Hello - anyone out there taking T3 only? I have Hashi's (hypothyroid) and am taking 37.5 mcg a day. Results are below - I hear Free T3 should be near top of range wondering if I need an increase - it feels like I do.
TSH: .06 (.4 - 4.5)
Free T4: .2 (.8 - 1.7)
Free T3: 2.9 (2.2 - 4.4)
previous post discussing T3 doses
healthunlocked.com/thyroidu...
What are your most recent vitamin D, folate, ferritin and B12 results
Please add that you live in USA to your profile
I'm struggling trying to understand all this. My functional doctor has NOT been on top of the T3 testing or how to test or when to change my dose so am taking it on myself until see new doc first week of Feb.
Vitamin D: 54 (30 - 100)
Ferritin: 42 (16-288)
Folate: don't have exact numbers but was mid range
B12: don't have exact numbers but was in top third of range
Thank you so much for any suggestions.
dear jstein, I am also just starting on T3 only. My thyroid doctor is supporting me. Blood tests meaningless when on T3 only. Go on what you feel and as you increase by small amounts, check that you are not overreplaced by keeping an eye on body temperature and heart rate. Are you splitting your doses? And do you have low cortisol? I find a lot of help in Paul Robinson’s book ‘Recovering with t3. I am 5 split doses 15, 10, 10, 5 and 5. 45mcg. Probably need to slowly increase to 55mcg. As others have said we are all different.
Best of luck. Pm if you want to know name of doctor. X
Thank you for this input! I do not split my dose and yes my morning cortisol is just a little low. I do keep an eye on my temperature and pulse My temperature is always quite a bit low! I am in the US so not sure I could use your doctor but I appreciate you giving me your input and offering his name. The last few weeks I have felt very hypo with all the joint pain and extreme fatigue, weakness, brain fog. I am going to bump my dose and keep an eye on things. I go to a new doctor in just 2 weeks that should help! Thank you again.
I am just curious did your doctor say the blood tests are meaningless or was that in the book? I just ordered the book! Thank you thank you for your input!
my thyroid doctor said that. She has hashimotos herself and has a big clientele of patients with hashimotos. Susie
To say that ‘blood tests are useless’ is not actually correct. What she probably meant is that uninformed doctors (and there’s many in the UK) think that only the TSH is important and if it’s correct as far as they are concerned, it doesn’t matter how you feel. That’s totally rubbish. I’m on just T3 and my TSH is around 0.001 and I feel good.
what she meant is that it is difficult to get any useful information from when you are on T3 only as t4 almost disappears. Possibly it is useful for T3 to be tested just to see that it is not way too high. I didn’t quote her accurately. I have a TSH if between 0.01 and 0.005 and have had for ages. Endo and doc understand that it is not important.
Signs and symptoms are what is important so how you feel and whether you are replacing too much.
Yes thank you that is what I am starting to understand! My functional doc prescribes T3 for me (I am intolerant to T4 and cannot take it) but he doesn't have any idea how to dose, test etc. I go to a new doc next week who I've researched and is good with T3. Yes my understanding now is TSH will drop way low and T4 goes low as well. Free T3 like you said can be helpful to make sure we don't go way over. So far for two years now I have been undermedicated and feeling horrible until I take it upon myself to bump up and I literally come back to life overnight! Thanks again and good luck to you!!
Another quick question about T3 - when you increase your dose how long before you notice it might help? Could it take a couple weeks to settle in and make a difference or do you tend to see an improvement quickly? Thanks so much for your input!
jstein1979. We are all individuals. I am taking a stable dose of 45 mcg (5 split doses) for two weeks. Then I will carefully increase by no more than 5 mg on one of the doses. Not adjusting the timing. I am in the early stages of only T3 and had low cortisol all day until the evening when it raised.
I think it takes 12 weeks for all T4 to clear out of the body. I am hoping that the increased T3 will raise the cortisol which will make me more comfortable. At the moment I feel a little better but still need a bit more T3 I think. You can raise T3 more quickly than T4. But it can be tricky. Don’t increase if stressed or unusually busy.
All experimental at the moment and helpful to have docs support. Susieibbo
When you split your dose Do you always give it an hour after taking the dose before you eat or take other supplements? I have SIBO and histamine intolerance on top of hypothyroidism so this has been a huge challenge! I have not had any good medical guidance in spite of seeing many many doctors who just don't understand this combination. I go to Cleveland Clinic in 2 weeks after a 6-month wait to see a Sibo specialist and hopefully get this all in order. I really really appreciate your input just wondering how you take those five doses if You avoid food the hour after you take it. Thank you again!
Sunny3 - I don't worry too much about food with lio (T3) . I take lio at 5am, 10am, 1am 3pm and 5pm. I tend to take the 1pm dose before I have a snack for lunch. With SIBO may be different but your specialist will presumably help with that. Maximising your thyroid hormones tends to put a lot of things right. Best of luck. Susieibbo
Thank you so much for this information I feel like my eyes have really been opened the last couple days with some of these great comments people have made Thank you!
Hi jstein,
It's individual , some people on here who take T3 only are fine on just 25mcg , it is more usual to need approx 50/60mcg T3 ,, and some need more than that .
How many hours before the blood test did you take the last dose of T3 ?
( we can't interpret fT3 /fT4 results without knowing time of last dose)
It's not so much that fT3 'should' be near the top of the range , it should be 'wherever you feel best' , for some 'near the top' might actually be a bit too much.
Some people won't feel ok if their fT4 goes too low for them , even if their fT3 is level is good. But some people feel ok on T3 only even if their fT4 level is more or less 'zilch'
There are some people here who take T3 only . ( not me ~ i don't take it at all ~but hang around . they will be along
I took my last dose the morning before the test so 8:00 a.m. the previous day is when I took the T3 and the following day at 9:00 a.m. had the blood test. Thank you thank you for your response.
The dose timing was much too long. Your last dose of T3 should be 8-12 hours before the test. 24 hours later your T3 level will have dropped too far to be useful. Do you normally split your dose over the day or are you taking it all at once?
Oh boy! I take it all at once about 8am. So this probably means my T3 is even lower than this test shows 
If you took the test 24hrs after the last dose you are seeing the lowest your T3 gets before you take more. Ideally you want to see what it's like 12 hours after dose, sort of mid working day and base dose increases on that. Your T3 could be too high at that point, we just can't tell from these results.
You need to split your dose on the day before the test so that you have 1/2 or 1/3 of your dose 12 hours before.
That makes sense and I have never realized that. Can't thank you enough.
Just checked and 3 months ago I did the very same test the very same way and my free T3 back then was a whole point higher than it is now. It went from 3.9 to 2.8. so all things equal between these two tests The T3 level has dropped. I just feel so bad!
You need to experiment with taking T3 as split dose every day ……either 2 doses approx 12 hours apart or 3 doses approx 8 hours apart
Some people find it significantly better
Others prefer single dose
But ALWAYS day before test split T3 as 3 doses and last dose approx 8-12 hours before test
Thank you so much for this explanation. Again, my functional doctor has not given me much direction around taking T3. I will get it retested and see where I am.
3 months ago I had a Free T3 blood test which, like the recent test, I took my full dose about 24 hours BEFORE the blood was drawn. If 3 months ago my results Free T3 was 3.9 (2.2 - 4.2) and last week my results were 2.8 (2.2 - 4.2) wouldn't that point to a decrease and perhaps need a small dose increase? Again, will be rescheduling.
ferritin is too low
Aiming for ferritin at least over 70
Look at increasing iron rich foods in your diet
Eating iron rich foods like liver or liver pate once a week plus other red meat, pumpkin seeds and dark chocolate, plus daily orange juice or other vitamin C rich drink can help improve iron absorption
List of iron rich foods
Links about iron and ferritin
An article that explains why Low ferritin and low thyroid levels are often linked
preventmiscarriage.com/iron...
irondisorders.org/too-littl...
davidg170.sg-host.com/wp-co...
Great in-depth article on low ferritin
oatext.com/iron-deficiency-...
drhedberg.com/ferritin-hypo...
This is interesting because I have noticed that many patients with Hashimoto’s disease and hypothyroidism, start to feel worse when their ferritin drops below 80 and usually there is hair loss when it drops below 50.
Thyroid disease is as much about optimising vitamins as thyroid hormones
healthunlocked.com/thyroidu...
restartmed.com/hypothyroidi...
Post discussing just how long it can take to raise low ferritin
healthunlocked.com/thyroidu...
Never supplement iron without doing full iron panel test for anaemia first and retest 3-4 times a year if self supplementing. It’s possible to have low ferritin but high iron
Iron and thyroid link
healthunlocked.com/thyroidu...
Excellent article on iron and thyroid
cambridge.org/core/journals...
Posts discussing why important to do full iron panel test
healthunlocked.com/thyroidu...
healthunlocked.com/thyroidu...
Chicken livers if iron is good, but ferritin low
healthunlocked.com/thyroidu...
Shellfish and Mussels are excellent source of iron
healthline.com/nutrition/he...
Heme iron v non heme
hsph.harvard.edu/nutritions...
Ferritin over 100 to alleviate symptoms
healthunlocked.com/thyroidu...
Low Iron implicated in hypothyroidism
healthunlocked.com/thyroidu...
Ferritin range on Medichecks
healthunlocked.com/thyroidu...
healthunlocked.com/thyroidu...
We have received further information the lab about ferritin reference ranges. They confirm that they are sex dependent up to the age of 60, then beyond the age of 60 the reference range is the same for both sexes:
Males 16-60: 30-400 ug/L
Female's: 16-60: 30-150
Both >60: 30-650
The lower limit of 30 ug/L is in accordance with the updated NICE guidance and the upper limits are in accordance with guidance from the Association of Clinical Biochemists. ‘
Thank you for these articles I will work my way through them. I see now my ferritin is too low so that gives me something else to work on.
perhaps increase to 40mcg daily
Experiment with splitting dose
20mcg waking, 10mcg mid afternoon and 10mcg bedtime
Yep that is what I plan to try. I'm in a tough situation as I have SIBO and extreme histamine intolerance on top of hashimoto's. It has been a real nightmare trying to figure everything out and get well. I have been to countless doctors and spent so much money. After many months of waiting I finally go to the Cleveland Clinic here in the US first week of February to work with a doctor who has a proven track record and understands this mess. I am so grateful I have this site to turn to when I need answers you guys are lifesavers when doctors don't help.
Hello I am in America I take 75 mg Armour. The doctors here don't seem to know much about low thyroid. What is the book I hear you mention?
It is a travesty how little doctors know about thyroid! One of the comments above mentions this book if you want to go back and read it it's about taking T3. Paul Robinson’s book ‘Recovering with t3.
thank you
I'm in the US and get my T3 from a functional practice, as well. I order my labs from UltaLabs online, which uses Quest Diagnostics. I order the TSH, FT3 and FT4, and Total T3. I posted the link to Pfizers Cytomel dosing instructions below. Scroll down to 2.6 under monitoring T3 levels in adults. Honestly, I don't pay much attention to the FT3 and FT4 levels these days and go by how I feel. I test the Total T3 to make sure I'm not overdoing it. In my particular situation the Total T3 is more reflective of what's going on in my body with my thyroid issues. It wasn't an easy decision to go to T3 only but for three years I've tried every T4/T3 combo, NDT, NDT + T3, and this is a last resort. Currently I take 15mcg at 430am(then go back to sleep,) another 15mcg around 11am, and then 10mcg around 6pm. I'm still feeling a bit low so it seems I need more.
pfizermedicalinformation.co....
This is great info thank you so much! The link is helpful!
I had no choice - after being so sick for so long I finally figured out I have SIBO and histamine intolerance - and through that I became intolerant to T4 so HAD to go with T3 and thankfully I don't react to it.
I am just learning my functional doctor was NOT treating my thyroid correctly (or SIBO either!!) and NOT tuned into T3 even though he prescribed it! Can I ask you a couple questions -
How do you watch Total T3 - I mean - to make sure it stays middle of range? Like my total T3 is 129 (71 - 180) - do you shoot for somewhere in the middle of the range?
Also, when you change your T3 dose about how long before you can tell it is working? I just 2 days ago bumped from 37.5 to 40 mcg because I literally felt like I I had been hit by a truck, so achey and joint pain, headache, horrible, fatigue, fluish! Should I give it a couple weeks for it to settle in? I can tell already today I am feeling better, but I also took some antihistamines (being hypo increases your histamine load and that is very bad for me :(... I go to a SIBO specialist at Cleveland Clinic in 2 weeks and am thinking she will be a big help finally.
Thanks you thank you SO MUCH for any further info!
I posted three links below that have useful info on T3 dosing and optimal ranges. I use Pfizer's instructions on monitoring with TSH and Total T3. Others may feel differently but this works best for me. I'm still new to dosing T3 only so this forum is a big help. Yesterday, upped my dose to 45mcg. Feeling a bit tired but still had some facial swelling and water weight so it's clear more was needed. I keep my Fitbit on to track my heart rate and use the weight scale to track water weight loss. I'd give it some more time if you just upped. What helps me the most is splitting the doses three times per day with close to 8 hours in between and taking the first dose at 430am. If the doses are too close together I feel bad. Also had to make sure my body was completely clear of all T4 before further raising. I'm lucky the registered nurse who runs the functional med practice has hypo and she was on T3 only for years. I've been on Thorne iron 100mg every other day which has helped. Just give the T3 some time and slowly raise, even if you have to wait a few weeks and if it feels too much back down for a few weeks. I've been trying different thyroid meds and combos over these past three years and guilty of making changes too quickly. From the advice on this forum, patience is necessary lol.
Thank you so much for this valuable information I will be looking at those links today. My functional doctor prescribes the T3 but he is totally clueless on how to take it. I think I need to split out my dose instead of taking it all in the morning. So you say if you take the doses too close together you feel bad, does that mean all over bad like your symptoms get worse or just tired? I am paying closer attention now when I wake up in the morning is when I always feel worse I never feel good or normal but in the morning I have worse aches and pains and generally a real tightness and pressure in the back of my head and often I feel much better later in the day. I just wonder if splitting out my dose wouldn't help. I have been diagnosed with SIBO and extreme histamine intolerance so that on top of the thyroid has really been horrible. And I just learned that not having my thyroid optimal if I am hypo so to speak, that will increase histamine as well. So it has been tough! I really appreciate your input as I try to work on the thyroid side of things!
I have probably seen 15 doctors in the last few years and none of them really understand sibo and histamine. No one has been good with the thyroid either! I go to Cleveland Clinic in 2 weeks and I'm very hopeful the specialist I see there for SIBO will help me get things in order!
I would never be able to take that T3 all at once. If I take that much all at once it makes me feel like I have hypo symptoms but at the same time hot and flushed. I still feel pretty terrible in the morning and have difficulty getting up. That part is worse on T3 than it was on levothyroxine but I haven't been on T3 long enough to figure out the dose. I may try to take a tiny bit of it before bed like 5 micrograms. Sounds like you definitely need to split yours.
Sorry to hear you are not feeling great
I’m in the UK and I currently take T3 only (since Oct 2021) I feel so much better on this than on T4 BUT still nothing like my normal self. My split dose is 20 at 6am, 20 at 1pm and 10 at 6pm as directed by my endo but I feel like I’ve been hit by a bus when I wake up in the morning- I’m wondering if it’s because there’s no T3 left in my system by then. Once I take my first dose and come around a bit I start to feel a little better.
Anyone else take T3 later in the evening- or might this cause sleep issues?
I’m just starting a gluten free diet to see if this helps with any of my other Hashi symptoms
Thank you for your response! I have had zero guidance My functional doctor has been so bad I am just picking up on so many mistakes! Did your doctor tell you to avoid food with the T3 or other supplements like magnesium? Good luck to you I think it's a matter of just getting the dose just right for your body and if you're like me I'm ultra sensitive!
my endo said I didn’t need to wait to eat or drink when I take my T3 like I used to with the T4, although not sure if that’s just his take on it.
I hope you get somewhere soon x
Yes That is what I'm reading it's not like T4 where you had to wait to eat what I'm reading is with T3 when you eat doesn't matter. Thank you!!!
I’m in the UK and I have been told by my endo and the admin people on here not to eat for an hour before or after taking T3. That’s what I do. For the person on here taking t3 five times a day, that could be a problem! It must really be difficult to cut the pill up that small (or do you have very small dose pills in the US?) unless she’s on a very high dose.
I started t3 in January 2019 with three doses of 2.5mcg a day, starting an hour before breakfast. I was advised not to increase more than 2.5mcg at a time and not for around a month. I have been up to 75mcg a day but have reduced to 62.5 now and still feel fine. And that’s the point, it’s how you feel that is the key.
This is great info thank you! Yes agree I am not eating the hour before or after taking T3. And I only increase by 2.5 - I am up to 42.5. We do have 5mcg pills in US and I am able to cut them if needed. My functional doc has NOT given good guidance on how to increase, when to take, etc. But at least he gives the prescription (I am intolerant to T4). I go to a new doc next week who I've researched and is very good with T3. I also have SIBO and severe histamine intolerance and symptoms definitely overlap so makes it very difficult to know when to increase. Thank you for your inpu!
Should I stop T4 and take T3 only medication?
Test Results Taking T3 only
Free T3 results when taking T3 only and when to take last dose before test
TT in 2013. Taking T3 only but T4 showing in blood tests
