T3 starting dose.

[DylanA]

I appear to be a poor converter of t4 to t3. I had my first private endo appt today and have a private prescription for Liothyronine.T3. I have been given 3 months at 10mg daily. Is this a good starting dose. Just wondering whether to try 5mg daily first to see if it has the desired effect. Also going to reduce Levo from 100 to 75mg. I currently take my Levo at night away from all other meds food drink etc. Is it ok to take T3 at the same time ie at night or can I take it anytime?

[SovietSong]

I started T3 almost two months back and was advised on here to start on small dose so I cut my 25mcg pills in quarters and take 6.25mcg daily. My T3 has risen from mid 50's to 81 on this dose.I did have a little wobble last week but was given more great advice on here and ever so slightly decreased my Levo and it has done the trick. There's lots of fine tuning when on T3/T4 combo.

[SovietSong]

I take my T3 and T4 together on waking on empty stomach.Lots of people on here split there T3 dosage

[FallingInReverse]

I started on 10 Lio, concurrent with a 75 -> 50 Levo reduction.

While it’s true that I was under replaced - o can also say that I wish wish wish I had not jumped in with the entire 10 at once. For me. The palpitations were intense, constant and only resolved about 9 months later!!! Not sure if other things contributed, but it started after the Lio started.

I was told to take 5 upon waking and 5 at bedtime.

I have since split to 2.5 waking 2.5 noon and 5 at bedtime.

T3 generally peaks 2 hours after you take it. Splitting and taking that noon dose eliminated a 2-3 pm nap that was happening frequently at the time.

[T3sortedme]

Be aware, as indicated above, that you should spread your T3 doses. T3 is the active version of the hormone and is used up in the body faster than T4 (the storage form of the hormone which the body converts as and when needed). You therefore need to split the dose. Most of us have an early morning dose and then one at midday and another late afternoon (varies from person to person). The first dose is often larger (eg half tablet early, quarter midday, quarter late afternoon). It’s important to take the doses at exactly the same time every day. I am on T3 only and others on combination T4/T3 will have better experience/advice to give, so listen to them. We are all different and it takes time to settle and find the best way for us. Be patient and don’t keep making changes or you will end up confused. The body needs to adjust its cycles each time. Leave at least 6 weeks between making any changes once you decide what to do. Best wishes - I really hope it works well for you. T3 can make a big difference.

[SlowDragon Administrator]

have you got 10mcg tablets or capsules

Assuming tablets you can cut into 1/2 or 1/4

Definitely don’t start on more than 5mcg …..taking waking

You could try 2.5mcg morning and 2.5mcg mid afternoon initially

Then after week or so increase morning dose to 5mcg

And wait another week to increase afternoon dose to 5mcg

What are your Ft4 and Ft3 results now BEFORE starting on adding T3

Also are vitamin D, folate, ferritin and B12 at good levels

retest 6-8 weeks after getting to 10mcg daily

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)

T3 ….day before test split T3 as 2 or 3 smaller doses spread through the day, with last dose approximately 8-12 hours before test

you may find Ft4 drops too much reducing levothyroxine

It can take many months of experimenting to fine tune both doses

TSH is highly likely to drop very low or suppressed, that’s to be expected

[McPammy]

I take 5mcg T3 twice a day 8hrs apart as advised by my private only endocrinologist. I feel brilliant since I added the t3 to my usual t4 levo dose which I also split.

T3 7am

T4 noon

T3 3pm

T4 5pm

This works well for myself. My levels are always optimal and TSH is around 1.00 just in range. Importantly I feel energised and healthy. I can now go the gym regularly and do brisk walking the days I don’t go gym. Prior to adding T3 I could barely walk.

[Hashiboy]

Hi DylanA just to echo others, maybe phase the T3 in a the reduction in t4 takes effect. Maybe start with the 5mcg for a couple of weeks and see how you go. Otherwise you might experience unpleasant palpitations.