been feeling without it. Only issue I got was lower back pain which lasted about 3 weeks. I called my private endocrinologist about this. He said not to worry and it’ll go away. It did. ThyBon Henning flushed out water due to the way they’re manufactured, it was my kidneys waking up. Also my cortisol jumped from a very low figure of 150 under range to 450 within a month. This was revealed on my blood tests. So adrenals waking up too. Infact my whole body woke up. Giving me energy like I hadn’t felt since my 30’s. I was 60 then. I’m still full of energy 2.5 years later with no problems. I’ve lost 4st 4lbs that piled on when grossly under medicated too without even trying.
It’s all about getting your body functioning well again and T3 reaches every single cell in your body to do this.
I never reduced my Levo when I started T3. Go with what your Endocrinologist has prescribed. I stayed in same dose and just incorporated 5mcg T3 twice a day 8hrs apart.
Yes reduce your Levo. I think you can find a fomula on line for how much a certain amount of T3 equals a certain amount of T4. T3 is 4 times as strong as T4. So in general 5 T3 equals 20 T4. I take 2.5 T3 three times a day. And one 112 T4 once a day right before bed and at least an hour after dinner. I find I feel a lot better using T3. You should take it 2 hours after eating and one hour before eating. However, it is not as sensative to food in your gut as T4 is. Best of luck.
Why would she reduce Levo when her FT4 is only 59% through range? Reducing Levo will lower her FT4, taking T3 will lower her FT4, so she will end up with a very low FT4 level which may not be right for her. Just adding T3 now and leaving Levo as it is will increase her FT3 and lower her FT4, she can then decide if she needs to further tweak either dose.
We are all learning here and we hear different things from different sourses. Your explaniation makes sense to me. Thanks. My endo recommended reducing T4 when I started taking T3 which she describes as 4 times as "strong" as T4. But then again my Endo seems to think TSH is the most important number, which of course is nuts. Your explaniation makes good sense. Thanks.
Reducing Levo when adding T3 is correct sometimes, if FT4 is over range or top of range then reducing Levo is the right thing to do, it just depends on where the FT4 sits within it's range.
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