when to take T3 if already taking levothyroxine

[Clauds123]

hi. I’ve just received my T3 (Tiromel) and I’ve been advised that my dose is 5MG daily. I take 50 MG levothyroxine on waking each day. When is best to take the T3? At the same time? Is food/caffeine/other medication to be avoided for a few hours after similar to the levothyroxine? Thanks!

[FallingInReverse]

50 mcg of Levo is just a starter dose. Since Levo is a replacement dose vs a top off, it’s highly unlikely 50 is enough for you and more than likely you should be adding more Levo before you try to add in the complexity of Lio.

But this board will not be able to give any good advice without more information about your history, bloodwork and symptoms.

Personally, my doctor did the same thing - took me from 50 mcgs and added Lio as the next step. I wish he had not, and now I’m stuck trying to work myself out of it. Also, it was too much too soon and I spent months with symptoms I probably could have avoided with my blood chemistry adjusted and calmed down.

Also incidentally usually addition of Lio is accompanied by a reduction in Levo.

But again, I won’t say anything at all about what might be right for you since we have no info to go on.

Can you share your blood test results here?

[Sparklingsunshine]

As Falling wisely says 50mcg of Levo is just the starting dose for people under 65 or without heart problems, its extremely unlikely to be enough, unless you are very petite. The normal step is to increase in 25mcg increments every 6-8 weeks or so, until symptoms are controlled. Is there a reason you are only taking 50mcg? Normally we need to try Levo at a full theraputic dose for several months before adding T3.

[DippyDame]

We really need more info re lab results.

Why are you being treated by an endo....GPs usually treat folowing initial diagnoses of hypothyroidism....or have you had thyroid surgery?

We don't know why your FT3 is low ( has T4 toT3 conversion been established) but since 50mcg is a starter dose it seems far too soon to be considering adding T3 particularly if you are being left to self source....that seems unfair!

Your endo sounds pretty clueless!

Have you been advised to optimise Vit D, vit B12, folate and ferritin in order to support thyroid function and T4 to T3 conversion.

Have you had thyroid antibodies tested for Hashimoto's/ thyroid autoimmune disease?

It is usual to increase levo dose to approaching 100mcg ( or higher) before considering the addition of T3 if symptoms are not resolving...the intervening test results will show how well you are converting and therefore your need for T3...along with optimising core nutrients.

The addition of T3 will reduce both TSH and FT4....

I doubt 50mcg levo +5mcg T3 is going to provide the hormone level you need.

You can take both together but dosing is often a case of trial and error to find out what suits you best. Some find splitting the dose best.

Avoid food and drink for at least an hour before taking the dose

When testing .....for FT4 test 24hrs after previous dose and for FT3 leave 12 hours befor testing.

Keep a record of the T4/T3 medication you take and of any symptoms you may have.

I need high dose T3-only to function so have shared the journey!!

Good luck

[SlowDragon Administrator]

As others have already said…..what you currently need is next 25mcg dose increase in levothyroxine NOT adding T3

Far too soon to consider adding T3

[Hidden]

Others have stated the dose you are taking is 50MCG- NOT MG!! you would be peeling yourself off the ceiling with a dose as you suggest! These drugs are potent and can do no end if damage, so please make sure to READ what you are taking!!

[RedApple Administrator in reply to Hidden]

needlewoman22, ' the dose you are taking is 50MCG- NOT MG!! you would be peeling yourself off the ceiling with a dose as you suggest! These drugs are potent and can do no end if damage, so please make sure to READ what you are taking!!'

That's an unnecessarily harsh comment. Many people are not aware of the difference between mg and mcg. Even doctors can make this mistake! Also, neither levothyroxine nor liothyronine are 'drugs'. They are thyroid hormone replacements.

[Hidden in reply to RedApple]

I stand corrected, of course they are thyroid hormones. It's just that so many people-including gp's at times do not know the difference in dosing quantities.

[RedApple Administrator in reply to Hidden]

needlewoman22 'It's just that so many people-including gp's at times do not know the difference in dosing quantities.'

We want all members to be comfortable posting here. Please try to be more supportive with your replies, most especially to new members, who have come here for help with a condition that is so misunderstood by the medical profession.

[Clauds123]

Hi, sorry for the slow reply. It’s been a busy week! Thanks to those who have sent helpful/supportive comments so far.

It’s probably helpful to give you a bit of background, I’m under the care of an endocrinologist and he’s been reticent to prescribe any thyroid medication at all. I’ve been under a couple of consultants due to Hypothalamic amenorrhoea (no periods for 3 years!).

My T4 and T3 levels have been below the normal range for many years but to be clinically underactive, they said that my TSH would be high which it isn’t. I’ve pushed to try the levothyroxine, and they agreed. This is why I am only on the 50 MCG dose and I’ve been on it since May. In June, my periods returned and I have had a regular monthly cycle ever since. I am also no longer getting the constant low heart rate notifications on my I watch !

My endocrinologist says that I’ve proved him wrong, but isn’t able to do anything about my T3 level which has remained low (2.8). The levothyroxine has helped bring the T4 level up (from 10.3 to 16) and the TSH has remained in normal range. He said he would support me and continue to review bloods if I decided to source the T3 myself. Again something I have very much pushed for. He said the dose would be 5 MCG per day. I now have the Tiromel, I’ve been taking the dose first thing, at the same time as my thyroxine, I’ve been cutting 25 MCG tablets into quarters.

Although my cycles have returned, I am still struggling with other symptoms that suggest underactive thyroid and low T3 in particular such as incredibly sluggish digestion, difficulty in managing weight, hair loss and dry patches on my skin. I’ve put up with this for so long, I just want to see if the T3 will make a difference.