Hi there! I was recently prescribed two doses of 5mcg Liothyronine on top of my Erfa Thyroid (90 mcg in the morning and 60 in the afternoon).
I find it very difficult to go without food for long enough to squeeze in my second dose of Erfa in the afternoon. This issue has been worse for me lately as I've had to fit in other medications around it. It's kind of driving me nuts to always feel like I'm taking my thyroid medication in a suboptimal way.
Has anyone here had the same issue and resolved it?
I was planning to take the 90mcg Erfa with one of the 5mcg Liothyronine in the morning and my second dose of 60mcg Erfa with the second dose of 5mcg Liothyronine in the afternoon.
I've seen some posts on here about people taking all there thyroid medication in the middle of the night and that this saturates the receptors and actually works better for them?
Would this be completely mad in my case? I don't think the posts I saw were people on NDT.
I'm sorry... I feel like I need a lot of help lately. I try to search on the topic first, but all the types of thyroid medication are so unique so I feel unsure if the split dose is necessary. Then again, I think the T3 is completely out of your system in 8 hours so maybe this answers my own question -- unless this is in dispute?
I'm open to different philosophies and advice. I know everyone is different.
Thank you so much for any support you're able to give!
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The-Wasp
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NDT comes in grains. Generally, 1 grain is 60mg and contains 38mcg of T4 and 9mcg of T3. Some brands have 65mg.
You take 90mcg/ morning and 60mcg/ afternoon
Daily NDT total 2.5 grains
NDT hormone content
T4 = 95mcg
T3 = 22.5mcg
With additional 10mcg T3. Total 32.5mcg
So, a fairly substantial dose
There is no one correct way to take the hormones because we are all different but I'm of the opinion that it's best to find the easiest way and that dosing can be made more complicated than it need be
I was planning to take the 90mcg Erfa with one of the 5mcg Liothyronine in the morning and my second dose of 60mcg Erfa with the second dose of 5mcg Liothyronine in the afternoon.
This is perfectly reasonable if it fits well into your day....it's basically trial and error!
It is also possible to take your hormones in a single dose
A number of years I tried various dosing protocols and decided on the following
I currently need 125mcg T3-only which I take in a single dose at bedtime, with no problems...I'm lucky that works for me.
I haven't used an NDT/T3 combo but I see no reason why it shouldn't work in the correct doses
Then again, I think the T3 is completely out of your system in 8 hours
Not so! The T3 remains in the serum for around 8 hours but stays in the cells for roughly 3 days and is released into the system in waves throughout the day which gives a "journey" roughly close to natural production. On the other hand splitting the dose does, in my own experience, cause more peaks and troughs....but we are all different
So, the important question is, how do you feel on this dose.
Do you have recent test results....bearing in mind that adding T3 lowers both FT4 and TSH
When you take your dose depends on how you feel.
As a very wise member here told me, years ago, "You won't know unless you try"!
It's a bit of a ramble but maybe something will resonate!
Wow, that was a fantastic answer and not at all rambly. Answered many of my questions that I didn't know how to articulate. I have some test results, but they are from a year ago before I started the 10mcg Liothyronine. I was thinking of doing a new test, but it may not be worth it because I might be moving to Sweden in about six months and NDT has become very political in Sweden with all sorts of bureaucratic hoops even if I go private. In short, I might need to switch to T4 and T3. Hopefully they don't force me to be on Levothyroxine for a year as the rules officially state. I've done my time on Levo (took two decades to break free) and it didn't help me much at all.
I just told my husband, "DippyDame is not at all dippy. She's super smart and helpful". And he said, "Tell her. When you have something nice to say, say it!"
Hey, thanks! I agree in a way because I just started to add the two doses of 5 mcg Liothyronine and got a small headache after the second dose so I wonder if it's too much. I have the opportunity to do a thyroid test at home about a week from now but I'm taking a B Complex so I don't think there's time to go off it in time for the test?
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I have had my Liothyronine changed from 10mcg daily to having to take 10mcg one day, then 5mcg the next day . 
