I recently got prescribed T3 and will be starting next week! My doctor mentioned that I might experience some jitteriness, stress, and heart palpitations at the beginning, which she said is normal and should subside within a few days as my body adjusts to the medication.
However, on the report she sent me today, it says that these symptoms—like jitteriness—can sometimes last up to six months, which has me a bit confused. I assume it's different for everyone, and they need to provide a range of possible durations.
Since I tend to get anxious (especially because I’ve experienced jitteriness before due to Graves' disease), could anyone share their experience with starting T3? It would really help to know what to expect.
Thank you!
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Faith442024
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My tip is to add Liothyronine slowly over time, especially if like me you can suffer with anxiety. Have you been advised to reduce your Levothyroxine dose prior to starting combination treatment?
I added 5mcg Liothyronine initially and only added more (in increments of 2.5mcg) when well tolerated.
It’s nowhere near as bad as it was when my thyroid medication and key vitamins were less than optimal. I’ve also learned coping mechanisms that really help me day to day (eg meditation, time outdoors, journalling etc).
I was initially diagnosed as having ‘health anxiety’ and offered medication for this from my GP. Joining this forum helped me realise that my symptoms were largely related to being under medicated thyroid wise. I did have a lot of CBT and I actually found some of the techniques from these sessions useful for coping with anxiety symptoms.
Thanks so much Buddy195 for sharing your experience and advice! My doctor told me to start taking 2.5mg 3x times a day. After six weeks, she wants me to book blood test to see how I’m responding before she start reducing my Levothyroxine. I’m really nervous about it, and like you, I worry about how my anxiety will react.
Starting slowly on lowest dose Is the way to go like you're saying.
She said that if I start experiencing heart palpitations, jittery or similar side effects, I should persevere until my body adjusts and the side effects subside. If the side effects do improve after a week, I can then increase to 5 mg three times a day.
Is there anything else l should know when starting T3??
I personally would start on 5mcg (you can take this as 2.5 x2 in a split dose morning/ afternoon) and monitor how you feel. If no adverse symptoms, then add a further 2.5mcg to your morning dose. Your doctor is correct to ask you to retest 6-8 weeks after being on a consistent dose.
Just to add, I personally didn’t get the ‘eureka’ feeling some members report when adding Liothyronine, more a steady improvement in symptoms over time.
Buddy195 I experienced the same as yourself. I did not have by no means eureka moment when adding T3 with my T4. Not having T3 hormon after my TT dosing sole with T4 sole for 23 years. To add insult to injury not being a good converter. When finally adding T3 to my lowered T4 it was a disaster. My adrenaline had a hard time to adjust to the new T3 addition. I had to go slow and steady for a long time till my adrenals settled. It took a few years. Nutrients are very important components. Iron was very very helpful vitamin D, C, B-complex and B-12.I learned in my personal thyroid journey to not give up and to go slow to give my adrenaline and body to a climate to the new T3 . T3 is very powerful and immediate .
Thank you for sharing your experiences. Very helpful.
Don’t panic! 2.5mcg x3 is a really tiny dose. Enough to notice a difference but I wouldnt worry. It is short acting too - why you’ve been recommended to take it 3x a day - so any jitteriness will wear off quite quickly.x
Personally I'd start on 5mcg first thing and if well tolerated after a few weeks then add another 2.5mcg around 2-3pm.Its all very individual but I found no need for a 3rd dose.I take a quarter pill(6.25mcg) on waking and a further eighth at 2.30pm.The addition of the eighth made a huge difference to me.It got rid of the mid afternoon slump and keeps enough in my system until the following mornings dose.
Hi SovietSongInteresting to see that you alternate your doses..was this advice by Endo or through yr trial n error?..also could you share your last bloods please..?
Hi Sully, I've never seen an Endo and I don't go near my GP surgery anymore regarding thyroid issues. I order my Levo through them but source my own T3. It took me nearly three years to get back to full health.I don't bother with blood tests now but just go by symptoms. My last blood test was when on 125mcg levo and 6.25mcg T3. My T4 was 90% through range and T3 80%.I was mostly well on that dose but the very slight decrease in Levo coupled with the little extra T3 was the final tweak I needed.
There is no ‘loss’ starting very low. My experience was I started very low 2.5mcg. I did very well for a month. Brilliant. Then I hit a problem. It gave me such a fright, it totally undermined my confidence.
My problem (and some ‘old hands’ tried to explain it to me at the time) was that I had only been taking it once per day. T3 has a recognised Circadian Rhythm (even in orthodox medical circles). This means most patients must take doses at least twice per day.
Simply put your T3 can run out. It’s more complicated than that but that info will be important later.
The theory is that you make yourself more ‘hypo’ doing it once per day and that can bring on symptoms of under medication, which are unfortunately extremely similar to over medication. The unlearned (me) mistook the symptoms for over medication. I have not been able to bring myself to reintroducing T3 since, although it’s very clear I need it.
Anyway the message is “Don’t do as I did. Do it as the Forum says!” Twice per day and don’t let yourself become more hypo.
You will read about Forumites who do well on once per day - most of those appear to be on T3 only and on very large doses. There is an entirely different and sound reasoning for that but whatever, you need to go gently, slowly and low for this time of introduction.
Don’t spoil your chances of doing well and easy.
I was intrigued by your guidance that it could take time to settle and persevering. I have never known anyone having that conversation with a medic. It’s something they clearly shy away from. Your medic at least seems to have some awareness of issues around this. I am impressed.
Her recommendation is to start with 2.5 mcg three times a day—first in the morning with levo, then at noon, and again at 3 pm. If I tolerate this well, I should increase to 5 mcg three times a day. One thing I know for sure, I’ll be taking it slowly and listening to my body. I can’t allow myself to be on edge again, as that’s been a difficult and debilitating experience for me for many years before my hashis diagnosis.
"Don’t spoil your chances of doing well and easy" - Thank you for your insight I greatly appreciate you.
l'm so sorry to hear about your struggle with T3 and l'm wishing you all the very best 💐
I've been taking T4/T3 combo for nearly a year now, first 10mcg daily (split) and now 15mcg. I never had jitters, heart palpitations, stress; nothing to be concerned about. We are all different+we all respond differently so don't expect a problem when there may not be one! For me T3 gave me a fresh lease of life and the loss of the swimming ring round my middle!! Go slow+steady and trust you, too, will experience a new you!
I wish I had been warned of the possible palpitations. I had existing AF, and no one had warned me about possible side effects of T3. I am particularly anxious about any medication anyway! I panicked and stopped taking the T3. I did restart again later but it would have helped me so much if I’d known in advance.
It sounds like you had such a tough experience, especially with the added worry of your AF and your natural anxiety around medication. It’s understandable that the palpitations and uncertainty would be overwhelming, especially when you weren’t forewarned. I’m so sorry that you weren’t given the guidance you needed up front. How're you doing now?
I’m on Liothyronine only and I’ve never experienced any side effects whatsoever from taking it. Everyone is different so hopefully you have an easy journey
when i started T3 i did it graduallly, i took quarter of a tablet at first for one week, then next week i took half a tablet, then 3 quarters of a tablet the 3rd week, then on the fourth week (a month) i took the whole tablet. this way i had no jitters, id of thought her being a professional would of known this……..!! why over whelm your body so that you get undesirable side effects?? this way was best for me and my body. good luck!
Congratulations 🎉 Start your T3 with a very small dose & build up gradually - Just listen to your body. I've been on T3 Only for many years & I've never had any side effects. Years ago I was diagnosed with PTSD & taking T3 has never caused me any problems. To be honest the thought of not getting my regular T3 prescription completely stresses me out. I take my full T3 dose in the morning with two mugs of coffee - I don't eat breakfast. A lot of people say coffee messes up their T3 absorption - I've never had that problem. I think eating & taking T3 at the same time would not suit me. Best Wishes.
When I originally started liothyronine over 20 years ago I got no instructions so took the whole 20mcg in one go in the morning. Felt great, no problems at all. I’m now on a lower dose and still find it works best for me to take it in a single dose - a couple of hours after my levo dose.
I did try splitting the dose at one point as by then I’d read about it on here but that feels no different to not taking t3 for me.
I'm amazed by the mix of responses I received, and I'm grateful for each one. It just goes to show that we are all individuals with our own unique health histories, which is why our responses can vary.
I have eventually settled on 5 mcg per day divided evening and morning. Wish I’d started low as the 10 mcg proved too much and hated the palpitations which felt like my whole body rocked! It’s been enough to make a big difference with 100 mcg T4 plus an extra 25 mcg 3 times a week.. Feel tip top now instead. I was a poor convertor. Good luck,
I didn’t notice any good benefits from adding it so I dropped it. My ft3 is usually in the low 3s but hoping to get it to mid to upper 3s. What was yours to start?
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