Advice needed on best way to take 75mcg T4 (Levothyroxine) + 10 mcg (x2 doses of 5mcg) T3 (Liothyronine) daily, please?

[Tabi-Lion5]

Following the positive appt I had with Endo I have been prescribed 75mcg Levothyroxine (T4) (instead of 100mcg that I currently take) Plus 20mcg T3, cut into quarters, then to be split into 2 doses (making 10mcg per day). (I've bought a pill cutter).

I'm not sure as yet how to do this. Any advice would be appreciated. I currently take my Levothyroxine early hours 6.00am (ish) then go back to sleep until about 8.00am then have coffee & breakfast. So do I take my Levothyroxine as normal and one dose of T3 at same time, then another dose of T3 later in day? (Not sure how many hours to leave in-between morning T3 & afternoon dose of T3?) Also, if I forget afternoon one then what do I do?

I also wondered if I should lower my dose of Levothyroxine from 100mcg to 75mcg first before I start to take combination of T3 & T4? If so, how long for before I start the T4/T3 combination? Would it be for days/weeks to allow body to adjust being taking a lower dose of Levo + T3 combination? Or do I start straight away with new dose of 75mcg Levo + T3.

I've been advised to do a blood test after two months which I will do.

In the meantime, what do I do if I get fast heartbeat (hyper)? I only ask this because I have read that this can happen but perhaps someone took too much T3? It seems my Endo is doing it right by giving me a low dose to start off with, which I appreciate and trust him on this as it's what I wanted to do. Just in case though, would it mean I should miss a dose or stop taking the T3 or something else? Just being cautious in case it happens in early hours and I'm not able to get advice from anyone as what to do should it happen, although it probably won't if I do it right as per Endo's instructions on dosage.

Would you be able to advise me on how long before I start to feel the effects of T4 + T3 combination? I've been waiting such a long time to feel better.

[SlowDragon Administrator]

I currently take my Levothyroxine early hours 6.00am (ish) then go back to sleep until about 8.00am then have coffee & breakfast. So do I take my Levothyroxine as normal and one dose of T3 at same time,

Yes that likely best option

Suggest you initially only reduce Levo by 12.5mcg ….do this 2-3 days before adding T3

You could initially cut the 1/4 tablet in half (yes it’s tiny) for first few days

Starting with just 2.5mcg waking up and 2nd 2.5mcg roughly 8-10 hours later

Using a sharp craft scalpel can be easier than a pill cutter

Mop up any crumbs with damp finger

Assuming 2 x 2.5mcg is going ok

Either keep Levo dose as is or reduce further so on 75mcg daily

After 2-3 days then increase morning dose T3 to 5mcg

If that’s ok …..increase afternoon dose 3-4 days later

Retest bloods 6-8 weeks later

Also, if I forget afternoon one then what do I do?

set an alarm on your watch

Brands and doses

what was your most recent Ft4 and Ft3 results

Which brand of Levo are you taking

Do you always get same brand

which brand is T3

Would you be able to advise me on how long before I start to feel the effects of T4 + T3 combination? I've been waiting such a long time to feel better

Some people notice immediately, others it’s a slow improvement

[Tabi-Lion5 in reply to SlowDragon]

Thank you SlowDragon.

Sorry for late reply to your questions.

My recent Ft4 result was 18.6 (Range 12 - 22).

My recent Ft3 result was 3.9 (Range 3.1 - 6.8).

I take Levothyroxine by TEVA (I chose TEVA as it is lactose- free). I always get this brand as others that I tried previously made me feel sick.

I specifically asked that my T3 tablets were lactose- free, which are (THYBON HENNING T3).

Hope this helps.