T3 dosing schedule : 👋 For those taking T... - Thyroid UK

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T3 dosing schedule

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👋

For those taking T3, would you mind sharing your dosing schedule with me and how you feel on it?

I’m beginning T3 and trying to decide how I want to dose it. I’m one of those people who doesn’t notice their T3, so wondering if I can get away with taking it as one dose in the morning.

Thank you in advance 🙏

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43 Replies
TiggerMe profile image
TiggerMeAmbassador

I'm a one dose wonder 15mcg Roma first thing with 100mcg Aristo/ Vencamil

When I first started I would split the dose but the slumps in between were noticeable so I swapped to first thing and the slumps were gone!

Once I started to approach my sweet spot I experimented again but I still find a morning dose works best and allows for better rest and recovery overnight 🤗

in reply toTiggerMe

Thanks Eeyore! OK sounds like I’ll get away with a single dose possibly…!

TiggerMe profile image
TiggerMeAmbassador in reply to

Well... it happens to tie in with my cortisol being in a good place first thing.... 😉

Think I might have picked that up from you 🤗

in reply toTiggerMe

well that’s where I am actually coming from too! I find my afternoon doses can cause me some angst, but the morning is smooth because I take my HC then. I need to do an update as I’ve changed a few things up.

Do you have your synacthen results? Be so curious so see those x

TiggerMe profile image
TiggerMeAmbassador in reply to

I seem to get a better uptake for the dose first thing and it lasts which must be linked to the cortisol as my cortisol is pants later in the day.

I find I can take 15mcg in one dose as opposed to 25mcg split, bloods much the same but the lower single dose feels much better so assume more is actually making it into the cells 🤷‍♀️

in reply toTiggerMe

Yes, I remember you saying you only take 5mg HC atm unless that’s changed?

I’m on 15mg now but find my cortisol feels too high if I don’t have enough thyroid hormone to match it, it’s such a fine balance and is taking constant monitoring and effort.

I’ve been using a Kinesiologist and it’s been quite a game changer. She isn’t meant to but she will test my meds too and she said I need 15mg at this stage so I’ve gone to that and I’m getting slowly more stable. Was having a bit of a nightmare before with the HC dosing as it wears off so quickly, been considering prednisone instead. She’s also put me on a supp called MasterGland and Chinese herbs, I am definitely calmer since starting that a few days ago. It’s a totally witchcraft feeling when she’s testing but I am a complete convert at this point!

TiggerMe profile image
TiggerMeAmbassador in reply to

Interesting stuff... I'm still on 5mcg and doing a saliva test today to see what effect that is having overall 🕵️‍♀️

jade_s profile image
jade_s in reply to

15 mg is not very much. Are you sure you're on enough HC? Most people need at least 20mg, i take 30mg equivalent. Do you split it so that you take no more than 10mg once an hour? Taking more just increases its clearance effectively leaving you with less circulating HC.

Is she doing muscle testing? :)

Anyway for T3 I take 12.5mcg T3 every 2 hours. Don't do well taking it later in the afternoon nor all at once.

in reply tojade_s

yes it’s been SUCH a long journey to get here to the 15mg. I meant to make a post as wanted to pick your brain!

So I began on 5mg and was immediately improved on so many fronts - even for my period back and life long hypoglycemia was gone! 🙂 and I increased to 20mg as I know this is probably the most standard full day coverage dose but within a few days I was having headaches, terrible anxiety, dissociation, and one night I stayed awake until 6am! I actually lay in bed wide awake until the sun came up ☹️ I went to NHS endo, he more or less told me to dose as I see fit - so I monitor all my vitals very closely and wear my Apple Watch to monitor progress, but I just knew 20 was too much. I tried 3 more occasions to increase but each time I had the same response. BUT I was not on much thyroid hormone at the time, so I increased my thyroid hormone and found I could go from 5mg HC to 15mg HC, but not more. I anticipate needing more as I raise thyroid hormone, but so far I am unsure.

Presently I am dosing like this:

6am: 10mg HC + 7.5t3 + 100t4

12pm: 2.5 HC + 2.5 t3

4pm: 2.5 HC + 2.5t3

Bedtime: 1.12HC

And I don’t have any issues at the moment with “overmedicated” symptoms but my T3 is still low so I think I’ll need to increase HC as I increase T3.

Yes I use muscle testing and I love it! Kinesiologist told me that I need 15 HC right now but it might change. That said, if I felt she found something that didn’t make safe sense to me or my endo I would override the advice.

jade_s profile image
jade_s in reply to

Whew that is an interesting schedule but far be it from me to fix what aint broke ;)

Sorry to hear about the sleep. For that reason they say 2/3 or so of the dose should be taken before noon/lunchtime. And some people can't do a later afternoon/nighttime dose. I can appreciate you know your body best though :)

The T3/HC thing makes sense.

I wish i had a kinesiologist near me. They helped us a lot when i was younger. I now muscle test at home including yes sometimes meds, but it can be unreliable at times.

in reply tojade_s

I am actually very interested in what you’d recommend for my dosing as I know it isn’t perfect, my sleep is still disturbed. My morning dose works and I’m happy with it, but after midday it goes downhill and I’m unsure.

I know my low symptoms - I get clumsy, very very nauseous, anxious but ofc I would like to be able to dose before that situation arises!

Yeah, I love kinesiology. If I were well enough I’d love to train in it x

jade_s profile image
jade_s in reply to

Well hard to say what's best, as you can see in this paper there's lots of variation onlinelibrary.wiley.com/doi...

Keep in mind i am not a doctor!

I think your morning dose is too high and there's not enough later on

You could try something like

6am: 7.5 mg HC + 7.5t3 + 100t4

9 am : 5 mg HC

12pm: 2.5 HC + 2.5 t3

4pm: no HC + 2.5t3

Bedtime: no HC

And if that leaves you with too little in the afternoon, split the 9am 5mg into 2 x 2.5 take one 2.5 then and take the 2nd 2.5 at 4pm.

Just a thought. Keep an eye on symptoms obviously. Do you keep a daily log?

in reply tojade_s

thank you, I’ll have a look at the paper and consider the new timings.

Yes i am spreadsheets galore 🙂

TiggerMe profile image
TiggerMeAmbassador in reply to

Sorry forgot that bit... no nothing yet from SS test

SarahJane1471 profile image
SarahJane1471

I take mine first thing. 125mcgs Levo 6 mcgs lio . I have high cortisol in the morning. ( don’t know about the rest of the day as I’ve never tested levels later only morning serum). I find T3 quite stimulating so would rather not have it later. I have tried splitting but I prefer all in one go as it seems to stop my early afternoon slump.

in reply toSarahJane1471

🙏 thank you for sharing. Do you feel the benefit of added T3 generally?

SarahJane1471 profile image
SarahJane1471 in reply to

generally….. yes. Sharper mentally…. still working in the physically part.

I think if you have been hypo for a long time it takes a long time to get back up to speed. I would rather take my time increasing the T3 dose so I don’t miss my sweet spot 🤷‍♀️

seveneleven profile image
seveneleven

Glad to have found this discussion...about to start T3 myself alongside HC and been told to take 2.5mcg 3 x a day, but my cortisol is pants in the afternoon/eve as well, so that's interesting that you can get dips/notice it more when cortisol is low because of worse uptake. Will be interested to see what you settle on, and hope it goes smoothly :) It's all a bit of a minefield this cortisol business!

TiggerMe profile image
TiggerMeAmbassador in reply toseveneleven

It is maybe worth making notes? A slump doesn't necessarily signify a dose increase I'd adjust timings first before raising... it's good that you know where your cortisol peaks and troughs are, ideally dose when it's nicely mid range, too high is likely as bad as too low 🤗

seveneleven profile image
seveneleven in reply toTiggerMe

Thanks! Oh no chance of it being too high...my only 'peak' is just before bed when it sneaks just into range 😂 Will definitely keep track...not yet started the T3 but been on 15mg HC for a few weeks with no change to energy levels/crashing. Am wondering about just starting the T3 at 5mcg first thing in the morning for a while and then increasing from there depending on how I feel. Otherwise 2 of the doses would be when my cortisol is barely detectable, so I guess that's when you can get the unpleasant adrenaline effects.

in reply toseveneleven

seveneleven if you are seeing no change on 15mg in your position, if it were me, I would go to 25mg.

TiggerMe profile image
TiggerMeAmbassador in reply toseveneleven

I'm afraid the best advice is to listen to your body, giving it time to react and settle, thankfully this is initially quicker with T3. I feel timing is as important as dose when it comes to the elusive sweet spot.

Temperature, BP and RHR are surprisingly useful to note 🤗 but don't give yourself white coat syndrome 😂

in reply toseveneleven

Yes I have noticed before in one incident I took 5mcg of T3 with 2.5HC and felt very anxious. I then took an additional 2.5HC and the anxiety melted off, so for me if I don’t have enough cortisol coverage my T3 can make me feel anxious in “real time” if you get me.

seveneleven profile image
seveneleven in reply to

That's really helpful to know...yes HR is going to be a big one. I did briefly try 20mg HC but I have a low HR to begin with, and going up higher on HC made the bradycardia worse - dipping to almost below 40 at rest and when trying to go to sleep....not fun! Made my head swimmy as well. Backed down to 17.5 and then 15. Quite possibly happened just because I've only been on T4 (zero conversion happening), so might be able to tolerate more HC when T3 is added, and vice versa. Are you taking your HC all at once in the morning or tapered through the day?

in reply toseveneleven

ahhh! I am v interested to see how the bradycardia will respond to T3! I am in the same boat as you, if I take too much HC I feel rotten but I think this is because my cellular T3 is too low to meet the new cortisol standard if that makes sense.

Presently I am dosing like this:

6am: 10mg HC + 7.5t3 + 100t4

12pm: 2.5 HC + 2.5 t3

4pm: 2.5 HC + 2.5t3

Bedtime: 1.12HC

But before I added my thyroid hormones I couldn’t take more than 5mg HC and I’d take it in the morning x

seveneleven profile image
seveneleven in reply to

That totally makes sense. Aye I think I'll try pairing the T3 with the HC and loading more in the morning. Hope you find a good rhythm with it too!

TiggerMe profile image
TiggerMeAmbassador in reply toseveneleven

How are you getting along? Did pairing the HC and T3 do the trick? 🤗

seveneleven profile image
seveneleven in reply toTiggerMe

Still working out the right schedule, but now taking the two together yes. Needing a lot more HC to manage the T3, but will get there!

TiggerMe profile image
TiggerMeAmbassador in reply toseveneleven

I'm finding the same, just upped my HC 🤞

Lovecake profile image
Lovecake

I take my T3 split.

5mcg with 100mcg T4 an hour before lunch (this is because I get morning migraines and taking T4 makes them worse, so I need to get rid of the bad head first). Then 2.5mcg an hour before evening meal and 5mcg in the night (approx 2-4am).

I’m having a morning 9am blood cortisol test a week Monday as I struggle big time with morning fatigue. So it will be interesting to see what that shows up.

Thanks for your posts, very interesting and extremely helpful

in reply toLovecake

thanks lovecake 🙏 do you feel the benefit of the T3? Be interesting to see your morning cortisol blood, could well be contributing to fatigue x

Lovecake profile image
Lovecake in reply to

adding T3 made a huge difference at first. I felt I could play at Wimbledon 😂 Can’t play tennis to save my life though. Splitting the dose seems to suit me and taking it in the night also seems to help me sleep

It calmed, but I would not give up my T3 for anything. It’s not perfect, but that could be other factors and not my thyroid levels 🤷‍♀️ Hence the cortisol test (me requesting).

Before adding T3 I would be lucky to get through a sort of busy day (not normal person busy) and then have 2-4 days of barely doing anything to recover. With the T3 added that changed to 1-2 days. But the good days are miles better.

There is possibly something else going on with me. I just had a 10 day run with 8 of the days having a bad head. But it’s calmed again now. Low thyroid levels give me migraines (other triggers too). But getting a doc/endo to link it all is not going to happen. My endo is private and I can’t afford to see him too often. My GP is great, I think I’ll keep researching and prompting her to try different tests. The 9am cortisol is the next one, I’ll post once I get results etc ☺️🧁

in reply toLovecake

😂😂 that’s marvelous it makes you feel so good! I wonder if you need more? It’s so interesting it helps you sleep, some say it’s too stimulating for them… there is just so much to learn and try to understand.

I agree, getting an endo to actually join all these dots will probably not happen. The current endo I see is actually NHS but i went to him with my own plan already firmly in place with the attitude that he can support me or not, I’m going to self source if I must and I was lucky (for once!) that he was onboard and his ego was not offended by my understanding my condition. Having said that, just because he’s been willing to prescribe HC and told me to self source T3 that doesn’t mean he’d have been able to get me to where I have now got myself. I had s functional endo from Harley street (£450/hr 😭) for 3 years and endless consults and she never even found that I have adrenal insufficiency…

Yes add results when you get them! X

Enuffisenuf profile image
Enuffisenuf

I take T3 every 8 hours (roughly 08.00, 18.00 & 24.00,) as it doesn't last in the system, which makes me feel better.

Having read about the body using T4 overnight to repair whatever it is it repairs (clearly not my memory) I switched from the recommended morning dose to a bedtime one.

Moving my T4 to late evening was revolutionary for me.

My T4 dose has increased recently, so I'm experimenting with a split dose (roughly 08.00, 24.00,) to see if it makes any difference.

Splitting the dose extends my coverage for days like today. 11.50 and writing this has finally reminded me I've taken nothing this morning!

in reply toEnuffisenuf

ooooo! I didn’t know that about t4 specifically, do you have any links to stuff on that? Thanks for sharing 🙏❤️

Enuffisenuf profile image
Enuffisenuf in reply to

I'm going back a long time, but I'll see if I can find it again.

UPDATE

Sorry, I can't find anything. I remember thinking that it makes sense, so gave it a try and it was noticeable, so I stuck with it

Lovecake profile image
Lovecake in reply to

Try SlowDragon for info on splitting T4. Sorry SlowDragon if I’ve got the wrong person (but you are very knowledgeable either way)

in reply toLovecake

thank you I will x

SlowDragon profile image
SlowDragonAdministrator

I also take T3 every 8 hours ……

it’s the ONLY way I can tolerate/get good results

6.20am, 2.30pm and 11pm Approx

6.20am…….alarm goes off I take first dose T3 and half dose levothyroxine and go back to sleep

I originally switched to taking all my levothyroxine at bedtime at my endocrinologist recommendation about 12 years ago …..for me that was much better than taking in morning

But about a year ago I started splitting Levothyroxine……half dose 6.20am and half at bedtime

in reply toSlowDragon

thank you for sharing SD. I’m going to swap my T4 to bedtime and see if that changes anything

BiscuitBaby profile image
BiscuitBaby

HiI take 15 t3 and 100 t4. I was splitting every 8 hours but I found I kept forgetting or wasn't able to take the afternoon one because of work. I then tried 10 am and 5pm, then 5am and 10pm. Recently I started taking 15 in the morning and I feel better than before. My palpitations have almost resolved. I hardly get then now. I also don't notice any immediate effects from t3 but I definitely feel better!

in reply toBiscuitBaby

ooooo that’s interesting and v encouraging that the more convenient way also yields better results! I think Dr Lowe (?) used to say it can work for some to take all T3 as one dose and just batter the receptors with lots of T3!

BiscuitBaby profile image
BiscuitBaby in reply to

I think it's a little bit of trial and error. Unfortunately the error part can take weeks to recover from! But you just maybe need to experiment a little to find what regime suits your body the best!

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