T3 Total Newbie Looking For Guidance - Thyroid UK

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T3 Total Newbie Looking For Guidance

Sparklingsunshine profile image
25 Replies

I posted a little while ago asking for PM's regarding self sourcing T3, firstly a very big thank you to everyone who responded, I had several very helpful messages and I really appreciate members taking the time and trouble to reply 😁

Secondly I'd appreciate some pointers on how to introduce T3 to my Levo. In October I posted my MMH results. I was taking 200mcgs of Levo at that point. On Slow Dragon's advice I dropped Levo to 175/ 200mcgs alternate days to get 187.5mcgs daily. I've just had an NHS thyroid test today and am awaiting results.

I know I need to start off low and slow with T3, presumably on 5mg, but have not much idea beyond that on how often to increase dose and to what. Also what would members suggest regarding a decrease in Levo? Thanks.

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Sparklingsunshine profile image
Sparklingsunshine
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25 Replies
SarahJane1471 profile image
SarahJane1471

Hello, for me personally, I started very very low. My FT3 was pretty low compared to FT4. I take 125 mcgs of Levo and only 3mcgs of Lio 🤷‍♀️it suits me but we are all different. I suggest you look at your new results then if you decide to start T3 then do it very slow and low.

Sparklingsunshine profile image
Sparklingsunshine in reply to SarahJane1471

Thank you.

Lalatoot profile image
Lalatoot

If your ft4 is near the top of range or over then reduce levo dose by 12.5 or 25mcg. Wait one week after reduction to get levels drop.

Add 5mcg or 6.5mcg, depending on tablet size, liothyronine to levo dose.

Wait 1 or 2 weeks.

If all ok add another 5 or 6.5mcg dose lio.

I would then wait 6 to 8 weeks and do bloods.

Increases and decreases in lio are no more than 5 or 6.5mcg daily every 2 weeks.

Sparklingsunshine profile image
Sparklingsunshine in reply to Lalatoot

That's very helpful, thanks.

Sparklingsunshine profile image
Sparklingsunshine in reply to Lalatoot

Is it necessary to split the Lio or just take it in one go? I've tried splitting Levo before, but felt no benefit and found it a bit of a faff fitting around meals, hot drinks and other meds/ supplements?

Also does Lio need to be taken with the Levo or can you take it alone and does it need to follow the same rules as Levo, ie empty stomach, no caffeine drinks, 4 hours away from HRT and other meds and away from vitamins? Much appreciated Lalatoot 😄

Lalatoot profile image
Lalatoot in reply to Sparklingsunshine

You can take lio in one go. Quite a few find that suits them better. It doesn't have to be taken with levo. Not so much research has been done on lio absorption and vitamins or food. It is said that lio is more forgiving re closeness to these. However to be on the safe side nany of us treat it like levo for gaps between vits and food.

Dosing is quite an individual thing when on combo. It is trial and error to find what suits you and your routine.

If you think it will work for you give it a go.

SarahJane1471 profile image
SarahJane1471

I didn’t reduce my Levo as on this forum it’s been suggested that FT4 lowers when taking T3. So for me I wanted to add Lio without making any other changes. It’s worked for me 🤷‍♀️

Sparklingsunshine profile image
Sparklingsunshine in reply to SarahJane1471

Thanks, my FT4 was pretty high on my MMH test in October, 21.4 on a range of 12-22. I've seen posts on here warning against high in range or over range FT4, due to possible health issues.

I seem to be someone who needs to have a high FT4 on Levo to get reasonable FT3 conversion, which is why I've decided to try T3. Have you felt better since adding T3?

SarahJane1471 profile image
SarahJane1471 in reply to Sparklingsunshine

Yes! Much better. I still don’t seem to have that extra “power” when needed but overall I’m much better with T3. Your FT4 May drop when adding T3. If it were me I would stick to one change at a time. 🤷‍♀️just my opinion

locky8 profile image
locky8

Hi, I was on NDT and had to go back to levo/liothyronine combination when I got a new Endo. My dose is the equivalent to 200mg levothyroxine a day and I'm on 100mg levothyroxine and 10mg liothyronine twice a day. 10mg in the morning around 7am with my levothyroxine and 10mg around 2.30pm. My Endo said 4.30pm but I found I struggled to sleep taking it that late in the day. I am forgetful and occasionally forget the afternoon dose ,even with an alarm. My Endo recently checked my dose and actually said I'm OK to stay on it as levels good. I did educate her about my Tsh as it rarely changes from 0.01 no matter what dose I'm on ,ranging from 100mg to 200mg. It only changes when I have a hashimotos flare up.

Good luck. I found T3 to be a game changer!

Sparklingsunshine profile image
Sparklingsunshine in reply to locky8

Thank you, it's good to know it's helped you. Hoping it does the same for me 😆

Easylover profile image
Easylover in reply to locky8

Locky8, when you say game changer , what do you mean? And how is it all better than NDT please. Thanks, Easy

locky8 profile image
locky8 in reply to Easylover

I did like NDT but when hubby was off work I couldn't afford to buy them anymore. I don't do well on levothyroxine only as I have conversion problems T4 levothyroxine isn't the active hormone. T3 is. So taking T3 liothyronine with T4 levothyroxine helps me feel better and more like my old self. Plus you can adjust the dose easier.

Easylover profile image
Easylover in reply to locky8

Ok, so over all you feel just as good on NDT as you do T4 n T3. Which do you prefer? And I agree the doses must be easier to adjust because T3 is easier to adjust?

locky8 profile image
locky8 in reply to Easylover

I do well on both. But the bonus of t4, t3 combo is its available on prescription for free. So as hubby couldn't work it was the best option for me. I would go back to ndt if it was offered but for now I'm doing well on t4,t3 . The ndt was costing me £266 for 3 months supply.😪

Easylover profile image
Easylover in reply to locky8

May I ask how and when you took your NDT? I'm still trying to get mine right. Thanks. For example, time, dose, ate or not, how long wait to eat, etc....

locky8 profile image
locky8 in reply to Easylover

Hi, I used to take mine first thing in the morning around 7am with wateror sometimes I let them melt under the tongue. I would leave at least 30 min before I had food or cup of tea. But occasionally I would have to eat breakfast sooner but not too often.

Easylover profile image
Easylover in reply to locky8

Thank you do much for replying. I truly appreciate it Locky, easy

locky8 profile image
locky8 in reply to Easylover

You're welcome. Happy to help as been at this thyroid lark since 2005. Learnt lots of good and bad info during that time. 😊

Easylover profile image
Easylover in reply to locky8

Nice!

FallingInReverse profile image
FallingInReverse

Haven’t read the other responses, so shh h sting my experience.

I dropped 50 to 25 Levo and added 10 Lio - 5 in the morning and 5 at night.

I had zero guidance and had not found this forum yet, and for me … that was too much too quickly.

The heart racing and unsettled feeling in my chest lasted forever and was awful. I rode it out, but would never do it so bluntly again.

Lastly, I did a lot of googling of Lio peaks and saw that it peaks about 2 hours after dosing. I have article links but not in hand, and others might weigh in on the science of it all. That being said, I found I was generally getting “better” but was still falling asleep at 14:30 many days. I split my morning dose between 6-7 am and noon and my afternoon naps stopped.

Also - Levo has a longer life in your blood (about a week) so splitting that would make no difference. (See lalatoot post below for correction to this)

I have to be reminded ALL THE TIME to be patient. Starting low and slow is never a bad approach.

Make the change… stick with it for 6-8 weeks, then retest.

Looking forward to what you decide, let us know how your are feeling, and come back if you are tempted to be impatient in the 6-8 week period before you test again.

Sparklingsunshine profile image
Sparklingsunshine in reply to FallingInReverse

I have some experience of T3 as I took NDT for 6 months or so and my T3 shot up to the top of the range, but NDT is expensive, difficult to source sometimes and subject to global supply issues, at least Thyroid S is.Plus batch potency seems a bit of an issue. I thought I'd try T4/T3 combo as it seems much more affordable and easier to tweak. I'm hoping it works for me 😁

FallingInReverse profile image
FallingInReverse in reply to Sparklingsunshine

Wishing you good luck and looking forward to how it goes!

Lalatoot profile image
Lalatoot in reply to FallingInReverse

Some folks find splitting levo improves conversion.Our body has a fail safe mechanism. When ft4 reaches a certain level, it converts more to rt3. This is to stop ft3 rising too high.

Nobody can tell what personal level ft4 has to reach for this to happen. The thought is, that for some, the level of the spike as their total daily levo dose enters the blood is high enough for them to trigger the safeguard mechanism so conversion is compromised. Those folks find their conversion improves when they split their levo dose because the lower spike level is not high enough to trigger the safeguard.

Sparklingsunshine profile image
Sparklingsunshine in reply to Lalatoot

I tried splitting mine to improve conversion as I'd seen several posts from SD on it, unfortunately it never seemed to make any difference to me, but I sometimes think I'm not that sensitive to Levo, which is kinda strange as I'm normally very sensitive to medication.

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