Thanks to some comments from shad on a thread a few days ago, I’ve been reading up on the work of the late Dr John C Lowe, and in particular that some people with thyroid hormone resistance may need to take a single, large dose of T3 per day in order to saturate the body’s thyroid receptors, as opposed to taking multiple, smaller doses.
This is interesting to me, as I’ve been taking 120mcg T3 only for 3.5 weeks now and whilst I’ve observed one or two things, I still feel absolutely dreadful in myself.
My prior understanding was that T3 was short acting, and therefore taking it once per day would mean there would be long periods whereby the body has little available T3.
Have I misunderstood, and is it worth me giving a single dose a go? Does it work for anyone else on here?
Thanks!
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JonnyA
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The idea that T3 is short-acting seems to be based on its half-life in our blood.
But when T3 is transported into cells, its action can continue long after the blood level has dropped. It just won't get topped up again until the next dose.
I suggest as an idea for discussion that there could be two groups of people. It could be complete rubbish. Yet we repeatedly see the population divided between once a day and multi-dosing.
Group A: They can take a large dose of T3 and it quickly becomes available to all cells of the body. Once there, it continues acting for some time - maybe 48 or 72 hours.
Group B: If they take a large dose of T3, it is transported into cells faster than the cells can cope with. That is, they get too much T3 and suffer from it.
Also, a single dose a day will tend to shoot up high in the blood within two hours, then slowly drops for 22 hours until the next dose.
Whereas taking three doses a day means that there will be three peaks, and three troughs. The peaks will not be as high, of course. Nor the troughs so low. So they might be better tolerated in some (such as Group B). But Group A people might manage better with the single peak and trough.
Although on a lower dose of around 30 mcg I was on 105 mcg for many years. I used two doses daily and found it worked. My feeling is that multiple doses are better and safer. Thyroid hormone receptors need to be saturated with T3 for several hours to trigger, hence short term fluctuations in T3 are not so important. However, with single dosing there will be greater fluctuation which may have advese consequences. One consideration is that each tissue or thyroid hormone action has different timescales. For example the effects of thyroid hormone on bone or cholesterol will occur over many days or weeks or months but the effect on the heart occurs over a matter of hours.
I have great admiration for John Lowe, he was one of the best thyroid scientists. I have found that the bedtime dose of T3 is most cruical, too little and my sleep was shallow with little dream and I would wake up feeling tired all day. When I got the bedtime dose right I would manage to get to sleep, have deep sleep with vivid dreams and feel refreshed the next day. I don't know why John found single dosing better, he was on a very high dose of 150 mcg.
Whether you single or multiple dose I would urge you to closely monitor your pulse / hand tremor and be prepared to drop your dose quickly if you experience signs of over activity. My problem was caused by endocrine disrupting chemicals and our exposure and response can change over time.
Thyroxine occurs naturally as levothyroxine and dextrothyroxine - same formula but different shapes to the molecules. Levo is the dominant form and much more potent than the dextrose form. Similar for liothyronine.
I always refer to levothyroxine or liothyronine (LT4 or LT3) when referring to the drugs. I refer to thyroxine (T4) or triiodothyronine (T3) when discussing the hormones from the thyroid or from deiodinase.
Apart from being more correct it’s possible we will find a property of DT4 that is important. So, I like to explicitly refer to T4 or LT4 just so I remind myself they are a bit different.
dextro / levo ...... as in right / left 'handed' ?
maybe that's where i've been going wrong all these years... my right hemisphere is in charge ( usually )...maybe i need to give it "right-handed levo" lol
DT4 has been trialled but seemed to cause heart issues - and needed a much larger dose.
I have looked it up before but have just done a new search and, while I didn't notice anything just about to happen, there have been several recent mentions.
Can I ask what time you normally take the night dose (so when is bedtime)? It seems if someone goes to bed at 10 PM then it would peak at 1:00 AM so a little early, I think the peak is around 3-4 AM. Paul Robinson (I'm sure you've heard of him) said taking a night dose did not work, so he gets up around 3-4 AM and takes a dose. Thanks
I take it at whatever time I'm ging to bed which is usually between 10pm and midnight. You're right that serum T3 peaks around three hours later which is good as it coincides with deep sleep which is when I believe T3 is most needed to get effective sleep and be on form the next day.
In healthy people T3 varies very little through the day, about six percent. If you look at the graph make you take into account the numbers on the vertical axis as they have a habit of zooming in on a little bit of the graph.
Thanks, yes I noticed on the graph its not as wide a range as one may think, yet its enough to see more T3 is produced overnight than in the day, with lowest levels around 3 PM give or take, then after 6 PM slowly creeping up.
I've used some Slow release T3 overnight, 20 mcg, but its probably not releasing fast enough, but better than none, I do believe its made some difference. Thanks
Dr Ken Blanchard has given a different opinion on the dosing and has written about it. He advocates combo levo t3 for all his patients and states that we only need a little slow release t3 added to levo. He treats with adding amounts such as 2.5 MCG slow release t3.power-surge.co/2013/10/05/h...
I am not saying that this applies to you Johnny. I just wanted this as part of the t3 dosing discussion as we are all different and it is good to acknowledge that some only need a tiny amount of added t3.
What I liked about Blanchards work is that he as with Dr Lowe acknowledged the impact that hypothyroidism had on the whole body and it's functions.
This is a really interesting post. I am having the same dilemma. I have recently been offered T3/T4 combo on the NHS. My endo suggested starting with adding 10mcg of T3 split over two doses. One, first thing, 2nd 2-3pm in the afternoon. I have also just read Paul Robinson’s book, who suggests 3-4 doses per day, mimicking the circadian rhythm, starting with one in the early hours of the morning. However he is on T3 only. My endo said I could take it in one dose, but said most people ‘do better’ on two. Here is the thing, I take my levo before bed. For me it’s easier, I don’t forget it. It’s long after my last meal and any drinks. My endo did suggest if I take it once to take it first thing, but I always find it gets too close to breakfast and or teas and coffees and I tend to forget. I don’t particularly like the idea of having to take pills all day every day for the rest of my life, so I am edging towards the one dose. But I am completely confused about how to do my bloods once started. I am not familiar with John Lowes protocol and am interested in jimh111 comment about bedtime dose??…
John Lowe deals mainly with fibromyalgia which he (and I) believe can be caused by a form of hypothyroidism caused by a form of resistance to thyroid hormone. These patients need very high doses of T3. For those who need normal doses (i.e. 10 mcg daily) it would seem bette to split it into two doses, at breakfast and bedtime. Liothyronine is very well absorbed and I take my first dose a few minutes before breakfast. Also, bear in mind that fT3 levels peak about three hours after taking the liothyronine tablet. So, if you take just before going to bed you will have peak fT3 levels about three hours later, which is around the time when the body naturally has a small (6%) peak in fT3.
I take my dose first thing - 7 am and then have breakfast and tea and 8 am. I take 75 mcg Eltroxin (T4) and 25 mcg T3 and I take it all at once. For years, and until a few weeks before I started taking the T3 in Feb 22, I took my T4 at night.
At first, after starting the T3, I felt great. I should say that I reduced my T4 from 125 mcg to 75 mcg before starting the T3. After some time, I began to have my symptoms again (hair falling out, and my voice becomes horrible and a real strain to speak). It was wonderful feeling okay for those couple of weeks.
I have been trying to test my T3 since the end of April. I have finally given up on having it done on the NHS and have ordered a private test. It arrives today or tomorrow. I will do it on Monday.
My T4 is down to 13.4 but I have no idea what my T3 is so it isn't useful!
For years my TSH has been suppressed and over the last year or so, my T4 crept up and my T3 went down.
Dr Lowe also resigned his licence because he was being pursued (I assume by Big Pharma). so that he could do his scientific research and still help people and so that they could sell plenty of levothyroxine (T4 alone).
Dr Barry Peatfield was also another expert in the use of T3 but has now died but he also was pursued as if a criminal so much so that he resigned his licence so that he could advise patients how to recover their health and well-being.
I take T3 alone, but it is a low dose - I have also lowered the dose I took and am still well.
It is people who have 'resistance' to thyroid hormones that need larger doses.
I also state I'm not medically qualified.
I have reduced my T3 dose recently and am healthy, well and active.
Dr Lowe took his T3 in the middle of the night when he went to the toilet, so that nothing in stomach could interfere with the uptake of it.He stated that one daily dose 'saturated all of the T3 receptor cells' and that dose could last for three days.
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Giving the Dr John Lowe middle of the night single T3 dose a go!
Split T3 dose effectively
T4 and T3 split dosing
Would this method of splitting a pill into tiny doses work for t3?
After splitting my dose of T3
