How many hours in between dosing with T3

[Nellie2016]

Good Morning, im going to ask again about T3 private Endo says taking T3 early morning when i wake at 6 to 7am then at 12pm then take last dose again at 3pm so its 5 hours from morning dose to 12pm dose, but only 3 hours to 3pm dose i thought T3 stays in system 8 hours? Im sorry to keep asking about T3 i dont really want 3 x a day dosing but this is a new private Lady Endo who says its best im more concerned about the timings of taking it Thank You

[greygoose]

The half-life of T3 in the blood is about 24 hours. That means that if you took 10 mcg this morning, there will be about 5 mcg left tomorrow morning when you take your next dose. Less what got into the cells. What gets into the cells stays there for about 3 days. So, providing you take your T3 every day, you'll always have some in the system.

Just because your endo says you have to take it three times a day doesn't mean you have to do it. I take all mine in one go when I get up in the morning. That's what suits me best. So, find out what suits you best and do it that way.

[Nellie2016 in reply to greygoose]

greygoose I just find it very complicated this T3 these timings just dont sound right to me and to up it to 5mg 3 x a day so soon even worse so i wont be but ive never had my Levo dropped from a 100 to 75mcg adding T3 by my Nhs Endo im just more panicky with T3 as folks on here can see by my posts

[greygoose in reply to Nellie2016]

Well, it is complicated, but you'll soon get used to it.

There are no right timings, there's only what suits you. Experiment with different times and see how you feel. And take your time increasing. I doubt your endo knows anything about dosing T3 and is just making it up as she goes along. They all do that.

But don't panic. 15 mcg is a high starting dose but you don't have to do it. Start with 5 mcg and increase when you feel ready. You do not have to do what your endo tells you. She prescribed the T3, her job ends there. Now, it's up to you to find the best way to take it for you. She's not the one taking it, you are! So it should be done in the best way for you.

What was your FT4 level when she prescribed T3? Perhaps it didn't need reducing. The FT4 level will drop, anyway, when you start T3. And endos usually drop it by too much, anyway!

[Nellie2016 in reply to greygoose]

It was only just slightly over at 22.7. Range was 12-22pmol/L my T3 was 4.8 range 3.1-6.8pmol/L. TSh was 0.054 range 0.270-4.2

[greygoose in reply to Nellie2016]

Well, it was much too high, anyway, and would have been converting to more rT3 than t3. You'll have to wait until your next blood test to see what it is now, but it'll probably be ok when taking T3.

[Nellie2016 in reply to greygoose]

Thank you greygoose I have a lot to understand Rt3 my Dr mentioned that

[greygoose in reply to Nellie2016]

He may have mentioned it, but I doubt she understands what it is. It's irrelevant in and of itself. It doesn't cause symptoms but the fact that there's more of it means that there's less T3 and it's the low T3 that causes symptoms.

[SlowDragon Administrator]

i dont really want 3 x a day dosing

Well initially you will need to start by splitting dose

Then you might eventually find you can move to single dose

Or you may find it’s best to remain on split dose indefinitely

Every person is individual as to what suits them

I have been on T3 20mcg since 2017 and still find it much better to split dose

4 x 5mcg per day ……6am….11am….5pm …..11pm

[Nellie2016 in reply to SlowDragon]

Its the 3rd and last dose at 3pm confused me thats only 3 hours from 12 pm dose im only on 2.5mg 3 x day but wants me to up it 5mg 3 x a day in two weeks cant even get this dose right

[SlowDragon Administrator in reply to Nellie2016]

So experiment with last dose being 4pm

[Nellie2016 in reply to SlowDragon]

Ok Slow Dragon ive missed my 12 pm dose now will it be ok to take now

[SlowDragon Administrator in reply to Nellie2016]

Yes fine

Set an alarm on your watch/phone in future

Best to still to roughly same times …if possible

Especially in early days of starting

[jimh111]

I find my bedtime dose of liothyronine most useful, it gives better sleep quality and I'm more refreshed the next day.I would take it in two or three divided doses at equal intervals.

[Nellie2016 in reply to jimh111]

When you say equal intervals thats what confused me with what i was told to do its not equal times i took it at 7am with Levo not took 12pm yet then Endo says 3pm 3rd dose if take at 7am how many hours apart should it be between doses?

[SlowDragon Administrator in reply to Nellie2016]

Initially you are quite likely to find T3 might keep you awake if took it late in day

So endo recommends last dose by 3pm

But, once you are settled on a dose……after 2-3 months……then you can experiment with spreading doses out more evenly through the day

Many members find a small 5mcg dose T3 at bedtime improves sleep

But it doesn’t suit everyone

[jimh111 in reply to Nellie2016]

Your endo is silly, she seems to have little knowledge so bear this in mind. There's a belief among some doctors that taking T3 later in the day will prevent sleep. This is so if you are overdosed but not otherwise. They seem to believe that giving you more early on in the day will give you more energy in the day, this is not my experience, I find the bedtime dose more useful.

There's been no studies into optimal timing of T3 medication. In healthy people there is a small rise (~6%) in fT3 overnight.

You are reducing your levothyroxine from 100 mcg to 75 mcg and adding in 3x 5 mcg liothyroine. Liothyronine is about 3x as potent as levothyroxine. I would try 2x mcg liothyronine as 3x may be too much. Try taking 5 mcg when you wake up and 5 mcg at bedtime (T3 from liothyronine peaks around three hours after taking a tablet which is around the time we naturally have peak fT3). This doesn't quite even out the doses but it won't matter in practice.

If you find you need 15 mcg liothyronine then it will be simpler to take 3x doses perhaps before breakfast, mid afternoon and bedtime (assuming you have 5 mcg tablets or are quartering 20 mcg ones). You don't have to worry to much about avoiding food when taking liothyronine as it is very well absorbed, unlike levothyroxine.

Timings of T3 are not critical. Technically speaking it is the difference between 'pharmacokinetics' (how the body processes a drug) and 'pharmacodynamics' (how the drug works on the body). Doctors, particularly endocrinologists never catch on to this. Although liothyroine has a relatively short half-life of 24 hours it's actions in the body tend to take longer. A good analogy is water, it has a very short half-life, say an hour or two if you drink a litre but it's 'pharmacodynamics' are much longer, you can hapily go overnight without a drink.

[Nellie2016 in reply to jimh111]

I Really appreciate these replies i think dropping my Levo down and adding the T3 doses which i thought getting my dose to 5 mcg 3 times a day in couple of weeks was bit much my T4 was just over range my t3 not great and because she is a new Private Dr who actually has Hashimoto's i thought she will know more than my Nhs Endo to be honest i panic more withT3 think its quite clear to everyone !

[jimh111 in reply to Nellie2016]

Forgot to say because LT3 has a much shorter half-life than LT4 I would skip a couple of days of levothyroxine when you introduce the liothyronine. This will smooth the changeover.

[Nellie2016 in reply to jimh111]

Ah i started the lower dose 75 mcg 3 days ago , and started Liothyronine 2days ago but twice a day so far 2x 2.5 so 5mg a day for this week hope im doing it right then see how i go to 3 x 2.5 a day im just hoping my t4 doesnt drop quick as i might get undermedicated?

[jimh111 in reply to Nellie2016]

After a week you will be 'on' 87 mcg levothyroxine. So no problem.

[Nellie2016 in reply to jimh111]

I dont get tested till 6 weeks time

[Hashiboy]

Hi  Nellie2016 . I take 100T4 at 7am along with 5mcg T3 then another 5mcg T3 at 1pm and another 5mcg at 5pm. Endo advised this and advised against taking at night. I know some people feel better taking a single dose and others work out the maths. For me the main thing was getting to a good dose and then adjusting my daily pattern to what seemed like a good fit to minimise feeling high or low. I think it’s probably a matter of personal response to T3, I used to try to calculate optimal times and do things like check my pulse but in the end I don’t have time to go down that rabbit hole. So I go with balancing what feels good (am I left tired or high) and what’s going to require minimal thinking. I use a medication reminder on my phone but I am quite lazy and often take my second and third dose half an hour later or earlier than planned either with or without food if that suits what I’m doing. Good luck

[Nellie2016 in reply to Hashiboy]

Thank You

[Sleepman]

Interesting thread

I am on T4 100 mg and T3 12.5 as I wake with T4 and 12.5 about 8 PM. It took over a year to move from low dose T3, I think because I was generally ok and relieved as I had been so bad before starting on T4 at 150 mg.

3onths ago I had been on a single 25 mg T3 in the morning but I was tired in the mornings and worried about the peek of T3 being too high.

I started on 6 mg in a morning then went to 12 which was too much and dropped by blood sugar levels. So I ended up splitting it. You take a while to get used to doses.

Remember the protocol of splitting your dose before testing else your T3 will be falsely low if 24 hours since you last dose. I forgot on my single 25 mg T3 and sure enough my T3 blood test was low.

[Nellie2016 in reply to Sleepman]

I know 24hours last dose T4 before testing and 8 hours last dose of t3 atm i take 2.5 t3 twice a day started it 3 days ago but where my new Dr wants to get me to 5mg 3x a day in couple weeks advise on here its too much i thought that as well so i thought try 3 x a day 2.5mg i dont see her till 3rd Dec on video call only. I do have worrys starting on T3 the only reason i started with new Dr is Hashimoto's runs in her family she has it too ive saved some threads on here as they are very helpful