How to reduce t3 meds please. As blood test sho... - Thyroid UK

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How to reduce t3 meds please. As blood test shows I'm too high. Also adrenal issues.

Everdean profile image

I was very kindly prescribed 3x t3 per day by an endocrinologist. However he gave me no instructions except to take 1x 3 times per day. I slowly increased to taking 3 per day but was feeling so I'll. I got a private thyroid test from Medichecks and the results are:

TSH 0.01 (0.27-4.2) mU/L

Free t3 8.82 (3.1-6.8) pmol/L

Free thyroxine. 0.5. (12-22

I also had other tests . The 3 that were abnormal were:

Cortisol blood test at 7-15 am 159nmol/L. Ref. Range for my age is. 383.23

Cholesterol. 6.46. Ref range for my age group is. 5-5.25

Ferritin. High. 186 ug/L. Ref range for my age is. 136

I obviously need to reduce the t3 but don't know how to do it. Can I reduce quickly or should it be slowly please? Please advise. I should then let the doctor know but it's such a palava. I'm so exhausted . Just want to get a bit of life back. I would be so grateful. AGAIN for all your invaluable help. Thank you.

70 Replies

Maybe reduce to 1, 1/2, 1 tablet at breakfast, afternoon, bedtime and then switch to one tablet at breakfast time and one at bedtime after a week or so. let things settle for a few weeks and then you can judge how you are doing. Three x 20 mcg L-T3 is quite a lot for many patients, I'm surprised they went straight to this dose.

SeasideSusie profile image
SeasideSusieAdministrator

Everdean

Cortisol blood test at 7-15 am 159nmol/L. Ref. Range for my age is. 383.23

Cholesterol. 6.46. Ref range for my age group is. 5-5.25

Ferritin. High. 186 ug/L. Ref range for my age is. 136

Are you sure the reference ranges are specific to age? I've not seen that before and I do regular iron panels with Medichecks which includes ferritin, the range is 13-150 and makes no reference to age. All reference ranges have a lower and upper limit like that so you can't say that for your age your ferritin should be 136.

Serum cortisol tests, I think, have different ranges for different times of day not age, I think they should be done before 9am and there will be a range for that.

And I don't think cholesterol has age ranges either. High cholesterol is a symptom of hypothyroidism, but triglycerides result is more important than cholesterol result.

As for your endo prescribing T3 at 1 x 20mcg tablet 3 times a day and not giving any instructions, it seems as though he doesn't really know what he's doing.

Remarkably your FT3 is not over range by a great deal, but I would reduce gradually. Maybe reduce by half a tablet now. T3 has a half life of 24 hours so it may take a couple of weeks for the full effects of the reduction, so see how you are in two weeks and then maybe reduce by another quarter of a tablet. If you feel further reductions are necessary do so only 1/4 of a tablet at a time. If you get down to 2 tablets I'd hold at that for a few weeks and retest then reassess taking into account how you feel as well as your results.

It's possible that you will do well on the right dose of T3 only, but you might also need some T4 (Levo), those who are on T3 only are in the minority here.

Thank you so much I've tried taking a photo of the test results but don't know how to put it on here.

SlowDragon profile image
SlowDragonAdministrator in reply to Everdean

You can add one image in a reply

You are right Seaside Susy the normal range for cortisol is 166- 507 Noting that I am on 5 MCG of prednisolone. It is quite low

SlowDragon profile image
SlowDragonAdministrator

Was test done early morning, ideally before 9am and last 5mcg dose T3 approx 8-12 hours before test

Cortisol looks extremely low

Were vitamin D, folate, B12 tested

Looking at previous post …..you were on 60mcg T3 as 3 x 20mcg and dose has been dramatically reduced

Did the endocrinologist mean add T3 ALONGSIDE levothyroxine

How much levothyroxine were you taking before starting on any T3

15mcg T3 is only a top up dose to be prescribed alongside levothyroxine

Suggest you contact endocrinologist URGENTLY

i could be wrong but i read it as still on total of 60mcg / day as prescribed by original endo ... 3 x 20mcg tablet.

Can you clarify Everdean ,,, what is your total daily T3 dose , 15 mcg or 60mcg

Everdean profile image
Everdean in reply to tattybogle

I am on 20mg tablet 3 times a day. I was previously on just 1 x25 MCG per day from tablets I got abroad. I haven't been on levo for years because it didn't work for me.On the basis of my having the positive Dio2 gene test the endo. just rang me and said he would prescribe the 3 tabs per day and said he didn't need to follow with an appointment. Then I got a text from my GPGP saying the endo had given me a choice. I could have 3 X t3 Or 2 t3 and some levo.

Not being an expert I chose the 3t3. Knowing I couldn't just jump to 3 from

Recently when I asked for a blood test for thyroid the GP was hesitant especially when I asked for t3 test and then told me the Endo really wanted me on t4 and t3.

I

tattybogle profile image
tattybogle in reply to Everdean

am rather surprised an endo would prescribe 60mcg daily of T3 as a starting point .. seems a bit rash ,to say the least.

SlowDragon profile image
SlowDragonAdministrator in reply to tattybogle

Exactly!

Everdean profile image
Everdean in reply to tattybogle

Yes. I agree with others . He doesn't neither the GP know very much about all this. That's why I'm reluctant to get in touch with them

SlowDragon profile image
SlowDragonAdministrator in reply to Everdean

Sorry….my mistake….I read/assumed that was 3 x 5mcg T3

Well spotted tattybogle

So how much T3 were you on BEFORE endocrinologist prescribed and which brand?

If you were only on one 25mcg tablet…..you can’t just increase dose up quickly

Can only add 5mcg extra at a time …….wait 6-8 weeks.

Retest ……add further 5mcg…..wait 6-8 weeks etc etc

Changing brand can cause all sorts of issues

Which brand of T3 are you currently taking

Is this on NHS

So if now on 3 x 20mcg

How long have you been on this much

Was test done as recommended

Last 20mcg T3 approx 8-12 hours before test

What time are you typically taking your T3

Everdean profile image
Everdean in reply to SlowDragon

I took the test as recommended. 1 x20 mcg's ( a third of the dose about 10 pm ) then took the test at about 7 am next morning. After the endo prescribing this amount I increased slowly through the pandemic. After reaching the 3 tablets I waited about 12 weeks to test privately this week. They didn't do routine blood tests at the surgery during the COVID crisis.

SlowDragon profile image
SlowDragonAdministrator in reply to Everdean

So….if you have been on 60mcg 12 weeks and left recommended gap between last dose T3 and test ….it suggests Ft3 is too high

Which brand of T3 is this?

Some brands are stronger than others

Suggest you reduce last dose at bedtime by 10mcg (cut 20mcg in half using pill cutter or craft scalpel )

See how that is after 4-6 weeks

Cholesterol is still high (often linked to not being on high enough replacement dose thyroid hormones

What vitamin supplements are you currently taking

As you are gluten free are you taking magnesium?

Your low cortisol needs further investigation

Why are you on 5mcg dose prednisolone

Everdean profile image
Everdean in reply to SlowDragon

I was diagnosed with ME about 20 years ago. I struggled for a couple of years doing all the doctors advised. I got so sick I couldn't take care of myself. I was so desperate I tried a low dose of pred and it gave me a LIFE. At that time I knew I had thyroid problems but the doctor wouldn't give me meds. So still struggled but at least a bit better. Eventually low thyroid showed up in blood tests. But the levo wasn't working and so I continued with Pred. It's given me a life throughout a huge amount of stress with my husband leaving and other issues. I had had an endocrine saliva test back then and I was very low then. I had had years of stress over misdiagnosis of cancer and had 12 months of strong chemo Med befor I asked for second opinion and they found they had been reading scans wrong. We lost our house and I lost a baby. By now I think my adrenals have given up. I was on larger dose but endo asked me to try and reduce. So I got down to 4 MCG per day. But back up to 7and half now.

Alanna012 profile image
Alanna012 in reply to Everdean

That's a humongous amount of stress Everdean, I'm so sorry, what a strong person you must be to go through all that, and come out the other end.. yes your adrenals are probably and understandably shot to pieces, I hope you start feeling great again once you can reduce your T3 to a tolerable level.

Everdean profile image
Everdean in reply to Alanna012

Thank you SO much for your kind words Alanna012. That means a lot as I feel attacked on all sides sometimes.

Alanna012 profile image
Alanna012 in reply to Everdean

The thing is it's just the truth. But glad it helped a bit. You deserve it.

Everdean profile image
Everdean in reply to Alanna012

Thank you Alanna012

SlowDragon profile image
SlowDragonAdministrator in reply to Everdean

with so much stress….adrenal exhaustion

You’re endocrinologist should be keeping an eye on your levels

If you haven’t read “ Tears behind closed doors” by Diana Holmes ….I would recommend it

I was finally diagnosed as gluten intolerant after 25 years on levothyroxine…more on my profile.

Everdean profile image
Everdean in reply to SlowDragon

I am coeliac which if I hadn't asked the doctor about my blood results, they wouldn't have picked up on it. I know we need doctors but have come to feel nervous at trusting them sadly. Feel I have to sort myself out.

Everdean profile image
Everdean in reply to SlowDragon

My vitamin D is fine . B12 was done a few weeks ago and that was really good too. I have to brace myself to ask for Folate zinc etc. Too exhausted to go through the gauntlet at the moment. Thank you

SlowDragon profile image
SlowDragonAdministrator in reply to Everdean

What vitamin supplements are you currently taking

Everdean profile image
Everdean in reply to SlowDragon

I ha be taken lots of suppliments through out though difficult to fit in between 3 doses of meds. Very stressful.

Everdean profile image
Everdean in reply to SlowDragon

Zinc, magnesium,selenium , B vits. Calcium, vitamins D .

SlowDragon profile image
SlowDragonAdministrator in reply to Everdean

Have you had calcium levels tested

Not generally recommended to supplement calcium unless tested and low

I take T3 three times day (and levothyroxine twice day)

My Supplements regime

All After breakfast ….except magnesium

Better You Vitamin D mouth spray with K2 - 4000-5000iu daily

Vitamin B complex - either Thorne or Jarrow.

I can’t swallow large capsules, so tip powder out

Zinc piccolante once week

Selenium once week

Week before blood test, when need to stop vitamin B complex, I then take separate folate and separate B12 (Jarrow)

Magnesium after dinner about 6.30pm - Igennus triple magnesium one capsule (tipped out)

Everdean profile image
Everdean in reply to SlowDragon

They prescribed calcium because of osteoporosis or osteopaena (can't spell it) they keep changing the diagnosis. I take k also

Everdean profile image
Everdean in reply to SlowDragon

So don't you worry about the 2- 4 hrs between the thyroid meds ?

SlowDragon profile image
SlowDragonAdministrator in reply to Everdean

I take some levothyroxine around 5am

10mcg T3 waking ….usually around 6.30ish

2nd 5mcg dose T3 early afternoon….2.30-3pm

3rd 5mcg dose T3 and majority of levothyroxine (100mcg) at bedtime….11pm approx

B vitamins, selenium and zinc are fine at least 2 hours away from levothyroxine

and vitamin D fine at least an hour away (as it’s absorbed in mouth not gut)

Calcium needs to be 4 hours away from levothyroxine…..probably not quite so long for T3

Similarly magnesium - I make sure it’s 4 hours before taking levothyroxine at bedtime

Everdean profile image
Everdean in reply to SlowDragon

Thank you

Everdean profile image
Everdean in reply to SlowDragon

I wasn't previously on Levo before the prescription. I managed to get t3 from abroad. Then because of the pandemic I couldn't go. I was a victim of a scam online so got scared to order on line. Then after some excellent advice on here, I paid to have a gene test. Showing I had the faulty gene from both parents and didn't successfully convert t4 to t3. I rang my Dr and he got the endo. To ring me. Slow dragon

SlowDragon profile image
SlowDragonAdministrator in reply to Everdean

So homozygous Dio2

Everdean profile image
Everdean in reply to SlowDragon

Don't know what homozygous means

SlowDragon profile image
SlowDragonAdministrator in reply to Everdean

Homozygous means Inherited from both parents

I am heterozygous Dio2 (inherited from one parent)

Autoimmune thyroid (Ord’s), thyroid eye disease, psoriasis, vitiligo and Mitral valve prolapse…..all autoimmune

Gluten intolerant…..possibly coeliac….DNA test was ambivalent ….more details on my profile

Everdean profile image
Everdean in reply to SlowDragon

So sorry to hear you have all those things to deal with Slow Dragon.

SlowDragon profile image
SlowDragonAdministrator in reply to Everdean

I am now fully recovered, with the help and knowledge of this forum 🙂

More on my profile

shaws profile image
shawsAdministrator

Thyroiduk.org.uk had an Adviser/researcher/doctor who was also an expert in the use of T3. He himself took T3.

I follow his method of taking T3 once daily and he took his during the night when he went to the toilet

I take mine once daily when I get up. I feel I have 'normal' health, despite having other autoimmune conditions too.

Levothyroxine alone gave me awful palpitations and I felt unwell but T3 resolved them.

Dr John Lowe (scientist/doctor/researcher/T3 (expert in its use).

web.archive.org/web/2010103...

Dr Lowe states that one daily dose of liothyronine (T3) saturates all of our T3 receptor cells and that one dose can last up to three days. I did this experiment - took 1 dose and took none on day 2 or day 3 and, yes, I felt well and it did last 3 days. I trialled this myself:-

I used to take a higher dose of T3 but now take 20mcg and am fine. Also one dose per day allows me freedom to just be 'normal' and not worry about my stomach being empty if another dose was due.

Everdean profile image
Everdean in reply to shaws

This is my goal to be able to take the t3 just once in the morning.Does this have to be gradually introduced or could I just try it tomorrow Shaw's? I've taken lots of vitamin and minerals throughout but struggled to fit in-between doses. Still it looks like the t3 was absorbed anyway. Thank you.

tattybogle profile image
tattybogle in reply to Everdean

i could be talking out of turn because i don't take T3.... but i don't think it would be very smart to try it just yet , not while your FT3 is so over range . If it's that high 9 hours after 20mcg , think how high it would go in the hours shortly after you absorbed 50 or 60mcg all at once ?

That sort of huge peak of T3 in the blood may or may not present a problem... but , be careful.

There are recent studies suggesting it's not a problem , but i don't think those studies were done with anything like as much as 60mcg all at once . Can't remember what dose they used of the top of my head .. the studies looking at effects of fT3 peaks in blood were posted in the last month or so by diogenes

Everdean profile image
Everdean in reply to tattybogle

Ok tattybogle . What you say makes sense. I must be patient.

SlowDragon profile image
SlowDragonAdministrator in reply to Everdean

And definitely not with such low cortisol

Likely to need to split dose for many months/years before adrenals settle

And as homozygous Dio2…..likely to need to split dose indefinitely

I suggest that you do nothing until you have spoken with your Endocrinolgist or your local doctor. I cannot believe a medical professional would prescribe medication without proper instructions or that a pharmacist would dispense medication without reiterating the dosage.A dosage of 60mcg T3 daily without any T4 appears questionable but not unheard of.

Why didn’t you clarify the dosage with your Endocrinolgist?

Why did you opt for a private blood test when you felt ill as opposed to a visit with a doctor?

Hi ..what blood test did you do for cortisol at medichecks as I only got the saliva one where my morning one was extremely low but doc wouldn't accept it ... She did her own blood test but it was at half 9 and I had been awake 3 hours by then so all my jitters I wake up with ate gone by then ....🤨🤨🤨🤨

Everdean profile image
Everdean in reply to Mitch27

I had the cortisol blood test done by FORTH. I didn't ask for one from the doctor for 2 reasons. I have to travel to get to the blood test centre and I feel too I'll in the morning. Also by the time they took one a few years ago even though I had an early appointment the nurse didn't get around to doing it till it was past the point of giving a more accurate reading. At least with the home test I could do it early. Forth did tell me to have another test at a different time of day. And also to let the Dr know. Apparently the doctors sometimes use this Lab so I was hoping the Dr will accept these findings. Of course they are not happy that I took it into my own hands to take steroids so I have to brace myself for a backlash. It's nerve wracking .

Incidentally, I have got worse since having COVID for the second time last January. When I got to a doctor about a month ago he said it was post viral and just gave me meds for the dizziness.

SlowDragon profile image
SlowDragonAdministrator in reply to Everdean

Best cortisol test is this 4 point saliva test and importantly includes DHEA

regeneruslabs.com/products/...

cdn.shopify.com/s/files/1/0...

Mitch27

Everdean profile image
Everdean in reply to SlowDragon

Thank you for that. Will the doctor accept that test do you think?

SlowDragon profile image
SlowDragonAdministrator in reply to Everdean

Possibly not …..but it’s extremely useful to see if you have correct diurnal variation of cortisol

Everdean profile image
Everdean in reply to SlowDragon

It's ok I looked it up. Sorry to bother you again. Have a good day Slow Dragon and thanks for your help.

Mitch27 profile image
Mitch27 in reply to SlowDragon

Yup I know but doc disagreed and days bloods are ....just can't argue with them 🤷🏼‍♀️🤷🏼‍♀️🤷🏼‍♀️🤷🏼‍♀️ however if I get my own early blood test with sane result I can shove that in her face 🤨🤨🤨🤨

Everdean profile image
Everdean in reply to SlowDragon

Will they do this test while I am on prednisolone Slow Dragon? I have tried to message them but they haven't replied.

Mitch27 profile image
Mitch27 in reply to Everdean

Thanks a mil... Unfortunately we always have yo take matters inyo our own hands 😔😔

in reply to Everdean

I discovered my adrenal insufficiency from a Forth cortisol test. They advised telling my GP who then immediately referred me to the hospital endocrinologist

My cortisol was a lot lower than yours, but yours is also too low.

You need a Short Synacthen Test

The hospital would then check ACTH DHEA etc too

Everdean profile image
Everdean in reply to

Thank you Koala. I had to go to A&e on Friday with palpatations and very high pulse. They were very thorough. Slight rise in Tropinin. But think the Covid may have affected my thyroid and that I'm on too much t3. Which was prescribed by an Endo at the hospital.They are writing to my GP. So will hear from them soon.

in reply to Everdean

Good luck with it all.

Everdean profile image
Everdean in reply to

Thank you Koala

Sorry but I don't understand what that means

SlowDragon profile image
SlowDragonAdministrator in reply to Everdean

Cortisol should be high in early morning…..and then drop through the day

Results should be within the green section of the graph

cdn.shopify.com/s/files/1/0...

Everdean profile image
Everdean in reply to SlowDragon

Thank you

Have you tried contacting Paul Robinson?......he wrote several books on T3 only as he couldnt tolerate any levothyroxine. He has a facebook page and a group. He also looked at the circadian cycle with using T3 as a way of increasing cortosol production. And has found that by taking his first T3 dose in the early hours it has increased cortosol. It is a powerful mechanism so he describes how to do this as it has to be done carefully. Might be worth looking at?

Its good you have an endo willing to prescribe and a GP who backs it. Youve had a terrible time so its not surprising that your adrenals have suffered. I was also diagnosed with ME/CFS, am gluten intolerant, B12 deficient and ended up on a ndt as couldnt tolerate the synthetics.

You may find that lowering the T3 dose a little is all you need to do........its really about how you feel too and the signs symptoms you experience. These are more difficult to seperate out when you have several conditions that you are managing though!!! Lol.... My optimum dose of daily T3 is around the 30mcg mark......but I am on a combined treatment and can convert. We are all different.

Everdean profile image
Everdean in reply to waveylines

Thank you Wavy Lines. I have his first book but with brain fog I find it difficult to follow with no index in it.

waveylines profile image
waveylines in reply to Everdean

Yes I agree....I have his first book too & I found it tricky....but I'm also not great on the science side of things so I assumed that was me!! I just wondered if it might be worth your while contacting him....or join the T3 only group as well. They might have some top tips too. You have Shaws on here she's T3 only. Theyre great on here & very knowledgeable but not many on T3 only. x

Everdean profile image
Everdean in reply to waveylines

How do I join the t3 only group please and how do I contact him ? Thank you

waveylines profile image
waveylines in reply to Everdean

Sorry thought I'd replied. I cant copy the links in...for some reason my phone won't let me....lol . If Google search Paul Robinson T3 group only the face book group comes up in the search engine. You then have to request membership. Says membership of 2.5 thousand. If you Google Paul Robinson T3 only he has a new website. I dont know if he is contactable that way. Otherwise you could try writing to the publisher and asking them to forward your letter. He is also a member on this forum cos he occasionally comments. You could try posting him.

Everdean profile image
Everdean in reply to waveylines

Thank you Wavy Lines. I did email him and he was so helpful. Thanks again.

waveylines profile image
waveylines in reply to Everdean

Oh good am glad you managed to contact him & he was helpful. He will defo know what its like having gone through what you are going through.

You are right you have to reduce the dose of t3 its way too high. Your osteoporosis can become even worse because of it. If I were you I would have only the 20 mcg in the morning and see from there

Everdean profile image
Everdean in reply to Lolota

Thankyou Lolota. But is it wise to suddenly stop the other 40 mg?

Lolota profile image
Lolota in reply to Everdean

You're very welcome. Just see how you feel today with the 20. We are our best Gp. Our bodies talk to us, listen to it. You are feeling very exhausted because with that much t3 you need tons of calories and vitamins to keep up. I did my own research on those things. I am not a Gp. You have a lot of information out there with Google and you speak English so you have an advantage that a lot of people can't. I didn't want to answer at the beginning as I am literally going through hell right now for other reasons than health. I am in France and my life here is very rough because of persecution and abuse. When I read what you went through with the baby and house loss I felt bad. I really hope you will feel better and get a good life back. Good luck with everything.

Everdean profile image
Everdean in reply to Lolota

I am So sorry to hear about the mistreatment you are receiving Lolota. People can be so cruel. I hope you get some relief from your persecution and abuse. It sounds awfull. Have you got friends and family to support you?

Lolota profile image
Lolota in reply to Everdean

Thank you for your kind words. When you have to deal with corrupt and cruel people in very high position like I do you can count yourself very lucky if you have 1 or 2 genuine friends left as well as family members. People tend to have a scarcity mentality and be selfish in difficult situations, they are not aware that strength is in numbers and letting nasty psychopaths without putting a fight it's empowering them. To go back to your case t3 is 4 times stronger than t4 and act very fast and has a less long shelf life in the blood. I really recommend you to reduce the dosage otherwise you will have bones, teeth other trouble. It's the way your body is getting the nutrients to keep you healthy. A very good medicine can be a very bad poison used the wrong way. Have a nice day.

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