Why I struggle with T3: The penny has finally dropped…

[TiredMummy]

I’d imagine there are people reading this that already know all about my apparent revelation, personal to how my body metabolises T3, I hasten to add! For me, I think the penny has finally dropped as to why it’s been a very painful T3 journey. Sometimes when I take it, it makes me feel “death like”, my body “shuts down” and another it has me zipping around, happy as Larry like it’s the miracle cure I’ve been searching for. What I do now with the hypothesis I’ve formed, to stabilise my situation, will no doubt continue to be sticky with peaks and troughs, as I have choices, but hopefully I can avoid being at zombie status on a regular basis.

My personal revelation is this: My body wants to convert T4 to T3 naturally. If I take my T4 and then add T3 in ‘before’ my body has had a chance to convert what it can into T3 on its own, it shuts down the ‘natural’ conversion completely. I can barely function, I’m talking not knowing how to operate the microwave, reading email sentences 7 times and still not understanding them, struggling to stay awake and feeling death like. This is at its worst if I take my T3 at the same time as my T4.

If I take T3 about 6 hours AFTER my T4 it picks me up and makes me feel better.

So I have choices based on this hypothesis to try and stabilise my thyroid levels better as it’s difficult waiting the 6 hours to take my T3 (feel tired and a bit brain dead, but no where NEAR as bad if I were to take my T3 at the same time as my T4).

I’m currently taking 75mcg T4 at 6am and then 5mcg T3 at 12noon. I’ve stabilised my T4 levels on this dose and cut my T3 down to 5mcg from 10mcg after stopping it completely for a few days. Im not clear what amount of T3 is going to suit me best in the end, but Im starting again at a lower dose as the timing of T3 with my T4 dosing is apparently crucial if I ever want to feel better.

A) I could simply try increasing the T3 dose at 12 noon to see if that eventually starts to carry me through until the next 12 noon T3 dose.

B) I could try introducing a 2.5mcg T3 dose at bedtime to see if that carries me through the next morning better.

C) Take my T4 at night and T3 in the morning, either all T3 at once or split dosing.

D) I take my T4 and T3 together but with a MUCH higher dose of T3 as it will need to completely replace all T4 to T3 conversion.

Option D instinctively doesn’t look like the best option unless all other options fail. Option A or B will probably be the most comfortable trials to start with but ultimately option C might be the better answer (taking T4 at night and T3 in the day).

Apologies for what feels like another totally self indulgent post. In all honesty it helps enormously to document by posting and immeasurably helpful to get feedback from other people with the same condition (I’m Hashi). Ultimately, I really hope it might also help someone else if they are finding the same issue if they take their T4 and T3 together. I will ponder on my options and feel my way through this apparent hypothesis but, as always, comments and suggestions are so appreciated as it means the world to feel I’m not on my own going through this!

Thank you everyone xx

[tattybogle]

interesting thoughts ... i've been having similar thought's recently around my own 'adventures in adding T3 to levo' ,, haven't come to any firm conclusion yet ,,, except that taking T3 on it's own at around 11.30 am gives me an easier time than taking it together with levo.

i ,agree A,B or C sound like better options than D.

i was taking a dose of t3 at night with half my levo ( i always split levo half am half bedtime), because it just seems logical , 'natural' T3 level would be highest overnight if we had a healthy thyroid and didn't take thyroid hormone replacements, so it makes sense to try and replicate that.......... but i keep running into problems after a week or so , it disturbs my sleep after a while even though it starts out ok,,, and i keep end up feeling overmedicated on T3 with 2 doses and have to go back to single dose and then feel more stable again.

i changed from 2 x 4mcg to 1 x 6.25mcg at 11.30 am about 2/3 wks ago and am feeling better than i was.

but yes i'm definitely wondering about the effects on my deiodinase /conversion of my T3 timing , and whether it is is effectively turning off my own conversion. and how to optimise these effects / minimise downsides.

[TiredMummy in reply to tattybogle]

Hi Tattybogle, we seem to be having the same challenges for some time me thinks! I’m going to try keeping my T3 dosing away from my T4 in the theory I can get to my optimal T3 dosing and timing requirements more easily! I took my T4 first thing as usual this morning and then 5mcg T3 at 12 noon. I’m going to try adding 2.5mcg T3 at bedtime tonight and see how that goes. Keep me posted on how you are getting on xx

[arTistapple]

On the contrary. This is not a “totally self indulgent post”. It’s brilliant to see and listen to a completely new (as far as I can see) theory in action. I think you are approaching this creatively and I applaud you.

I am embarking on a theory (which I have found is not exactly new but it is creative) aimed at reducing my T4 levels, which on the face of it are good, excellent even but up until now never addressing my very poor T3 levels, in fact making them worse at every blood test.

Due to horrendous symptoms I have put down to T3 when introduced; I have continued to blame the T3. Well - now I am tackling it from the other end. What if it’s my T4 levels which are too high and what happens when I introduce T3, it upsets a very fine balance which has just managed to fool me into thinking it’s the introduced T3. My increased T4 levels appear to have been of no help to me at all but I have never considered that they are the issue. I have had some help with this coming to this possible conclusion.

So, like you, I feel a bit more creative (but afraid) and your post has come at just the right time in my understanding and previous mistake making, to create a bit of confidence in my new strategy.

Thank you Tired Mummy. Your timing is spot on.

[TiredMummy in reply to arTistapple]

If it’s any help, I wasnt able to tolerate any amount of T3 when my T4 levels were higher. I had to gradually reduce it down from 125mcg to 75mcg and now I can tolerate T3 but only at certain times. I’m glad my post might be of help but the proof is in the pudding so my hypothesis might be incorrect but 14.5 years after diagnosis…I have nothing to lose but to try it! Good luck with your trials and I hope you find a routine that keeps you stable and we’ll soon xx

[arTistapple in reply to TiredMummy]

An extra wonderful reply. I am hopeful. I have always kept my Levo at a modest level. Strictly speaking weight wise I should be on considerably more than my 100mcgs per day. I have always been a little confused about that and it keeping my T4 level highish. I have been rereading some of jimh111 and see that I have misunderstood some of what he said. There (obviously) is a difference between dose amount and actual T4 levels in the blood. I now see I have been provided with this proof but I failed to truly see/understand it.

More helpful ‘proof’ that I could at last be on the correct track.

It’s amazing how our ‘fixed opinions’ (especially when based on our misunderstanding) can be formed and lead us astray.

Yes our hypotheses might be wrong but what if they are not?

I am just so keeping my fingers crossed!!

[inthedoldrums]

I found your post really interesting and had never thought of this. I am on T3 only but am always interested in how any of the thyroid hormones act and react with other things. So thank you and my very best wishes to you.

[RoseStar]

I’m coming to the realisation that I might be the same!

[Simplyred57]

This is a very interesting post , I’ve often wondered if taking T3 with my thyroxine stops the natural conversion happening, and thought about taking thyroxine in the morning and T3 at night ? I do try to follow the same protocol when taking my thyroid medications on an empty stomach and nothing for an hour afterwards so a bit harder to take mid morning ( I take my T &T4 at 6am).

[FallingInReverse]

Excellent post !!!

I’ve recently started staggering my morning dose after levo.

And my latest is to wonder whether I should return to a partial dose before bedtime.

Have gotten good replies recently to the benefits of the bedtime dose (when the logic of the t3 boost would say “why take that at night!” Or “why waste the boost at night!”

Thanks for sharing your thoughts and options … totally love it!

[Dobby]

Really found your post interesting. I was on 125mcg T4 which was initially reduced to 50mcg when the Endo started me on 5mcg T3 twice daily. She has reluctantly increased my T4 to 75mcg daily. Never mentioned it could be beneficial to take T4 & T3 separately! I have felt dreadful since the change in meds but she seems to think it is Ok because my TSH levels show I'm below the normal range, however my T4 shows I'm only just in range . TSH - 0.06 (Range - 0.35-4.94) Free T4 9.3 (Range 9.0-19.1) FT3 3.0 (Range 2.3-6.0) I am just so fed up with having a battle with these 'experts' just to feel well again.

[redsquirrel68]

Just came across your post last night and couldn't stop thinking about it.....wonder how you are getting on and how far did you get on on your trials? I have just started splitting my T3 dose from 1x5mcg at 6am, taken with 50mcg T4 to 2.5mcgT3 with 50mcg T4 at 6:00am and a second 2.5mcg T3 at 4pm. Felt terrible on first day as expected, but day on day getting better. Sorted my afternoon slump and surprisingly I have been sleeping much better through the night. Your observation to separate the T3 dose away from T4 is very interesting and whilst I can feel myself getting stronger everyday, I am too curious to ignore that and am very keen to try your option C. Taking T4 at bedtime would mimic closest to our natural state where TSH highest at night and T4 highest in the early morning hours, then to take T3 at 6am. Keen to hear if you did try Option C.

In Paul Robinson's book, he talked about using T3 within 4 hours of waking up window and tweaking T3 dose time to coincide with our cortisol production. Low Free T3 in our body during the night will result in lower cortisol production. However this circadian cycle affects some people more than others. He goes into detail how using T3 following his CT3M can help support adrenals.