T3 question…

[JoJoloveschocolate]

I’m taking 100mcg levo (taken about 5am) and 10 mcg t3 (taken 5mcg at about 5am with levo and 5mcg at 4pm).

Last results in Dec 2024: (fasted, last t3 taken 12hrs before test and last t4 taken 24hrs before test) on 87.5mcg of levo and 10mcg t3 for 6 weeks, showed that:

-the t4 had dropped from 19 to 15.5

-the t3 gone up from 3.9 to 5.5

so…(as per forum and gp advice) I increased the dose of levo to 100 and stayed with t3 10 (split as above)

At first, I felt absolutely awful with the joint/muscle and low back spasms/ pains, but then 5/6 weeks into the increased levo all the severe pain pretty much disappeared, leaving more low level intermittent aches. I feel quite well. Have more energy. Feel brighter in mood. Not sleeping all day and managing to stay awake until 9pm. A lot of the low back pain and muscle/joint pain has gone (at the moment), bowels ok, IBS completely settled. Managing to have a shower and get dressed and get out of the house in the morning to the shops/for a coffee, then to the local park for a short walk, then later managing a short stretching/yoga programme and a bit of light housework without too much fatigue/the muscle pain kicking-off. So…generally doing fairly well at the moment.

Now, I have been on the increased levo for about 7 weeks and on the t3 for about 3 months.

I take my morning tablets at 5am and then go back to bed u til about 730am.

The problem I seem to have at the moment is that I feel kind of a bit flat/disconnected from my body when I get up at 7-ish and it takes until about 930/10 to “come alive” …it feels like quite a big difference/jump …like when someone puts money into the jukebox and it suddenly fills with music!

I’m having my next bloods done in Feb, but wondered if it might be due to timing of my t3 doses? Or maybe just need the new levo dose to settle a bit longer.

Any ideas what might be going on? x

[greygoose]

Low early morning cortisol?

[JoJoloveschocolate in reply to greygoose]

greygoose oh yes…forgot about cortisol. Gp never mentioned it, but these are the results. What do you think?

cortisol from 2024.

[greygoose in reply to JoJoloveschocolate]

What would a GP know about cortisol? lol Most GPs I've seen don't even know what an adrenal is!

What time was that first sample taken? It could be a lot higher.

[JoJoloveschocolate in reply to greygoose]

Hehe! Very true.  greygoose the first sample was 7am.

[greygoose in reply to JoJoloveschocolate]

OK, so I think that's possibly your problem, low-ish cortisol. Do you get plenty of vit C, B vits and salt?

[JoJoloveschocolate in reply to greygoose]

No I don’t. I’ve been really craving salt lately though. I don’t cook with salt and never used to add it to anything. I’ll add some extra vit c and b vits too. Thanks greygoose

[greygoose in reply to JoJoloveschocolate]

Add salt! No wonder your adrenals are struggling! Cravings are for a reason, you know. It's your body telling you what you need.

[JoJoloveschocolate in reply to greygoose]

Will do. Thank you for your advice greygoose

[greygoose in reply to JoJoloveschocolate]

You're welcome.

[jimh111]

Try taking T3 at bedtime, I find it helps a lot. The brain works hard during sleep and needs T3. It gives more vivid dreams and a sharper mind thr next day.

[JoJoloveschocolate in reply to jimh111]

Thanks @jimh111. I’ll give that a try. I take 5mcg twice a day (first dose about 5am) so if I take the second 5mcg at bedtime should I take the morning dose a bit later?

[DippyDame in reply to JoJoloveschocolate]

Try taking your T3 as a single dose of 10mcg., that can provide an extra "push" which can make it easier for the hormone to enter the cells.

I take all my T3 at bedtime ....100mcg which would be far too much for most, but I have a form of Thyroid Hormone Resistance.

I have no problems sleeping.....

Splitting has never worked for me.

But... there are no set rules because we are all different, with different needs, so it can be trial and error to find one's therapeutic dose.

Try to keep it simple...no need to be clock watching all day...and sometimes, night.

Also...

have you considered an adrenal cocktail ?

I like the classic adrenal cocktail...

4oz of orange juice (for vitamin C)

1/4 tsp of Cream of Tartar (for potassium)

1/4 tsp sea salt (for sodium and other minerals)

It is recommended to drink it a few times a day on an empty stomach.

healyouradrenalfatigue.com/...

Salt, like good fat, is not the enemy !!

Good luck!

[JoJoloveschocolate in reply to DippyDame]

Thank you for all your advice DippyDame . I’ll try the adrenal cocktail first and then look at changing how i take the t3.

[Simplyred57 in reply to jimh111]

Hi jimh111 do you take thyroxine in the morning and T3 at night ?

I’m thinking of doing this not sure if anyone has tried this, but wondering if you convert more T4 to T3 if thyroxine taken on its own ?

[jimh111 in reply to Simplyred57]

I take half my liothyronine with levothyroxine in the morning and the other halt liothyronine at bedtime. We store about 10 days of T4 so I don't think the timing of levothyroxine makes any difference.

[Simplyred57 in reply to jimh111]

Thank you , I feel fine taking my 10mcg in one go but might split it as I suppose it’s gentler on the system not dumping too muchT3 all at once , will give it a go ☺️

[FallingInReverse]

Hi Jojo! You’re catching up to me! 112 Levo and up until a few weeks ago 10 t3 (which I was on steady for nearly a year and a half while I brought my Levo up from 25!)

For those two years I took t3 upon waking with Levo and at bedtime (alone.)

Timing , as far as one reads here, of course is highly individual trial and error.

 jimh111 always gives smart input, and I had no issues with my bedtime t3 dose all that time.

Note - for a while my ft3 was well over range (in retrospect it does seem it was contributing to my wired/tired and Palpitations) and a few weeks ago I decided to reduce to 7.5 a day.

So my point in this reply is that I decided to 1) take only Levo upon waking and 2) delay (all) my t3 until mid-morning/lunchtime. And 3) don’t take at bedtime anymore.

I read some comment that someone said about why take the Levo WITh t3 when your body will get some with the Levo conversion and so why not stagger the actual t3.

The charts on this thyroid.ca page thyroidpatients.ca/2020/07/...

Helped me a couple years ago as in envisioned how the t3 dose was taking course. It guided me early in when I played around with splitting.

Nonetheless none of the above is a recco, just sharing my experience and reasoning… not sure how sound or flawed : )

Good luck and keep us posted!

[JoJoloveschocolate in reply to FallingInReverse]

Thanks for sharing your experience and advice, Fir. Tricky to know what to do for the best. I’ve got a few changes to make, starting with changing my t3 to thybon henning after my next blood test in Feb. I may even need the doses tweaking again at that point so I’ll wait until I get the results before i change over. Once all that has settled I think I’ll play around with how I take the t3….and in the meantime maybe try the adrenal cocktail.

[Cat_bluenote]

Hi jojo, I don't have any advice to add, sorry, but I wanted to thank you for posting this. I'm in a similar situation: on 10 mcg T3, and just started to increase to 100 mcg Levo, and feeling terrible with awful low back pain, muscle ache and tired. I was almost wondering whether to give up and reduce dose. Pleased to read that for you those symptoms resolved after 6 weeks. It's given me hope, thank you 🙂. Best wishes

[JoJoloveschocolate in reply to Cat_bluenote]

I felt exactly the same. I thought everything was getting worse and going backwards. My pain was off the charts - shoulders, forearms, between my shoulder blades, elbows, neck, low back pain and every time I bent down awful muscle spasm in my lower back that was so bad I couldn’t get my breath and took me a few minutes to slowly straighten up. The pain and stiffness in my forearms and shoulders was awful - I couldn’t push the hoover, lift the kettle, carry anything. The pain between my shoulder blades was constant! I was in pain every day and was taking regular painkillers. Then week 5/6 after the increase the severe pain went away. The back ache and spasms stopped. The stiffness eased. I’m not 100% pain free, still have a few low level aches which is kind of good in a way because they remind me not to do too much, but they are really not too bad at all. I haven’t needed painkillers for a good few days now and I have been able to start some very light/easy yoga/stretches which is also helping. This 5/6 week timespan after an increase seems to happen every time for me. Hang in there! x x

[redhead41]

Levo is a very particular/ fussy medication - I would try taking it on its own and taking the t3 at least an hour later. T3 has a short half life so often better if taken as 3 split doses each day.

[JoJoloveschocolate in reply to redhead41]

Thanks for the advice redhead41 - much appreciated.

[JoJoloveschocolate]

Thanks everyone. I’m taking it all on board. You’ve given me lots to think about and all the advice will help me to hatch my next plan!