T3 starting dose and when to take it? - Thyroid UK

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T3 starting dose and when to take it?

Onlymeandyou profile image
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Hi all, I have finally been able (through my own endeavours) to source liothyronine) Having read previous posts I understand it is best to start on a low dose split throughout the day, I would appreciate any advice on how to do this please. Can I take them with thyroxine? Do the same rules apply re an hour apart from other meds, food, supplements and caffeine? The tablets are 25mcg, should I cut them into 3 or 4 perhaps, what is the optimum time to take them? I am so excited at the thought of getting some semblance of a life back since my cancerous thyroid was removed 30 years ago

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humanbean profile image
humanbean

I understand it is best to start on a low dose split throughout the day

This is true for some people, but not everybody. Timing and dosing of both Levo and T3 is a matter of personal choice.

Some people take all their Levo in the morning before breakfast. Others take it in the evening just before bed.

Some people split their dose of Levo (although I think this is quite rare) and take two doses a day.

The same comments apply to T3. It can be split into as many doses as you want, although most commonly people will take it all in one go, divide it into two doses, or take it in three doses.

Some people feel great and sleep well if they take T3 just before bed. Others can't tolerate it at all at bedtime.

Another thing to bear in mind is that as your body adjusts to taking T3 the perfect timing for you might change. I used to split dose T3 but now I take it all in one go with Levo, before breakfast.

Personally, I found dosing thyroid hormones to involve a lot of trial and error.

Can I take them with thyroxine?

Yes, if you want to.

Do the same rules apply re an hour apart from other meds, food, supplements and caffeine?

Usually, yes. Although if you are splitting dose it may be difficult to do this. As for keeping thyroid hormones and supplements apart...

Levo and T3 should be taken at least 4 hours away from iron, magnesium, calcium, oestrogen, and vitamin D. I hope my list is accurate and I haven't forgotten anything. Other supplements and medications can be taken 2 hours away from Levo and T3.

The tablets are 25mcg, should I cut them into 3 or 4 perhaps, what is the optimum time to take them?

Yes, you should cut them if you want to split dose. To begin with, you might want to take just quarter of a T3 tablet with your Levo.

After a week, add a second quarter a couple of hours after lunch.

After another week, add a third quarter at bedtime or switch your second quarter to bedtime if it isn't working just after lunch.

Never go up in dose more than quarter of a tablet at a time. Some people split T3 into eight, but that can be very difficult. I keep a scalpel with spare blades at home (bought from Amazon), as well as a pill cutter. Different pills respond differently to the method of cutting. Some people just split pills with their finger nails but that has never worked for me.

SeasideSusie profile image
SeasideSusieRemembering

Onlymeandyou

Having read previous posts I understand it is best to start on a low dose split throughout the day

Yes, start with 1/4 of a tablet and wait two weeks, if no adverse reaction add a second 1/4 tablet, wait 2 weeks. Personally I would stop at this and retest after 6 weeks to see how my levels have changed and how I feel. I got up to as much as 31.25mcg T3 but have finally settled on 12.5mcg so it's not always necessary to go past 1/2 a tablet. If you do need more add 1/4 tablet at a time and retest after 6-8 weeks to check levels and how you feel. More is not necessarily better and you could very well miss your sweet spot because you "think" you need more.

I would appreciate any advice on how to do this please

Make sure you have current test results, if necessary test TSH, FT4 and FT3 before starting to add T3. Also ensure that key nutrients - Vit D, B12, Folate and Ferritin are all at optimal levels:

Vit D - 100-150nmol/L

B12 - top of range for Total B12 or for Active B12 100 plus

Folate - at least half way through range

Ferritin - half way through range

Post results on forum, tell us how much Levo you take and we can tell you whether or not you need to adjust your dose of Levo before adding T3.

Can I take them with thyroxine?

Yes.

Do the same rules apply re an hour apart from other meds, food, supplements and caffeine?

I use the same rules because I take one dose of T3 at the same time as my Levo. When I used to split my dose of T3 I tried to stick to the same rules as much as possible. Some people say that T3 is not as fussy as Levo, I prefer to err on the side of caution.

The tablets are 25mcg, should I cut them into 3 or 4 perhaps,

You wont be able to accurately cut into 3 pieces but they can easily be cut into 4. I use a pill cutter, some people use a sharp craft knife.

what is the optimum time to take them?

That's something you have to work out for yourself by trial and error, it's different for everyone.

SlowDragon profile image
SlowDragonAdministrator

No previous posts on here with vitamin results

If you haven’t recently had full thyroid and vitamin testing done, get this organised BEFORE starting on T3

We need OPTIMAL vitamin levels

What vitamin supplements are you currently taking

Vitamin D, folate, ferritin and B12 need testing at least annually

Also need to know where within range Ft4 is at moment on current dose levothyroxine

If Ft4 is right at top/over range will need to reduce levothyroxine before adding T3.

Typically reduce levothyroxine by 25mcg ….waiting 3-4 days after reducing before adding just 5mcg T3 waking

If Ft4 is mid range, you may not need to reduce levothyroxine at all

If Ft4 is near bottom of range, you need dose increase in levothyroxine before considering adding T3

SlowDragon profile image
SlowDragonAdministrator

thyroid blood tests early morning, ideally before 9am last dose levothyroxine 24 hours before test

Once you start on On T3 - day before test split daily dose into 2 or 3 smaller doses, spread through the day at approx 8 hour intervals, taking last 1/2 or 1/3rd of daily dose 8-12 hours before test

Private tests are available as NHS currently rarely tests Ft3 or all relevant vitamins

List of private testing options and money off codes

thyroiduk.org/getting-a-dia...

Do full thyroid and vitamin testing once year minimum, more frequently if correcting deficiencies

Medichecks Thyroid plus antibodies and vitamins

medichecks.com/products/adv...

Blue Horizon Thyroid Premium Gold includes antibodies, cortisol and vitamins by DIY fingerprick test

bluehorizonbloodtests.co.uk...

cheapest option for just TSH, FT4 and FT3

Use this 6-8 weeks after any tweaking of dose…..if change levothyroxine or T3

£29 (via NHS private service ) and 10% off down to £26.10 if go on thyroid uk for code

thyroiduk.org/getting-a-dia...

monitormyhealth.org.uk/

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