increasing T3 advice

[HotelHurricaine]

Hello,

My endo has told me this week to increase from 5mcg T3 to 7.5mcg and if that feels ok / no palpitations after a week to go up to 10mcg. I’m also on levo 150 and have been told to go up to 175 at weekends.

I posted my recent blood results on Monday. All vits tested December and optimal. Iron top of range so have stopped heme 3 arrows on advice from  SlowDragon .

I take Thorne B complex & 7000 Vit D/K2 & magnesium 400mcg/day.

I took 7.5mcg T3 Tues & Weds and felt ok. But last night started to feel a bit like I’d drunk too much coffee - perhaps this is what palpitations feel like. Can’t actually feel my heart racing but feel an awareness in my chest, a tension, and a racing feeling in my stomach. Kind of like stress.

Resting heart rate is 60/62 and usually 52.

I gather from reading here this is common - maybe my body acclimatising to T3, waking up the T3 receptors?

My question is what amount of T3 to take today? Do I continue with 7.5mcg? And how long would you expect this bodily reaction to last to new dose?

Thanks so much for all your amazing support & advice on here. I’m beginning to worry I shouldn’t have started T3 now as isn’t as straightforward as I’d thought!

x

[Buddy195 Administrator]

I’m an advocate of low and slow increases, so would just have 5mcg today if you had an adverse reaction yesterday, then try 7.5mcg tomorrow. I like to split my Liothyronine, so maybe try 5mcg morning and an additional 2.5mcg in the afternoon.

[DippyDame]

There is quite a lot to unpick here....

May 15th 2024:

FT4 17.6 (12-22) 56% thro' ref range

FT3 4.8 (3.1-6.8) 45.95% ditto

Introduced 5mcg T3 in Feb '24.

Currently on 150 mcg Levo & 5mcg T3.

Today you say....

My endo has told me this week to increase from 5mcg T3 to 7.5mcg .....and, no palpitations after a week to go up to 10mcg.

I’m also on levo 150 and have been told to go up to 175 at weekends.

My question is what amount of T3 to take today? Do I continue with 7.5mcg? And how long would you expect this bodily reaction to last to new dose?

I would suggest that you are increasing T3 much too fast.....hence your body's reactions. It needs time to adjust

Why did the endo increase levo to 175mcg at weekends.....that is quite a considerable dose even before added T3. I would be inclined to stay on 150mcg × 7 days

You are pushing your body into overdrive....increasing levo and ramping up T3, at speed, and at the same time!

Before the palpitations, how did you feel on 150mcg levo and 5mcg T3...symptoms are vitally important.

I'm on high dose T3-only so I'm trying to step back into your shoes!

Adding T3 naturally lowers FT4....but we have to recognise that FT3 is the most important result, followed by FT4.....so I'd be inclined to focus on T3 at this point which is low at 45.95% thro' range

To attempt to answer your question....

You have been on 5mcg T3 since Feb so fine to increase now but since your FT3 is on the low side you may need to add the extra 2.5mcg slowly to allow the body to adjust.....and absolutely do not increase to 10mcg after a week....instead a 2 week gap minimum unil you reach 10mcg thereafter increase the gap before increasing

I suggest you split the 7.5mcg for a couple of weeks ... say 5mcg morning and 2.5mcg afternoon or evening. If that is ok then after the 2 weeks try combining to a single dose of 7.5mcg. After a further 2 weeks, or more if you feel it needs extra time, then try increasing to 10mcg. See how you feel!

I would then test again after 6 weeks on 150mcg T4/ 10mcg T3.....you may need to adjust T4 then

Thyroid hormone cannot be hurried!

We have to learn to listen to our body, it will soon tell us if something is wrong.

We are all different. There are no "rules" because we need what we need as an individual, and unlike a collection of identical machinery we cannot all be calibrated to a set point. Sometimes it's trial and error

You're correct, taking T3 is not always straightforward but if you need it then best to work to find what works for you.....I had a long bumpy journey with a complicated thyroid issue but eventually got there. Keep going!

Take the hormone on an empty stomach and at least an hour away from food and drinks....and with a glass of water to ensure it is well washed down!

Sorry that's a bit of a rant and my personal opinion based on my own experience....others may have different suggestions

We're all here to help....just ask

Good luck!

[SlowDragon Administrator]

I would only increase T3 at the moment

Wait a week or two before increasing Levo

T3 are you taking as 2.5mcg x 3 doses per day

Either 6am, noon and 6pm

Or if T3 helps you sleep (it does for many)

7am, 2pm and 10pm approx

When do you take your levothyroxine, waking or bedtime

[HotelHurricaine in reply to SlowDragon]

I take Levo at bedtime so is it ok to take 2.5 mcg T3 with my Levo?

So far have taken 7.5mcg in the am all at once and have felt fine until yesterday evening so no immediate response. Perhaps cumulative.

[SlowDragon Administrator in reply to HotelHurricaine]

I take Levo at bedtime so is it ok to take 2.5 mcg T3 with my Levo?

Yes many of us take Levo and last dose T3 at bedtime

Experiment

Initially try 3 doses waking, mid day and 6pm

Then creep last dose T3 later …..see how that goes

[FallingInReverse]

DippyDame said:

Thyroid hormone cannot be hurried!

So true. I’m a broken record with this, but when I started T3 I dropped 50 to 25 Levo and added 10 T3 (5 upon waking and 5 at bed).

This was before I found this forum. The palpitations were immediate and pretty constant and lasted 9 months.

I think chalk this up somewhat to being under-replaced in general, but they started upon starting T3.

I would never do that again! I’m a little shell shocked from other titrations I should have gone slower on so I’m biased towards low and slow.

In my opinion you can never go low enough or slow enough : )

[HotelHurricaine]

thank you Buddy195 DippyDame FallingInReverse SlowDragon I thought adding 2.5mcg after 3 months was taking it slow! Clearly not slow enough. I will try splitting dose for first 2 weeks then try 7.5mcg at once as that would be easier in the long run!

I take your point that adding in 50mcg of levo per week at the same time might be too much at once though.

I will stick to increasing T3 first and then check at 6-8 weeks before adding levo.

Endo doesn’t want to see me for 4 months so time to take it slow and test myself.

[SlowDragon Administrator in reply to HotelHurricaine]

I will try splitting dose for first 2 weeks then try 7.5mcg at once as that would be easier in the long run!

Personally I have been taking T3 for 7 years and the only way I tolerate it is as 4 doses per day (4 x 5mcg)

It’s easy enough to get use to

6.30am, 11.30am, 5.30pm and about 11pm

[HotelHurricaine in reply to SlowDragon]

Thank you SlowDragon I will do that. Not sure where I’d be without this group and your support. 🙏