How long should l leave between each T3 pill when splitting them into 5 doses daily?

[Angie33]

I have to split my T3 and metavive into 5 tablets daily. Does anyone know the minimum time l should have between pills? Some days l feel l may take these too close to one another this resulting in an increased heart rate. I have seen a cardiologist and all seems fine.

[SlowDragon Administrator]

How about

6am, 10am, 2pm, 6pm and 11pm

[Angie33 in reply to SlowDragon]

Hi Slow dragon, apologies for my delayed reply. I've been floored then away for couple of days.

Thank you. I avoided taking any meds after 6pm as I wasn't sure if it would interfere with my sleep, so it's good to know it won't.

[radd]

Angie

Some of us have had to multi dose x3 times daily. x5 daily doses could prove difficult to manage long term and it is imperative to dose consistently.

If you are having difficulties tolerating T3 have you considered adding some adrenal support. Also low iron can induce heart issues when introducing or trying to raise thyroid meds.

[Angie33 in reply to radd]

Hi Radd, thank you so much for your reply. Much appreciated.

Yeah 5 times is a pain tbh. I do take adrenal support too. Interesting what you say about low iron. I was told I was anemic despite my bloods stating they were ok by my GP.

I did have a sudden increase in my heart rate again 2 days ago (65bpm to 220bpm) again, I thought it was due to taking my meds too close together. My thyroid bloods state my T3 is mid range and my T4 is below range. My TSH is maybe undetectable now, despite being on the same dose for a few months. I am due another test this week.

[radd in reply to Angie33]

Angie13,

TSH has no direct influence on the heart. It is the levels of thyroid hormones that influence cardiac health. FT4 below range isn't good. You may find increasing your Levo helps your heart settle.

What dose of Levo & T3 are you medicating?

[jimh111]

If your heart rate goes too high (not just increasing from slow to normal) then it's a clear message you are taking too much, or there is some other issue to identify.

How much liothyronine are you taking? Metavive complicates issues because nobody knows how much hormone is in it (I'm sure the manufacturers have an idea but they won't say). You posted some blood test results which seemed to show a normal fT3 but I wonder if you left too long after the last dose?

It depends on your signs and symptoms but I don't think you need to split it five ways, the 'pharmacodynamics' of liothyroine (how long it takes to be absorbed, transported into cells, several hours at receptors etc.) suggest it would not act that quickly, at least not as a thyroid hormone.

I would try adjusting your dose to take more at bedtime, I find this really helps with cognitive problems, the brain needs T3 for effective sleep. If you find it takes too long to get to sleep your dose is too high.

You may need your current dose and to split it five ways but I would try other strategies first.

[Angie33 in reply to jimh111]

Hi Jim,

Thank you so much for replying. Yeah, my T3 is mid range, T4 below range and TSH despite it being 0.01 I wonder if it is now undetectable hence my sudden heart increase, which happened again 2 days ago. I have been checked out by a cardiologist who confirmed everything seems ok. It is scary when it happens. Thankfully once every few months. I can only think it's down to taking my dose too close, if I am on holiday or away and forget to space them out well.

I am due another blood test this week through medichecks. I may decrease my dose a little afterwards. It is really strange what is causing my hear to jump to high so suddenly. My GP thinks it is my meds. It can be quite scary trying to manage your own dose after seeing numerous clueless GP's and an endocrinologist. I do know my body can't convert T4 to T3.

Thank you for the advice on taking T3 at night time. I avoided this as I was concerned it would keep my awake all night.

Kind regards,

Angela

[jimh111 in reply to Angie33]

If you find it difficult to get to sleep you are probably on too much hormone. I find if I take too little T3 my sleep is non-restorative, shallow with multiple awakenings. I think if you take enough T3 to get good derp sleep if may be too much for organs such as the heart. So, we are in a difficult situation, we don't have much choice . I try to stay on the lowest dose that gives me decent sleep and reasonable brain function.What doses of hormone are you taking?

[thyr01d in reply to jimh111]

Thank you Jim, as so often you have again increased my understanding of T3, I am going to try taking more at bedtime since my cognitive function is poor.

[Angie33 in reply to jimh111]

Hi Jim,

Thank you again for taking the time to reply and apologies again for my delayed reply. I have little energy just now, therefore not on line much. I think I caught a bug 3-4 weeks ago and still drained.

My latest tests are T3 6.9 (range 3.1-6.8) so yeah, you are right, I am slightly over! My TSH is 0.005 and T4 6.9 (range 12-22). I was on 30mg of T3 and 160 mg of metavive. I have now increased my T4 by taking 210mg of metavive and 10 mg of T3. I'll wait 6 weeks before getting another test. I'm led to believe T3 is short lived (6 hrs) hence splitting it up throughout the day. I am now taking T3 before bedtime. Thank you again for the advice.

[jimh111 in reply to Angie33]

T3 has a half-life of 24 hours in the blood. However, the path to T3 receptors has mamy buffers on the way so the effective half-life is longer.