starting T3/T4

[Topes009]

Hi all

I’m about to add T3 to Levo. I’m currently on 100levo and have been prescribed 50 Levo with 2x5 T3 per day. When is best to take the T3? One in the morning with the Levo and one around 12 hours later? Can it be taken near food etc? Any tips and positive experiences would be gratefully received! 😊

[Lalatoot]

Topes don't go onto that dose overnight. It is too much for the body to cope with. You need to do it gradually.Reduce levo by 25mcg daily then wait a week.

Add 5 mcg t3 taken same time as levo. Wait 2 weeks.

Reduce levo by 25mcg then wait a week.

Add in 5 mcg t3 as an extra dose maybe bedtime or mid-afternoon as suits you.

Wait 6 weeks do bloods.

I found that a 50mcg drop in daily levo dose was too much of a reduction. But to keep the t3 prescription we need to be seen to be following the doctor's orders. So you've got to try it first as they want. However nobody can predict the doses you will need. It is trial and error. And it take methodical patience and time to find doses that suit

I was on 100mcg levo. The doctor wanted me on 50mcg levo and 20mcg t3. I worked my way as described to that dose. My ft4 was at bottom of range, can't remember where ft3 was. It wasn't right for me . Over the next 2 years I changed either levo or lio dose then waited 8 weeks and did bloods. Only change 1 thing at a time so you know what effect that change is having. I have ended up settling on 100mcg levo and 7.5mcg t3 daily taken as a dose first thing and a dose at bedtime.

Also note that symptoms don't necessarily all disappear right away. They can take years to fade. The body adapts slowly.

[FancyPants54 in reply to Lalatoot]

Good advice. Dropping 50mcg of Levo in one go is too much. And for someone not used to T3, telling them to take 10mcg a day from day one is a recipe for upset and discomfort.

How do you break 7.5mcg into 2 parts though? I can't get reliable cuts from a 20mcg tablet into 1/8ths at all.

[Lalatoot in reply to FancyPants54]

I am lucky. Living in Scotland I get my liothyronine on the NHS. My prescription actually is for 2 X 5mcg daily so that is what my GP surgery feels it should supply even though a 10mcg tab would be much cheaper.Of course I never say my dose is smaller. That way I have leeway and a stock.

[FancyPants54 in reply to Lalatoot]

Ah, that would be easier. Lucky you, and as you say, never tell them!

[Topes009 in reply to Lalatoot]

Thanks Lalatoot. I was sure I’d replied earlier but it doesn’t seem to be here.

I will follow your advice and start slowly. I had a feeling my endo was being a little gung-ho about it, he is greatly quite dismissive and not especially helpful.

Glad you have found the sweet spot with your dosage and thanks for the advice.

[SlowDragon Administrator]

What are you most recent thyroid and vitamin results and ranges

Recommended that all thyroid blood tests early morning, ideally just before 9am, only drink water between waking and test and last dose levothyroxine 24 hours before test

This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip)

important all vitamins are optimal first

Suggest you follow Lalatoot guidelines on how to SLOWLY start T3