Tips for increasing T3 dose

[MsWhistledown]

Hello all,

I’d be grateful to hear from those of you who take T3 what your experience has been with increasing your dose and if you have some tips on how to effectively increase T3 without too many adverse affects?

I started out really well on 20mcgs of T3 after coming off Levothyroxine and going onto to T3 mono therapy. I then successfully increased to 30mcgs. Honestly, I started to finally feel so much better at long last. However, after last appointment with my doctor my bloods showed good improvement in T3 levels but I am yet to get get my TSH under 2.5. I was still having some symptoms so we agreed that I slowly increase to 40mcgs.

This time I am really not feeling great with this slow increase. I have been trying to increase to 35mcgs. Then tried one day at 40mcgs but I have needed to return to 30mcgs again because it was making me feel anxious and nauseous at times. I am also getting this symptom I got before I was diagnosed with Hashimoto’s, which was a kind of tightness and anxiousness in my diaphragm/stomach area. Once I started thyroid treatment that went away. I’m also feeling cold and shivery in the evenings which was never a major symptom of mine, cold at times but not the shivering.

So, I am wondering if it’s a mix of the increase bringing symptoms out again because I am still under replaced or my body isn’t ready for an increase yet?

Last blood results dated 31/10/2024

TSH. 2.950 mIU/L (Range: 0.27 - 4.2)

Free T3. 5.4 pmol/L (Range: 3.1 - 6.8) (Previously was 3.9)

T4 3.0 pmol/L (Range: 12 - 22)

Many thanks and happy new year 🌞

[SlowDragon Administrator]

Mono T3 therapy doesn’t suit everyone

Very common to initially feel better when reducing Levo

How are you taking your T3

Are you splitting dose ?

Which brand of T3 are you taking

What are your most recent vitamin results

Are you on gluten free/dairy free diet

[MsWhistledown in reply to SlowDragon]

I split my dose twice a day. Tried 3 & 4 times a day but didn’t get on with that. Tried 20mcgs in the morning before I get up and then 10mcgs around in the afternoon. It worked much better for me that way. Now wondering if it would be better to go back to splitting it 3 or 4 times a day with the increase?

I’m on Thybon Henning.

Ferritin 45.60 ug/L (Range: 30 - 207)

Folate 11.6 nmol/L (Range: > 7)

Vitamin B12 - Active >150 pmol/L (Range: > 37.5)

Vitamin D 46.5 nmol/L (Range: 50 - 250)

I know my vitamin D is terrible. I really have to work on it. My ferritin isn’t great either but has improved slowly.

Did gluten free for some time. No longer gluten free. Now have lactose free milk. Used to be dairy free and use soya milk but told to stop using it. Do not get on with any other milk substitutes.

[SlowDragon Administrator in reply to MsWhistledown]

Folate not brilliant either

Exactly what vitamin supplements are you taking

Aim for vitamin D at least around 100nmol

Ferritin

Get full iron panel

Meanwhile increase iron rich foods in your diet

Soya not good for anyone on thyroid hormones

If only on T3 then you’re on quite low dose

[arTistapple]

Results are a bit ‘old’ for someone on T3 only medication. Maybe a check on levels before any more changes?

[CarnivoreQueen]

Years ago I read that T3 and cortisol work together, and that first morning dose of T3 is greatly benefitted by cortisol production in the early morning. I began taking my first dose of T3 around 4-5 AM (when my bladder calls anyway); it helped a LOT. I found that I do best when I split my 56.25 daily dose into 4-5 doses each day. If I take more than 12.5 mcg at once I get heart palpitations.

I would strongly urge you to cut out ALL grains and processed foods. Gluten is the worst culprit (the body needs 49% more thyroid hormone in the presence of gluten), but all grains interfere with digestion, therefor absorption of nutrients.

[MsWhistledown in reply to CarnivoreQueen]

Thank you CarnivoreQueen. It’s good to hear of someone else’s experience with T3. I started taking my first dose earlier as well, around 4am. So, I’ll see how it goes and I’ll split my dose into 3 while I’m increasing to 35mcgs and then maybe 4 when I finally get to 40mcgs. I think having two larger doses instead of splitting them into smaller doses may have been my mistake.

I have persevered many times with a strict gluten free diet but unfortunately I become chronically constipated every time and it makes me very unwell.

[CarnivoreQueen in reply to MsWhistledown]

I've found that avoiding grains altogether is much simpler (and healthier) than trying to avoid gluten. I have also found that the fewer carbs one eats, the more fat one needs to eat to keep things moving along.

[Incoguto]

I think your dose is too low with such tsh. Being on 30 t3 is usually not enough if you don't have any t4. Sometimes splitting dose more throughout the day is not beneficial if your dose is too low, you'll be more hypo and this happened to me.