Starting T3

[JoJoloveschocolate]

Hi all, I’ve been prescribed T3 starting at 2.5mcg three times a day with a view to increasing to 5mcg three times a day (building up to the three times a day by adding 2.5mcg at a time). The thyroid gp seems to think I may need more than that eventually. Feeling nervous about it.. Does this sound ok?

[Buddy195 Administrator]

I think that sounds like a good plan. I’m a huge fan of ‘low and slow’ adjustments, as this means you are less likely to miss your ‘sweet spot’ where you feel most well. Other members however report being fine starting with a higher dose. Whatever you choose remember to retest levels 6-8 weeks after being on a consistent dose.

Were you advised to slightly reduce your Levothyroxine before adding Liothyronine as a combination dose?

[JoJoloveschocolate in reply to Buddy195]

Thanks Buddy. The doctor said stay on same levo as I am just on 87.5mcg. Do you think that sounds ok?

She said to do 2.5 mcg three times a day but just for a week then go up slowly to 5 mcg three times a day eg: 5mcg, 2.5, 2.5 to start with but didn’t say how long to hold at that level. I said what if I’m ok on 2.5mcg x3 times a day? She said “oh, I think you’ll need more.

[Buddy195 Administrator in reply to JoJoloveschocolate]

If your FT4 was not at the top of the range, 87.5mcg Levo may be ok. I would leave a few days before adjusting Liothyronine upwards and keep a close check on any symptoms you experience. Some members just add one dose of Lio per day, but I prefer taking 2 doses (as I found I can slump in an afternoon without a split dose).

[JoJoloveschocolate in reply to Buddy195]

My t4 was 17 (24 hours after levo dose) and then messed up timings on my blood test showed t4 level of 19.1 (8 hours after levo dose) (12-22). I thought she would say t3 twice a day, but she said three times a day. Is that unusual do you think? I literally am totally paranoid where doctors are concerned. Just spent the past 7 years lumbered with a CFS diagnosis where the “CFS symptoms” were just getting worse and worse! I have no faith in any doctors any more.

[Buddy195 Administrator in reply to JoJoloveschocolate]

As 2.5mcg is a small dose, x 3 day should be fine, although I personally started lower than this (ie 5mcg per day)

Do keep us posted how you get on.

Although some members report a ‘eureka’ moment on combination treatment, for me it was a steady improvement over time.

[JoJoloveschocolate in reply to Buddy195]

Thanks, Buddy! She said if not too many side effects increase the dose after a week so I thought if all goes well and not too many side effects I could try 5/2.5/2.5, but don’t know how long I would need to stay on that before increasing again.,.,I suppose it all depends on how I feel?

[Buddy195 Administrator in reply to JoJoloveschocolate]

Yes, adjust by how you feel. I still go by what I’ve said before that ‘low and slow’ worked best for me.

[JoJoloveschocolate in reply to Buddy195]

Yep, thanks - definitely agree with the “low and slow” way forward x

[Hashiboy in reply to Buddy195]

100% agree Buddy195 best advice I ever got was go low and slow. Had a rough time because I was given too much too quick. I was really ill on T4 only. Now very nearly my old self on 100T4 and 15T3 split into three doses across the day. Endo recommended allowing up to six to ten months for this final dose to settle and that turned out to be good advice. Only thing I’d add is that for me it wasn’t helpful to take out too much T4 or to try T3 only. Good luck JoJoloveschocolate Hope you really improve and I’m sure you’ll get lots of advice here.

[JoJoloveschocolate in reply to Hashiboy]

Thank you so much, Hashiboy! Great to hear you experience. I hope the t3 will help me. The t4 has had some good effects on my constant tinnitus, ibs, constipation, and I do have some good days now, but the crashing fatigue and lack of stamina are still a problem. I have no tolerance for exercise and often end up back in bed in the afternoons with the electric blanket on. Hopefully starting slow will fend off any unwanted side effects. The thyroid gp said it will take some time to get the dose right and then possibly take a few months to feel better. We’ll see. I just had a message to say the T3 is on its way! I’m imagining a man in one of those full lab suits, wearing thick gloves carrying a smouldering canister! 🤣🧪

[Hashiboy in reply to JoJoloveschocolate]

Hi JoJoloveschocolate I had very similar symptoms on T4 only. It took a while to get to the right dose combo of T4 and T3 but I’ve gone from being in a heap to hugely improved. I’ve just booked to go trekking in Asia. Good luck.

[JoJoloveschocolate in reply to Hashiboy]

Wow!!! You’ve given me hope! That trip sounds amazing. Thank you so much for sharing your experience with t3.

[TiggerMe in reply to Hashiboy]

Yay 👏👏👏😁

[Dahliasanddaisies]

Ooh that's exciting JoJo! I hope you get on okay, keep me posted 😊

[JoJoloveschocolate in reply to Dahliasanddaisies]

I’m dreading it now DandD!! But gp reckons conversion is poor and t3 will help - basically same advice as people have said on here. I just dread any side effects.

[Dahliasanddaisies in reply to JoJoloveschocolate]

Well we have been through the mill with all the dose changes so I understand. Nothing ventured, nothing gained 🙏

[JoJoloveschocolate in reply to Dahliasanddaisies]

That is soooo true. All the issues and side effects of increases makes me wary. Plus I am a bit frightened of t3. I’ll just have to give it a whirl and see how it goes won’t I.

[greygoose in reply to JoJoloveschocolate]

Why are you frightened of T3? It's far safer than a lot of the drugs doctors prescribe to 'treat' the hypo symptoms that are caused by low T3. And if you don't expect side-effects you probably won't get any. T3 is a hormone and hormones don't cause side-effects. It's usually the fillers in the pill that disagree with people, not the T3 itself. As long as your nutrients are optimal your body should be able to use the T3 very well and you should feel a lot better.

That said, I really wouldn't start on 7.5 daily. I would start on 5 mcg, split into 2, for at least a week. Your body has probably been without decent levels of T3 for a long time, so starting on too high a dose would come as quite a shock - possibly one of the reasons people complain of 'side-effects'.

[JoJoloveschocolate in reply to greygoose]

Thanks greygoose that makes me feel better. I think it’s because it’s so hard to get t3 on the nhs…makes it seem a bit scary. Yep, that sounds better to me -I’ll do 2.5mcg twice a day for at least week. My ferritin is on the low side and my vit d is around 80. The thyroid gp advised me to increase vit d. Everything else is ok.

[greygoose in reply to JoJoloveschocolate]

The main reason it's hard to get T3 on the NHS is due to the cost, not because it's dangerous. But it's true that doctors tend to be terrified of all hormones, especially T3, but that's down to ignorance. I take 75 mcg T3 a day, now. At one point I took 225 mcg, just before bed and slept like a log! I was fine. But I don't need that much now - thank goodness! Because it was costing me a fortune! 🤣

Did the thyroid gp also advise you to take vit K2-MK7 and magnesium with your vit D?

[JoJoloveschocolate in reply to greygoose]

225mcg! Blimey! I’m no longer worried about starting 2.5mcg twice a day. She didn’t mention the type of vit d, but I was taking the oral spray d2 and K so I’ll go back to that and increase the dose. I’ve got magnesium bisglycinate capsules but I’ve been reluctant to try them because the last time i tried magnesium it seemed to cause an irritable bladder….plus the capsules look very big and difficult to swallow! I’ll have to look for a smaller tablet

[greygoose in reply to JoJoloveschocolate]

It should be D3.

You could use a magnesium spray, too.

[SlowDragon Administrator]

suggest you initially start with 2.5mcg twice a day

assuming that’s ok

After a few days increase to 3 x per day

Which brand T3 have you got

[JoJoloveschocolate in reply to SlowDragon]

Good idea! I like that approach, SD. I think “sigma”? is it…need to check

[SlowDragon Administrator in reply to JoJoloveschocolate]

Probably

5mcg tablets

Sigma contain mannitol (I think)

Are you ok with Teva Levo - this contains mannitol

Alternatively Morningside make 5mcg tablets- contains lactose

Roma capsules are lactose free…..but you can’t easily split a 5mcg capsule

[JoJoloveschocolate in reply to SlowDragon]

Yep, absolutely fine with Teva levo. No problems with lactose either

[JoJoloveschocolate]

Right…will start on 2.5mcg T3 twice a day for a week or so and then increase to 2.5mcg three times a day.

[JoJoloveschocolate]

Thanks Buddy195 SlowDragon Dahliasanddaisies greygoose xxx I’ve come down off the ceiling now. #queen of panic!

[DippyDame]

Don't be afraid of T3 it's perfectly safe if used correctly.....I'm on a huge dose of T3-only taken in a single dose at bedtime....and fine at age 79!!

Medics make it sound like something from a witches cauldron.....don't let the naysayers worry you.

If your conversion is impaired you need T3....end off!

You may eventually want to reduce the number of doses you take in a day....if the system is happy with that it saves clock watching!

No need to reduce Levo at this stage .....T3 naturally reduces both T4 and TSH

You will experience a few bumps along the way as dose changes but you need to ride that out.

Be aware of any changing symptoms because they are as important as labs

I used to record it all in a diary

Your doctor should guide you initially but as you learn more you may find you want to alter your dose/ timing. It's all very personal because we are all different.

You can raise T3 every 2 weeks ( unlike levo) but don't go beyong 20mcg daily without testing....and leave a 12hr gap between last dose and testing

Just a few thoughts.....you'll be fine.

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

[JoJoloveschocolate in reply to DippyDame]

Thank you soooooo much DippyDame ! xx They do make it sound like it’s feom the cauldron!! “2.5mcg t3 three times a day…with and eye of newt…sixteen spider legs once a day…one toad…two snails at bed time.” I will keep a diary - good idea.

[DippyDame in reply to JoJoloveschocolate]

They seem to forget it's a natural hormone produced by the body and essential to life!