Missed T3 doses: Because I had real issues with... - Thyroid UK

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Missed T3 doses

Jefner profile image
12 Replies

Because I had real issues with finding my usual brands, being messed about by not only my GP but two pharmacies,unfortunately it led to me being without any T3 and I missed around 2.5 days of my full dose of T3

As I am feeling so unwell with more severe anxiety and fatigue, I put it solely down to all the stress catching up on me as I spent over a week in trying to sort my T3 out and then before that my T4, because they had given me a different brand that I tried but didn't seem to suit me.

I can't take the slightest bit of stress these days but I also wonder if the missed doses of T3 has impacted me negatively?

Haven't tested since last July and have a full panel ready to do on Monday to see what is going on but not sure whether I should wait a week whilst I get my T3 back on track after those missed doses?

Plus I didn't realise I could in fact take a split dose of T3 with food, or not that far away from having eaten something?

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Jefner profile image
Jefner
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12 Replies
Buddy195 profile image
Buddy195Administrator

I personally would wait a couple of weeks Jefner before completing your blood tests, due to missing 2.5 days of usual dosing. It’s very much trial and error with split doses/ timing to find a regime that most benefits you. Personally, I’ve found leaving some Liothyronine until the afternoon improves my energy levels and reduces any anxiety flares.

I’ve also found taking magnesium early evening helps me relax and reduces anxiety.

Jefner profile image
Jefner in reply to Buddy195

thanks Buddy, you suffer with anxiety too?

I have tried so many different times especially before and around waking, as my waking anxiety is so bad anyway so as a trial some time back I moved my first 5mcg dose to early afternoon, there seemeds to be the very slightest of improvement as I know T3 can stimulate cortisol levels which I really don't need, but since all my med brands were messed up, verything has gone tits up. I usually take my second dose around 7pm, but as you say it's hit and miss and whatever I have changed doesn't seem to have made much difference

I always have my mag a couple of hours before bed as I sleep extremely late and if I feel the eeby jeebies I will pop a small amount of Diazepam most nights

Could just missing those doses make me feel more crap?

Do you chance split dose your T4 as well, as I recently read on here that others do

Buddy195 profile image
Buddy195Administrator

My GP initially diagnosed me with ‘ health anxiety’, suggested I saw a psychotherapist & offered me anti depressants. Joining this forum helped me realise that my symptoms were related to being under medicated and I followed forum advice to improve this.

Increased anxiety has been the hardest thyroid symptom to manage for me. I saw a steady improvement since slowly adding T3 to my Levothyroxine dose (I don’t split this- take all in a morning with 2/3 Lio), taking magnesium daily (I find dosing early evening helps me relax), being gluten free & practising mindfulness, Pilates and journalling (ie writing positive thoughts).

I’m so much better than I was, although did have a dip with peri menopause, when I needed to add HRT.

I need my thyroid medication & key vitamins to be optimal and if I need to make adjustments (either increase or decrease) I do this super slowly as my anxiety levels can flare. If needed, I only add 12.5mcg Levo (alternate days at first/ or 2.5mcg Lio daily)

I try to limit sugar and avoid caffeine in an afternoon, as this can make my anxiety worse. I eat an anti inflammatory diet, avoid gluten & I supplement with turmeric, omega 3 & magnesium.

For me the following really helped from the CBT sessions: active mindfulness (when you do certain movements to a recorded mindfulness track- eg Danny Penman/ Mark Williams), journalling books (where you have to fill in positive affirmations every day), aromatherapy and challenging negative thoughts (the psychotherapist had to help me a lot with this one…. For me, what worked best was trying to talk to myself like I would advise others) At worse, I have a tendency to catastrophise & sessions helped me stop my mind racing to ‘worse case scenarios’

Jefner profile image
Jefner in reply to Buddy195

you sound a carbon copy of me. I am isolated, agoraphobic and alone all day and every day so my thoughts just build up to the point where they feel uncontrollable since Covid, I have health anxiety now. I try not to Google things anymore as it just adds to the anxiety. I keep trying the positive thought stuff as I have been negative for most of my life so it's a hard thing to change and keeping the motivation going in doing it, is so very difficult so I slip a lot. I have put in for therapy "again" and just waiting to see what they offer me as I am told I need long term therapy as being 61 I have had anxiety issues for most of my life until I tried an AD and it changed my life. Had a few years of respite until perimenopause, then thyoid issues, then through advice from this site I got tested for Hashis

I am also wondering whether to try and split my T3 into 3 doses as I find with two, I get palps about an hour or so after taking each 5mcg but the tabs are so tiny and my pill cutter will just crush them to dust so I might have to use a stanley knife blade very carefully

Summerlove profile image
Summerlove

Hi Jefner

Can’t advise on the T3 as I e never tried it. But you talk about splitting doses. You can buy pill cutter very cheap on Amazon.

Sorry to hear about your anxiety I have the same. I am also 61 and live alone. Had CBT private and NHS many times. Mine is health anxiety catastrophising etc I didn’t have anxiety until hypothyroid 7 years ago. Then I blamed the menopause. Think double whammy

Think I’ve tried every supplement going. Have resisted AD. Have to cope from day to day. My chemist also messes about with my brand of Levo and I get stressed when I’m due for a repeat. Everything overwhelms me. I totally get where you are coming from.

Hope you get sorted with your medication

Jefner profile image
Jefner in reply to Summerlove

crikey, you are a carbon copy of me. My anxiety has worsened to the point of where I also catastrophise and feel very overwhelmed and can't control my brain, especially over my meds and I get stressed every time I put a new script in wondering whether I am going to be given my usual brands, and we shouldn't have to stress over that

Joant24 profile image
Joant24

I split my T3 pills into 8ths will very little trouble using this pill cutter

amazon.co.uk/Pill-Cutter-Sp...

I also split my dose into 3 so I can tolerate the T3. Hope this helps a little x

Summerlove profile image
Summerlove

sorry just read you have a pill cutter

Buddy195 profile image
Buddy195Administrator

I’m so pleased you have reached out to forum members Jefner; you are not alone.

My anxiety level is massively reduced now I’m on an optimal dose of thyroid medication & key thyroid vitamins are good. If I have an anxiety flare that lasts a few days, I retest my levels. I’ve found that I’m better with FT4 around 60% in the range, although I’m fine with FT3 higher. If my FT4 goes near the top of the range, I’ve also found this increases my anxiety (plus palpitations/ fast heart/ tremor).

We are all different & you need to adjust slowly & experiment with timings/ split doses (as you are doing) to see if this benefits you.

I have not needed antidepressants (although have been offered them several times in the past), as slowly adjusting thyroid medication alleviated my symptoms. However, I fully understand how others require antidepressants in addition to optimal medication.

I found CBT useful in giving me techniques to help with anxiety flares, although appreciate that other members have not found this useful. I would take up offers of therapy if you find this beneficial/ if the practitioner is right for you. I would try to spend time outdoors each day, even if it is for short periods at first.

Sending you very best wishes 🦋

Jefner profile image
Jefner in reply to Buddy195

I have been back on my T3 for a week and a half now but instead of taking 2 split doses, I started back on 3 because I am so sensitive but things arn't levelling out yet with my anxiety. It's usually bad on waking, part of the day and then dissipates in the evenings where I generally feel well. I am currently dosing at 8am, 3.30pm and 7.30pm. Before it was around 1.30pm and 5pm. Wanted to keep first dose away from my severe waking anxiety and my cortisol.

I am wondering whether that last dose at 7.30pm is still impacting my anxiety as T3 is a stimulant. T3 levels are said to peak around 3 to 4 hours after ingesting and I am still feeling the eeby jeebies,palps late at night. Plus since changing the timings, I feel a little sleepy in the day, my legs feel weak and stiff, I am fatigued (probably due to lack of exercise and also anxiety) and other hypo symptoms which also mimic anxiety symptoms. I think I need to go back to my 2 doses and see what happens?

On Monday I will have been back on my T3 for two weeks so I am going to test but wondering whether changing my timings will impact my results? In theory it shouldn't as I am still having the same dose every day but the night before my test I will need to take my 2nd dose around 12hrs before testing? I never used to do that, it was always a full 24hrs for both Levo and T3 until I read otherwise on here a few months ago.

Because of the recent stress dealing with the pharmacies, it's so difficult to tell whether the additional anxiety I am feeling is down to that or missing those 3 days of no T3, or maybe it's all combined. I just really don't know what to do at this point, it seems everything I try doesn't work. I feel like I want to come off T3 completely and go back to the 150mg Levo that I was on for many years and seemed fine on but then again that was before menopause hit and finding out I had Hashi's (which from seeing no thyroid left on an ultrasound back in 2016) I know I have had the disease a lot longer

Buddy195 profile image
Buddy195Administrator in reply to Jefner

Whatever you decide, please adjust very slowly Jefner. It took me a considerable amount of time to find my optimal dose. I always retest levels 8 weeks after being on a consistent dose.

Lovecake profile image
Lovecake

We just want to relax and feel ok. It seems this can be too much to ask for sometimes.

My pharmacy gave me a different brand of levo this time. This was after them dispensing 50mg to me instead of 100mg!!! I didn’t notice until I was just about to take one of them in the new packet. Obviously I had to take 2 at that point. Then had to go back to the pharmacy to explain I needed more or a swap or I would be 28 days short. More stress and anxiety 😟

Someone at my GP surgery also changed my prescription description for my migraine tablets from Imigran to sumatriptan. I cannot take the generic as it makes me very ill. (Worse migraine plus 7hrs of vomiting). No one told me. And the first I knew about it was picking up my prescription to find the generic tablets. Gave them straight back and explained. They refused to replace as they don’t get reimbursed for the Imigran if it’s not on the prescription (fair enough). It then took 3 visits to pharmacy and 2 to the docs to get my prescription changed correctly. Can you feel the stress mounting? Now, they say they can’t get Imigran!!! I nearly cried.

So I went home and ordered a pack of 6 Imigran online. Cost me £41 inc postage and they will arrive tomorrow. In the meantime I’ve had to ring round to see who can get my nhs prescription. I love stress, it does wonders for my health…….. I hope you get back on an even keel and feel less anxious very soon. We don’t ask for much do we? Just the correct meds so we can get on with our lives 🧁

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