How to take dose increase? Split timings - Thyroid UK

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How to take dose increase? Split timings

15 Replies

Hi all,

I've had a 5mcg increase in dose so i'll be on 25mcg but freedom to increase to 30mcg if necessary.

At the moment I take 125mcg T4 and 10 mcg T3 in the morning and 10mcg T3 at 3ish.

When would you add in the additional 5mcg? (or possible eventual 10mcg?)

Thank you. 🧙‍♀️🧹

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15 Replies
SlowDragon profile image
SlowDragonAdministrator

5mcg at bedtime

See how that goes

radd profile image
radd

W-hour,

Why are you raising your meds when you said in a previous post you felt improvements with good mental clarity on your present dose?

Improvements should continue on present dose, especially as you have now adopted a g/f diet that bought further positive change. Reducing antibodies lowers bodily inflammation that can be very impactful on how meds can work.

in reply toradd

Fair question! 😂

I do feel enormously better than I did and my metal health has improved dramatically but I still don't feel quite there. I still tire very easily and generally feel a bit 'meh'. Still chronically constipated, still have zero libido and still sleeping for 10 hours a night....

I can already feel myself declining as this dose settles. I have a very predictable response to dose increases... Feel meh, feel ok, feel amazing, feel great, feel ok, feel meh... The last time I tried letting a dose settle for 12+ weeks I ended up with a TSH of 3.5 so I'm keen to avoid that again!

TiggerMe profile image
TiggerMeAmbassador

I'm with radd ... why would you want to go up when you haven't been on 20mcg long enough to really see what it's doing for you? Especially in such big steps.... T3 is quick acting but it takes a good few months to see all the effects of each dose change

in reply toTiggerMe

I replied to radd. :)

I've been on roughly 20mcg T3 since April 2022. In various forms of either 2 grains of erfa or one grain of erfa with 10mcg T3 added... so I've been on a similar dose of T3 for yonks.

The difference is higher levels of t4, and I've always been a poor converter so I'm not sure I will see much more improvement from that. Likely to decrease if I increase my T3 anyway!

TiggerMe profile image
TiggerMeAmbassador in reply to

How are your latest bloods looking?

in reply toTiggerMe

TSH: 0.029FT4: 18.3 (12-22) 63%

FT3: 5 (3.1-6.8) 51%

TiggerMe profile image
TiggerMeAmbassador in reply to

I'd be tempted to add it in when your cortisol is in a good place 🤗

So maybe avoid your high at noon?

radd profile image
radd in reply to

W-hour,

'so I've been on a similar dose of T3 for yonks'.

No, you haven't been on this exact combo and dose before. This could be your exact sweet spot but because of previous complications and medicating three different meds in varying proportions, lingering symptoms might take a while to reverse.

As a indicator after starting T3 I felt immediate improvements but the lingering symptoms took longer and five years to re-establish good temperature control (always too cold, too hot, or had a hot body with sweats but absolutely freezing feet that hurt - nightmare). Now all is normal 😊

I'm not suggesting you wait for five years but you have implemented some good changes and often these changes can take many months to reach full potential.

If you overshoot your T3 need, it could set you back and the recovery can take months & months. Excess T3 up-regulates the D3 enzyme responsible for inactivating thyroid meds. This is when we have plenty in the blood but feel every hypo symptom available (cellular hypothyroidism).

radd profile image
radd in reply toradd

TSH: 0.029

FT4: 18.3 (12-22) 63%

FT3: 5 (3.1-6.8) 51%

Labs are good for the moment. FT4 is a good level and although many need slightly higher FT3 levels, you may not and you can not know without waiting longer.

Also, FT3 levels might naturally raise as further recovery invites better conversion. Are you supplementing selenium?

in reply toradd

They look good on paper but they don't feel good in my body. I'm not sure why you're insisting so hard that my dose is the right one for me? Tbh, it's actually pretty triggering because that's all I heard from GPs for years. 🤷🏻‍♀️

radd profile image
radd in reply to

No one can know your sweet spot except you. I was pointing out the pit falls of raising T3 too early but shan’t bother in future as it appears to offend you. Sorry.

in reply toradd

None of that offended me. What offended me was the fact that you were ignoring what I was saying and dismissing my symptoms.

I'm grateful for your help and I always will be but on this occasion I don't feel heard.

in reply toradd

Well, no but I never claimed to have been on this exact dose before.

I do understand what you're saying but when I can feel the decline it seems weird to actively ignore that and allow it to continue unabated.

For example, my husband is away today and the children had swimming. Without his support I sat on the sofa unable to muster the energy to get up and cook them dinner in time before we had to leave so we had a McDonald's instead.

Does that sound like a sweet spot to you?

helvella profile image
helvellaAdministrator

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