CT3M from Paul Robinson: Hi everyone, I have been... - Thyroid UK

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CT3M from Paul Robinson

Carlax profile image
49 Replies

Hi everyone,

I have been reading plenty of information available about T3 and the right dosage. My Endo is not helping and my GP has tried but does not have the knowledge.

I went privately and the doctor helped but he said to me he cannot help any further finding the right dosage for me. As blunt as that. I was devastated but he mentioned that it was a trial and error and that it was very complex thing to get. He was supportive but it was something I had to try myself to find out.

Devastating comment!!

Is there anyone that understand fully the CT3M from Paul Robinson? I have a terrible morning anxiety that it is getting worse despite me taking T3 and having improved my symptoms. Somehow this anxiety is the lingering one that I am determinedd to tackle next since I am in the verge of losing my job if I do not get better on that front.

Your help will be very much appreciated.

Carlax

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Carlax
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crimple profile image
crimple

Carlax, I see you have not yet had any answers. Could you explain CT3M.

Carlax profile image
Carlax in reply to crimple

Hi Crimple,

CT3M is the short for Cyrcadian T3 Method.

Summarising, how you take T3 matters, in terms of how you spread you daily dosage during the day.

It matters when it comes to getting a more effective treatment of your hypothyroidism symptoms.

It is very likely that my deadly morning anxiety (it lasts 4-5 hours) can be 'cured" if I nail the timing down.

However, I am finding it difficult and I would like to hear from others.

The book is great but loads of info.

This is the above mentioned book
RedApple profile image
RedAppleAdministrator in reply to crimple

crimple, see here paulrobinsonthyroid.com/why...

RedApple profile image
RedAppleAdministrator

Carlax, The best person to help you with this is Paul Robinson as he's the instigator of this approach. It's very specialised and not something many have any experience of.

McPammy profile image
McPammy

Do you have your latest thyroid blood results. Maybe good idea to add them to this post. Then people can work out if you are over or under medicated potentially. Do you have vitamin blood results also. These are also important. Your Endo/Dr is right in saying it’s tricky to get your own sweet spot and it is trail and error I’ve found. I split my T3 dose 8hrs apart. I also split my levo dose too. Splitting doses really helped me. I get my bloods checked 3 monthly. My TSH is normally around 1.00 with T3 and T4 midway to ranges. I do the blood draw at about 9am and do not take any medications prior that day.

crimple profile image
crimple

OK Carlax, now I understand. I take 100 mcgm levo and 15 mcgm liothyronine. I take 2 x 5mcgm in morning about 7am with my 100 levo and take the 5mcgm at 10pm before going to bed an hour later. If I take the lio and go straight to bed I know I will have to get up for a loo visit.

I self treated with lio before eventually getting an NHS scrip. I know I tried splitting the doses in half but what I do now works best for me, whereas I know some would split a 5mcgm in half to take 2 equal doses of 7.5mcgm. I' sorry you are having such bad anxiety issues.

I am a morning person, always more energy am, even before my thyroid issues so I think that's what made me decide the 10/5 split.

Hope you eventually find your sweet spot.

Carlax profile image
Carlax in reply to crimple

Thanks for sharing your case. I never take my T3 late since I am worried it will interfere with my sleep. I am on 100mcgrs T4 and 20mcgrs T3.However, your 'system' could well work for me...

I will try to get better understanding of the book and if not successfully, I will try to take my last 5mcgrs late at night.

Thanks again

Carlax

crimple profile image
crimple in reply to Carlax

I read Paul Robinson a long time ago but thought I would never manage the regime and as others have said trying to fit in T3 between meals, vit supplements etc just gets too complicated. I prefer the easy life dosing at start and end of day and it works. It is hard when you are not getting help from the so called professionals. I don' t know your dose regimes but would suggest you lower first dose of day and see what happens. best wishes

Carlax profile image
Carlax in reply to crimple

Thank you Crimple!!

buddy99 profile image
buddy99 in reply to Carlax

I also had anxiety issues (accompanied by insomnia). Since I take 5mcg T3 at 10pm I have seen significant relief. Whether it is from taking Lio at that particular time I don't really know for certain (it sure helps with getting bloodwork done in the morning 😀). I read somewhere that taking Lio at that time can cause different reaction in different people. It can either help with anxiety or make it worse. Maybe you want to give it a try and see whether it helps. All the best.

FancyPants54 profile image
FancyPants54 in reply to Carlax

I think the idea that T3 keeps you awake is wrong. High doses might. But 5mcg or 2.5mcg can really aid sleep.

Carlax profile image
Carlax in reply to FancyPants54

Thanks FancyPants54. I am kind of learning that now thanks to all of you. Big hugh from here to all really....I am getting strength from you.

Carlax

Stourie profile image
Stourie in reply to Carlax

hi when I was on t3 only, at one point I was taking 80mcg t3 at bedtime. I only stopped the bedtime dosing because I was up peeing 3 or mor times a night. I did sleep though. Jo xx

endomad profile image
endomad

CT3M didn't work for me, tbh I didn't have the patience for half hour tweaks at 3am I would rather sleep. I did find that it took 9 hours for t3 to work so I just take mine at bedtime. I also found splitting dose 2-3 times a day restrictive for eating and supplements. After 9 years I still get anxiety. T3 is not a magic bullet that fixes everything, certainly not for me after thyroid removed and decline on levo. CT3M works for many but it is all consuming sticking to such tight regimen. It takes time to find how much you need, plenty of info on here, start small, increases until feel better, followed by blood tests. Drs don't know much and care even less from personal experience. I followed the advice of Dr skinner who was t3 pioneer, he said better to soak sponge/thyroid than it stay dry being drip fed. We use the t3 in waves apparently over 24 hours, so your body splits the dose for you. Years since I read his stuff but it is on this forum if you type a search in.

Carlax profile image
Carlax in reply to endomad

Hi Endomad,Thanks for sharing.

I also find splitting dose 2-3 times a day restrictive for eating and supplements. Hence finding it really hard.

I will give it a go but I am not sure I will be able to do it, not without some guidance from someone.

Many thanks and again, thanks for sharing. Very useful as it does not make me feel like the only one that struggles or have struggled with CT3M.

Carlax

Stourie profile image
Stourie in reply to Carlax

Paul himself used to help people with his ct3m method. He might still do this. It might be worth trying to contact him but I don’t know how you would do that. Jo xx

Gingernut44 profile image
Gingernut44

You don’t say how much T4 and T3 you’re taking. Have you tried taking it all in one go before bed?

Carlax profile image
Carlax in reply to Gingernut44

I take 100mcgrs T4 and 20mcgrs T3.No, I have not tried taken them in one go. Is that what you do?

Gingernut44 profile image
Gingernut44 in reply to Carlax

yes, I take the same as you all in one dose before bed. It works better for me, I just didn’t do well splitting. Give it a try, you have nothing to lose by trying as splitting doesn’t seem to be working for you. I also found I sleep much better.

Carlax profile image
Carlax in reply to Gingernut44

That would be so much better. Thanks for sharing. I will definitely give it a go and see if sorts some of my anxiety. At the minute, it is unbearable. Quite frankly...I cannot carry on like this for much longer.

Many thanks x

Gingernut44 profile image
Gingernut44 in reply to Carlax

Best of luck - let us know how you get on.

Carlax profile image
Carlax in reply to Gingernut44

Thanks Gingernut44!!So far, the improvement has happened but not on the anxiety front and it is killing me. Mainly because doctors do not know what to do other than giving me anti anxiety pills which I know they are not the solution.

I shall keep you posted.

X

endomad profile image
endomad in reply to Carlax

I agree with gingernut taking at bedtime improved my sleep, hence setting alarm to take t3 seemed counter productive. Splitting dose left me permanently tired, taking in the morning I was still dead on my feet but awake at night, so I switched to bedtime and bingo. For some t3 acts like amphetamines instant alert/wide awake but not for me. I take a massive dose 125mcg of t3 only at bedtime, I go straight to sleep. Everyone has different experience, it is not a one size fits all, we find what works for ourselves individually. My Dr said same to me, try stuff till it works as best you can. I am post menopause so don't even have estrogen competing for receptors. It's a minefield, I kept a diary of meds, food, mood etc until I found what helped.Anxiety is a double edged sword it can be a symptom of over and under dosing! I also think that if you have anxiety for years it creates neural pathways leaving us suspectable to anxiety, breaking those patterns is not easy.

Carlax profile image
Carlax in reply to endomad

Did you ever experienced anxiety?

endomad profile image
endomad in reply to Carlax

Never until my thyroid was removed, I was the least anxious person in the world, so it was scary, especially the panic attacks. Iv learned to manage it over the years. I have had times where it's crippled me, unable to leave house or drive, it was bonkers. I have long periods with no anxiety now, I do have diazepam for days it's bad. I am anxious today as going out to lunch with large group of ladies, I only know 2 of them so not keen but I make myself go 😬 work really helps as I can focus on it and it keeps me grounded, same for reading. There are foods that also trigger my anxiety like bread ☹️ it's a sharp learning curve xx

Carlax profile image
Carlax in reply to endomad

Same in my case. I was not anxious until my thyroid got removed. I managed it kind of ok over the years, with difficulty but just about. However no, it is crippling me and I have nowhere to go because the doctor does not see how to help me...which is quite frustrating.

Thanks for sharing. I am thinking about going privately but not even sure which doctor I will have to go to...I guess a psychiatrist... let,'s see.

Thabks.

endomad profile image
endomad in reply to Carlax

The difficulty is my anxiety is not so much mental, it's definitely physical. It can come out of nowhere, for no reason. Normal anxiety like today going out, realistically I can choose not to go. Free floating anxiety that isn't rational can not be bargained with. The only thing I find that works for me is distraction, focusing on work, dogs, walking, not a great solution, it doesn't solve it or get to the root of it but I manage it.I was told to eat well, do yoga, reduce stress, don't drink coffee, tea or alcohol. There are so many variables when it comes to hormones. Maybe try a small increase of t3 just to see if it helps. If it doesn't then at least you have ruled that out,

thyr01d profile image
thyr01d in reply to endomad

Hi, I agree with some of the advice about anxiety given to endomad, Yoga can be wonderfully helpful, it can and does affect the nervous system as long as you have a very good teacher who understands well enough. I'm not looking for business (retired now) but if you look on my website I think there's some info on stress/anxiety there, though on reflection it might not be. I am also a counsellor and always recommend to clients coming for therapy for anxiety that they also do Yoga (given free) because the Yoga works on the brain and nervous system, so physical and mental while the counselling works on the emotional body. (pennyjollyyoga.com). Also have some thoughts on the T3. My endo advised not to take it after 4 pm or you can't sleep but what I did was try taking the T3 at bedtime when I was either travelling abroad or driving late at night and needed or wanted to be awake. I found it didn't keep me awake!!! It's a good way to find out without suffering a night lying awake.

waveylines profile image
waveylines

Paul Robinsons approach CT3M is to address adrenal issues not thyroid issues. I'm on a ndt and I remember trialling this approach. It's very potent and is all about the timing of when you take that early morning dose. My adrenal glands didn't show any impairment on formal testing so doing this approach actually left me feeling wired. This because it wasnt the right approach for me. I didn't do it for very long. For me feeling wired was one due to being a little over dosed and two because I needed to address my low but in range b12 and thirdly the need to go gluten free. Once I addressed those two areas the sense of being wired went.

debradee profile image
debradee

just in relation to your comments about food / supplements etc, T3 is fine to be taken at sane time or near food and supplements. It’s only levo that you have to worry about in that respect. I take it under my tongue to aid absorption.

I did the CT3M method, but unfortunately it didn’t raise my cortisol significantly and I’ve had to take adaptions (adrenal cortex) to raise it. Recently I realised I was on the wrong dose of adrenal cortex and I have significantly increased anxiety and a raise solved it .

Have you done a 5 point saliva profile panel to make sure cortisol is still your issue? I take my t3, 3 times a day and I’ve increased my disease by 5 mcg a week until my ft3 is in the upper range. I take 75 mcg.

Have you got all your other ducks in a row - optimal iron, b12, vitamin d etc?

I’ve used the stop the thyroid madness website and a coordinating Facebook group to help me with dosing. My endo wouldn’t help either and discharged me back to my gp who hasn’t a clue.

Best of luck.

thyr01d profile image
thyr01d in reply to debradee

Hi debra, I am curious about your comment about not needing to avoid food etc with T3. Where did that information come from?

debradee profile image
debradee in reply to thyr01d

It seems to be a very common misconception, based on the fact that you do need to avoid foods with t4. T3 is not the same and there is no instructions in my t3 insert to avoid food/coffee etc. I’m on t3 only and often take with food and coffee several times a day. The following comes from ‘stop the thyroid madness’ which is very knowledgable on t3.

Colour photo describing statement
Aurealis profile image
Aurealis

Anxiety could be caused by too much or too little t3.

You could try reducing the dose before the anxiety occurs and move the reduced amount to a different part of the day / combine with another dose. I say this from personal experience, not in terms of the CT3M.

Carlax profile image
Carlax in reply to Aurealis

Hi Aurealis,I dont quite understand what you mean. Do you mind explaining a bit more. Sorry about that but it is important to me since I do know it could be down to too much T3 as well as too little.

Many thanks x

Aurealis profile image
Aurealis in reply to Carlax

sorry, perhaps I didn’t explain clearly. It is a bit difficult to express. I mean keep your overall dose the same but redistribute - reduce dose taken prior to when anxiety usually occurs - move the amount you haven’t taken to a different time of day. If you get less anxiety in morning you know t3 was too high on the dose you reduced. If so, and you don’t get anxiety at a different time, stay with that arrangement. It’s all learning… if you know what I mean. An experiment. Always try redistribution before dose change as it’s amazing the difference timing can make.

Carlax profile image
Carlax in reply to Aurealis

Thanks Aurealis. It is hard and daunting because symptoms can be happening for over or under.....and it is so subtle!!!!

thyr01d profile image
thyr01d in reply to Carlax

Can you use something like how warm/cold you feel, or, say, constipation, to assess whether your need higher or lower dose? I think these symptoms work because if coldness is one of our under-active/undermedicated symptoms then we know we are taking enough when we are no longer cold and over-medicated when hot if everyone else is normal or cold. Sorry for long sentence but hope it makes sense.

Sulia25 profile image
Sulia25

Hi, as others have mentioned, CT3M is for when you have low morning cortisol and are trying to raise it. You would want to do the saliva cortisol test and get your results back before doing CT3M. If you have high morning cortisol, CT3M might make it worse, so you want to check it first.

The basics of it are taking your first dose about an hour and a half or two hours before you wake up. He says you want that dose to be at least 10 mcg.

He also says to check blood pressure, heart rate, and body temp throughout the day when figuring out dose changes and times because these can give you important information. I tried just going by how I felt but I realized that having that data helps a lot in making better decisions.

Hope this helps!

I'm going to be starting CT3M myself because my morning cortisol is really low and the other later times, it's too high. Trying to change that pattern.

Carlax profile image
Carlax in reply to Sulia25

Hi Sulia25,I am having the same problem with the cortisol. Really low in the mornings hence my anxiety.

Thanks for your post. Let me know / us know how you get on. It will be very interesting x

endomad profile image
endomad in reply to Carlax

Is your morning anxiety like an internal tuning fork, I found a brisk 5 min walk settled that.

Carlax profile image
Carlax

The issue is that it tends to start a 4 am and does not go until 9....so I guess I can go for a walk at 6 or 7 but still 3 hours of suffering...it is terrible really...then I start work and all is really hard because my head is tired from all the anxiety and my body feels like it has been on a fight!!! Some day I am lucky and it is 4 hours rather than 5 but still bad. I tried changing the time I go to bed, what I eat, when I eat....I tried many things...I shall keep trying.

Thanks a lot for sharing....I definitely could do with more exercise.

Aurealis profile image
Aurealis in reply to Carlax

so you’re taking a CT3M dose at 3 am and have anxiety starting at 4am? If so, I’d try moving or leaving out the 3am dose.

Carlax profile image
Carlax in reply to Aurealis

Not quite. My dosages are 6 am - 10 mcgrs then I take 5mcgrs at 13.00 and then another 5mcgrs at 5 pm

Aurealis profile image
Aurealis in reply to Carlax

sorry, I don’t know where I got that from. Thanks for your patience

endomad profile image
endomad in reply to Carlax

The reason for a short burst of exercise early morning is, if low in cortisol and you have high anxiety it's because you are pumping adrenaline due to low cortisol. It's the adrenaline that makes you shaky and nervous [fight/flight] a short brisk exercise will burn off the adrenaline. Give it a go x

Carlax profile image
Carlax in reply to endomad

I will definitely try. It is the least thing I fancy at 4 am in the morning but I will give it a go. I have been doing the opposite, meaning trying relaxation and meditation!!!!! They work only partially, and sometimes not at all.

Never thought of exercise as a way to relax but it makes sense. Thanks Endomad!!!

I will keep you posted

Vallillyann1 profile image
Vallillyann1

there is. Facebook group T3 Only support group which is based on Paul Robinsons book “Recovering with T3” and he has his own Facebook page.

Crucial to effective working of T3 is when you take it and your cortisol status. I’d suggest that morning anxiety maybe linked cortisol issue. CT3M is used to raise low cortisol by taking dose (12.5mcg as minimum) 1.5h before it is time for you to get up. You then work out from your vitals BP, pulse and temp the best time for your next doses. It is Labour intensive and can take upto 3 months to find the right dose. Average dosing on T3 only is 40-60mcg at which point your TSH will be suppressed.

Kassas profile image
Kassas

Hi Carlax - just wondering if, a year on since your post - you have managed to resolve or improve your anxiety issues?

Carlax profile image
Carlax in reply to Kassas

Hi Kassas,

Thanks for checking on me. My anxiety was ok for 8 months. I think my body liked the T3 and CT3 Method. However, since the beginning of the year, I have started to feel gradually worse for unknown reasons. I am not stressed from work, since I had to take a sabbatical to get my health in check. And other than worrying about my professional future from time to time, things are reasonably ok right now. However, I get these surges of anxiety, mainly in the morning, like I used to in the past. Not nearly as severe as in the past but still not good. It impacts my day significantly and my productivity, which is something, I must admit, I am mad about.

Two weeks ago, I had an iron infusion to get my ferritin levels up. It went well and I can feel my energy levels being much much better but no improvement on the anxiety front. I am also going to a chiropractor, my neck and shoulders have been bad for over 3 years.

I am struggling to go gluten-free and dairy free which are the two changes I want to incorporate in my life.

I will be checking my blood in 4 weeks and if my T3 is very high I may ask here what I should be doing with my Levo and Lio.

I shall keep trying. How about you? If there is anything that you would like to share, this website is the safe and right place to do so. It has changed my life so much for the better, it is unbelievable. I feel empowered and more hopeful than ever before re my health.

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