Starting on T3 with my Levo.: Hello all, I've... - Thyroid UK

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Starting on T3 with my Levo.

Sarfran profile image
5 Replies

Hello all,

I've just been prescribed 20mg of T3 and 75 if T4 daily. Having read other posts I am now wondering whether starting with the T4 and 10mg T3 in the morning and another 10mg T3 at about 5pm (as directed by my Consultant) is the best way to go?

Are there any reasons not to do this?

I was previously on 100 Levo one day and 125 the next, averaging out at 112.5 a day.

Any information would be gratefully received.

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Sarfran profile image
Sarfran
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greygoose profile image
greygoose

The reason not to do this is that it might be too much for you. We usually advise starting on 5 mcg T3 for a couple of weeks, and if that's OK, increasing by 5 mcg, then continuing to increase by 5 every two weeks until you reach 20 mcg. All hormones should be started low and increased slowly if you don't want to make things worse. :)

Sarfran profile image
Sarfran in reply togreygoose

Now I understand, thank you. 👍

greygoose profile image
greygoose in reply toSarfran

You're welcome. :)

fuchsia-pink profile image
fuchsia-pink

My endo started me on an astonishing 40 mcg - before I knew about this forum - which I duly took. I'm guessing it was a mistake as 6 weeks later, in an appointment lasting less than 30 seconds, he halved it! I must have the gut of a rhino as I was quite happy with the high initial dose (although it gave me permanent vitiligo on my fingers and face which is annoying), but really suffered on the instant halving. Low and slow is always best. I'd do it like this:

Step 1: reduce your levo first (always best not to do 2 things at once, so if something isn't "right" you know which it is).

2: after a week, have 1/4 tablet of lio with your levo

3: after another week or two, have another 1/4 of lio well-spaced from the first (mid afternoon, just before bed, whichever is easiest for you)

4: after another week or two, add a third 1/4 lio tablet - either with one of the other doses or as a third dose

5: after another week or to, move up to the full tablet - in 1, 2 or 3 doses as suits you best. Hold for 6 weeks and re-test bloods (obv including a free T3 test)

6. Experiment with the number of doses that you prefer taking it in - this is a personal thing with no "right answer".

If you feel really good on less than a full tablet, stop at that stage, hold and re-test bloods - there's no law that says you have to take a full tablet. Equally if you feel jittery with an increase go back to the previous level for another week or so - some people are very sensitive to lio. And ideally finish one tablet before you start to cut up the next. Unlike levo, you really want an equal dose every day because of the short half-life but it's tricky to get exact quarters. Lick up crumbs off your fingers.

Good luck x

Sarfran profile image
Sarfran in reply tofuchsia-pink

Thank you for your advice. Luckily I only started a couple of days ago, I'll 'go slow' from today. 😁

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