Split am and pm levo + T3 - Blood test

[AleB]

Hi AllI decided to split the levothyroxine to 6.15am and 10pm. So my dosing has been as follows for the past 8 weeks:

5 days per week

6.15am.50mcg levo + 2.5mcg T3

2pm 1.87mcg T3

10pm 37.5mcg T4

2 days per week

6.15am 50mcg T4 + 2.5mcg T3

2pm 1.87mcg T3

10pm 50mcg T4

My question is, because I have split the T4 to am and pm, how should I take the T4 prior to blood test. I am quite ok with splitting the T3 to allow 10 - 12 hours prior to the test, just not tried the split T4 regime before.

Thanks to anyone who can help. X

[Lalatoot]

AleB

I take my doses as follows 6am 50mcg levo and 5mcg lio , 10pm 50mcg levo and 2.5mcg lio.

I do not need to worry about TSH so I do not need an early morning appointment for bloods - my surgery doesn't do early for thyroid anyway.

The longest gap we have between levo doses is 16 hours so our low point is 16 hours after a dose. Therefore a blood test around 2pm will allow you to take your 10pm dose as usual and then defer your morning dose till after the test. This will give a measure of ft4 at its lowest.

Lio take as per usual at 6am then testing at 2pm will give you an 8 hour gap which is what you have between lio doses daily so it is measuring how low your ft3 gets before you top up.. Then you can take your next dose after the test.

I like this protocol for testing as it causes minimum disruption to my dosing regime.

[AleB in reply to Lalatoot]

Thanks Lalatoot for yoir response, I may try that when I have another test... Unfortunately this is booked for 8.50am on Wednesday. This is a gp test along with other markers, I'm not going to hold any hope for a T3 reading!! I have ordered a full thyroid panel plus b12, vit D etc., from Medichecks. Will update when I get the results!Thanks again for the information.

[SlowDragon Administrator]

I also split my levothyroxine and T3 very similarly

I test early morning and just delay the evening dose from day before test until after blood test. This will give slightly lower Ft4

Alternatively day before test you could take both morning and evening dose in morning. This might give slightly higher Ft4

Obviously also ……Delay morning dose levothyroxine and T3 until after test too

[AleB in reply to SlowDragon]

Thank you SlowDragon, I think I will go for this... not taking the evening T4! I will be interested to see the results, especially T3 and iron (when I get the medichecks done). The one I have booked for 8.50am is a gp blood test, they decided to include thyroid tests because I have been suffering wth a weiird skin rash!

[SlowDragon Administrator in reply to AleB]

Are you on gluten free diet?

Rash often linked to gluten

Or could be hives

[AleB in reply to SlowDragon]

I am strictly gluten free, I don't know why I came out in red itchy blotches. Took anti histamine to relieve the itching, seems to have calmed down a bit. I tried to take T3 at bed time again, it's a complete no, no for me... It keeps me awake. I seem to tolerate the 2.5mcg in the morning better alongside the split dose of T4, I get less spikes! For whatever reason 8 weeks in I am experiencing lethargy again around 1 - 1.30pm, holding out to take T3 at 2pm, then having to go to bed for an hour! As I have tried upping the T3 before, I just get hot, facial flushing and my heart rate is way too high for me, my next focus will be to up the T4 and reduce T3 slightly. I have also not had a period since November 2022... Wondering if it is the menopause(age 49).

[Jefner in reply to SlowDragon]

why are some splitting their T4 dose? Curious because it's just a storage hormone

[SlowDragon Administrator in reply to Jefner]

Quite a number of members split their levothyroxine as two doses

It can be smoother

If taking T3 as well, as split dose…..splitting levothyroxine is no more inconvenient

Lots of people on liquid levothyroxine split dose

[Jefner in reply to SlowDragon]

how do you mean "smoother"?

[SlowDragon Administrator in reply to Jefner]

Just seems more “normal “

Personally I only started splitting levothyroxine about two years after adding T3

Did it as a bit of an experiment as I noticed (like you) that several members were splitting levothyroxine…..as well as T3

I find I prefer levothyroxine split

[Jefner in reply to SlowDragon]

you clearly noticed a positive change then and in what way?

[SlowDragon Administrator in reply to Jefner]

smoother …..which is what I said in earlier reply

[AleB in reply to Jefner]

I took my T4 all at night, seemed to improve my symptons slightly, but then it's still finding a balance with the T3. I took my T4 always in the morning, with water on an empty stomach, waited 1 hour, sometimes longer, before eating breakfast. I did this for 10+ years.