Timing of T3 question.....

[goingholiday]

I know a lot of forum members take their levo in the morning when they have a loo visit between say 4-6am. My question is this - is it okay to do this with T3 - take it during a two hour or so window or is it advised to take at a set time? Thanks

[TiggerMe Ambassador]

Must admit I take all my T3/4 as a single dose varying between 4-7am and it works fine for me, earlier this week I had a blood test so for 2 days I took them at 9.30am and it knocked me sideways for a couple of days 😵 so always good to experiment, I think it depends how sensitive you are to it

I find having it in my system ready for when my cortisol level picks up seems to be key

[goingholiday in reply to TiggerMe]

That’s interesting. I’m just starting T3 and have been taking two low doses which I will gradually increase, the thought of taking T3 /4 together at one time is very appealing ! Something to hope for!

How do you know when your cortisol levels pick up ?

[TiggerMe Ambassador in reply to goingholiday]

I'd suggest before increasing try as just a single dose and see how it works for you, cortisol has a circadian rhythm which generally peaks within an hour of waking but you only really know what is going on by doing a cortisol saliva test as symptoms for high and low are much the same

[TiggerMe Ambassador in reply to TiggerMe]

Really useful profile 🥇

"January 2025 results:

TSH 0.42 (0.27-4.2)

FT4 18.6 (12-22) 66%

FT3 4 (3.1-6.8) 24.3%

February 2025

8th -12th February lowered levo to 112mcg

13th February 2.5mcg x2

15th February lowered levo to 100mcg

17th February 5mcg & 2.5 mcg

feeling drowsy a lot of the time, no increased energy or stamina, in fact finding it more difficult to exercise"

I'd also suggest you have lowered your T4 by too much as adding T3 will knock it down and 66% was already a little on the low side

[goingholiday in reply to TiggerMe]

My Endo wants me on alternate 75/100 mcg 🙆‍♀️ My plan was to stay as I am for another couple of weeks, then lower to 87.5/100mcg for a week or so then do 75/100mcg with the full 10mcg dose of T3 a couple of days later. Though the thought of cutting a 100mcg in half and a 25mcg in half along with a full 25mcg to get 87.5 mcg is giving me a headache and tempting me to just go for 75mcg in one hit ! SlowDragon agrees with you that my T4 will be too low and I will need to increase but what can you do when you've paid a fortune for a private Endo and then don't follow his instructions ?!

[TiggerMe Ambassador in reply to goingholiday]

Paying or not they are often pretty hopeless 😬 and the private ones like you to keep coming back 🙄

We've walked this path and you are very likely to feel horrendous and blame the T3 when actually lowered fT4 is the real issue

Personally I'd have maintained your T4 dose and added in T3, you never want to change 2 things at once ( unimpressed with your Endo's method!) then re-test after 6-8 weeks to see the effect and go from there

[FancyPants54 in reply to goingholiday]

I pay for a private endo. He keeps his eye on a few things for me. I rarely do what he tells me regarding thyroid meds! I pay, it's my choice what I do with the advice. I followed him blindly at first and suffered. He's on the right track but he's too heavy handed. I suspect most of them are. I consider what he's said and then I use his explanations and my knowledge to make a choice.

For one thing he won't prescribe Armour Thyroid, NDT. He likes Levo and T3 separately. But T3 separately gives me a hit and then fades too quickly. I've been on Armour for 2 years now. But it's not helping me really so I will be trying something different again soon I have no doubt.

I agree with others. He's lowering your T4 too much. They all do that. If you are already feeling sluggish, you need to stop where you are and try adding in the next dose increase of T3.

[goingholiday in reply to FancyPants54]

Like your advice FancyPants54 and it saves me the nightmare of more pill cutting ! Suppose I am lacking experience of taking T3 so I'm relying on endo knowledge. Hah! Better advice from the forum definitely.

One more question. If I now add in 2.5mcg of T3 so I'm then taking 10mcg a day, will I have been increasing slowly enough? I'm not sure how long a period gradually adding T3 is.

[FancyPants54 in reply to goingholiday]

I’m cautious so I usually wait about 4-6 weeks between increases. But a lot of people will try a T3 increase before that. Like every 2 weeks, because T3 is much faster to reach full strength.

[goingholiday in reply to FancyPants54]

That's helpful, thank you. I will hold out longer before increasing and not lower my levo any further 😀

[FancyPants54 in reply to goingholiday]

Definitely wise not to lower Levo further. If your doctor complains, tell them you were getting too tired to function.

They really do act like bulls in China shops sometimes. I saw a new GP at my practice recently. He didn’t like my high heart rate which is caused by another condition. He doubled my beta blocker. HR came down a bit, but not a huge amount. It was over Christmas. By the time new year came and work loomed again, I couldn’t understand why I felt so dreadful. I was falling asleep half way through typing a word! I was micro sleeping all over the place. I could not do anything. Then I remembered the increase in BB. Looked it up. Symptoms can take a few weeks to manifest! No one checked up on me.

I stopped the increase immediately. And I had more energy immediately. Sadly that’s slipped away again now, probably due to thyroid. But I might be tired and listless, but I’m not falling asleep typing a word.

[goingholiday in reply to FancyPants54]

Appreciate the advice, thank you. What a horrible experience for you and well done for getting it sorted yourself. I'm restraining myself from going off on a rant on your behalf .......

Perhaps your tired and listless symptoms at present are due to the BB effects wearing off gradually, might still be lingering in your system for a little while longer? Hope it resolves for you soon.

[goingholiday]

Hmmm....... yes the changing one thing at a time is something I totally agree with. When someone has Professor preceding their name though, you kinda think they know what they are talking about ! I was so ecstatic to be given the opportunity to take T3 and thought maybe I need to lower T4 for the T3 to work.

So shall I just continue on the 100mcg levo for now? And is a week of taking T3 (5mcg increased to 7.5mcg) enough do you think? Should I now increase to 10mcg?

I have to admit, I'm not looking forward to telling my Endo I've disregarded his instructions and not lowered the levo to the level he prescribed🤦‍♀️ or am I being cowardly ??!

[Zephyrbear in reply to goingholiday]

You’re not cowardly, but I would suggest telling him you followed his instructions for a while and felt much worse, so you have gone on/back to the regime you felt better on. He may appreciate your honesty and thank you for the feedback. These people are paid to work with you, not dictate your treatment to you. I know that’s a optimistic thought and it’s been my experience, that the more titles and alphabetty-spaghetti they claim after their names just makes them less likely to consider anyone else’s point of view, but it’s worth trying. My dad always used to say: “You’ve already got ‘no’ maybe you can get ‘yes’”.

Good luck. 😉

[goingholiday in reply to Zephyrbear]

Thank you Zephyrbear, your reply has made me smile and given me courage.

[humanbean]

I take all my Levo and T3 at once when I first wake up. If I happen to need a pee between 3am and 7am I might take my pills earlier if I remember.

I did try taking my T3 at bedtime but have never managed to tolerate it at that time. It gives me a fast heart rate which makes sleep impossible. But I know that some people find taking thyroid hormones at bedtime allows them to sleep better and feel better, so there is no cast iron rule that works for everyone.

Doctors sometimes tell patients to take their thyroid hormones at a certain time but we are free to experiment with our timing and find what works best for ourselves. We are also free to cut our thyroid hormone tablets up into smaller doses if we want to.

It is important to avoid taking thyroid hormones with food or supplements or medicines for at least an hour either side, and with some things the gaps need to be longer so that digestion of the thyroid hormones is not interfered with.

Four hour gap - Iron, Vitamin D, HRT/oestrogen, Magnesium, Calcium

Two hour gap - Other vitamins apart from Vitamin D

One hour gap - Food

It did take me a long time to tolerate thyroid hormones. Optimising my basic nutrients helped. Nowadays I take Levo + T3 and I tolerate them both.

[goingholiday]

Thank you for your response humanbean. Good to hear you now tolerate levo and T3. Amazing how different we all are and how we have to experiment to find what is best for us personally. What prompted my original post was this morning I took my T3 thinking it was an hour earlier than usual but it was actually two hours earlier. My half asleep brain hadn't registered the correct time. I wanted to check there wasn't some guidance I had missed whereby T3 isn't happy being taken in a two to three hour window 😀