How important is consistency in the time of day for daily T3?

[FallingInReverse]

Does anyone have any science or experience for how important consistency is with the timing of T3 doses during the day.

Ive been playing around with single dose timing and split dose timing. I’ve seen value in the past for different schedules.

Have found lots of value in this recent post: healthunlocked.com/thyroidu...

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BUT!!!

Recently as I’ve been trying out new patterns, I’ve become inadvertently inconsistent. After taking my full 7.5 shortly after waking for a while, I switched to half after waking, then half later in the day whenever I can avoid coffee or a meal.

But then, accidentally , sometimes I forget the second dose and take it at night… or the next morning.

I’m fully aware of the half life, and also fully aware that t3 acts on our overall t4 over time. Just not sure what matters short term and long term.

The good news is that I am near/at full replacement dose. Head fully above water and I am generally good most days. So I don’t think inconsistency in t3 is impacting my being functional …. but who’s to say when my peri-menopause is kicking up.

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Tagging those who replied to TiredMummy ’s post as I know you all are also actively adjusting your t3:tattybogle arTistapple inthedoldrums redsquirrel68 RoseStar Simplyred57 👋👋 And t3-only forum mates I can recall off the top of my head greygoose and DippyDame

But of course , would love to hear from anyone taking T3 here!

[greygoose]

When I take it doesn't seem to have any effect on me. Probably because that dose I've just taken is not going to have an instant effect. It doesn't go directly from my mouth to my cells. It will take a while to get into the blood, and then travel round in the blood for a while before it gets into the cells. But maybe that's because I have - or had, I don't know - a certain degree of resistance to thyroid hormone. Maybe it's different for those whose bodies react normally.

But let's be perfectly clear about one thing: half-life. People bandy that term around as if it explains everything. It doesn't. The half-life of T3 is about 24 hours IN THE BLOOD. But in the blood, it doesn't do anything. It is inert. It doesn't become active until it gets into the cells. But, the T3 that gets into the cells stays there for about 3 days. And is constantly being topped up. So all this talk about T3 running out because of its short half-life is absolute bunkum.

also fully aware that t3 acts on our overall t4 over time.

What do you mean by that? How does it act?

[FallingInReverse in reply to greygoose]

Thank you!

In writing that I just meant that I am aware that t3 does not JUST impact my ft3 levels in the relative SHORT term… but also that the t3 I take will in the LONG term impact ft4 levels.

I have seen my ft4 change with a long-consistent Levo dose, just by changing my t3 dose. So I know - to your point - that a relatively short half life of t3 does NOT limit t3’s impact to the “short” term. I can’t say I know exactly “how” I think it does that, but I am aware in my bloods t3 does does act on t4 over time.

Reason I made that point was thinking how - when asking a similar question for our Levo, I think we’d generally say that with the 7 day half life that there is a wider tolerance for what time we take our Levo and the consistency … some people prefer morning vs night …. But as long as a Levo dose is the same within a 24 hour period that our stability would be less impacted… or actually, we even recco alternate day dosing when we have trouble splitting pills within a day. Although we need to make a determination about what day to test, as there would be little variations between, say a 100 on one day and a 75 on the next. But generally many do alternate day dose.

I know we are all different, I’m using probabilistic language, as some things are “known” but our experiences vary so widely.

Will also note - I believe that consistency is generally important because eliminating variables is always helpful as we manage how we feel and why.

But that leads to my question - if I’m taking a consistent t3 dose in every 24-36 period yet the splits and the exact timing vary…

Does anyone have any experience or studies to cite that might explain what impact that may have, knowing what we know.

[greygoose in reply to FallingInReverse]

Taking T3 does lower the FT4 level, yes. But how long it takes to do that is unknown because retesting would be done at least six weeks later. It might be instantaneous or it might take several weeks. Who knows.

I would be very surprised if any research has ever been done into the effect of taking T3 at regular times, or haphazardly. I think people can only speak from their personal experience. It will be interesting to see if anyone comes up with any research.

[FallingInReverse in reply to greygoose]

When I was early in my journey and definitively under-replaced (ie afternoon coma naps)… I did find a split dose (upon waking and then at noon) did conclusively eliminate my afternoon naps.

But now that I am near/hovering at something very close to full replacement dose … I feel more like you said in your first reply:

When I take it doesn't seem to have any effect on me.

I’m getting to the end of the day and realizing oops! There’s t3 left over.

I know it’s all trial and error, but still wonder if there’s anyone who has an articulated reason I should be consistent. Either personal experience, and if not a study, some understanding of biology that will help me make better decisions.

Tx for your reply GG! Always appreciated a lot!

[jgelliss]

I dose with both my T4 and T3 bedtime. It works for me well for now. I have been doing it for over a year. I get a much better sleep. Wish you the Best.

[elaar]

"But let's be perfectly clear about one thing: half-life. People bandy that term around as if it explains everything. It doesn't. The half-life of T3 is about 24 hours IN THE BLOOD. But in the blood, it doesn't do anything."

That's true when it comes to Thyroid related activity, but T3 in the blood is likely to be involved in various feedback loops that dictate other hormonal systems (HPA axis), Cortisol and other Adrenal related Hormones for example.

Hence why some recommend that T3 dosing follow the circadian rhythm somewhat, in an attempt to control Cortisol (doesn't Paul Robinson suggest 4-5am dosing for this reason?). I certainly wouldn't want to take all of my T3 in the evening.

T3 dose timing and serum T3/FT3 probably will have some medical significance, but there's not many studies looking into it, and it's going to be incredibly complex.

[redsquirrel68]

My blood test is due tomorrow so I’ve started my T4/T3 dose timing transition as per recommendation here. This will be my first blood test since introducing T3 to my 50ug T4:

1. I started with 2.5ug and gradually worked up to 7.5ug experimenting with single dosing and twice daily. Double dosing is needed or I will crash in the afternoon. Stopped increasing T3 two weeks ago to stabilise my blood @5ug T3/6am, 2.5ug T3/1pm, 50ugT4/11pm.

2. LargerT3 morning dose needed to “lift” me: 5ug @6am. When I move it even earlier say 5:30-5-4:30, I can boost my energy further even at this low dose ( so, CT3M works for me), but I have trouble sleeping again so I stayed at 6am for practicality.

3. I need to take second dose before energy slump starts or it doesn’t help. On normal days, this is about 1pm. On gym morning days, this could be 12pm or earlier.

4.Moved T4 dose from morning to bedtime to separate T4 from T3 dose. Significantly positive.

I’m still under medicated which is why I respond very quickly to dose timings. Apart from increasing my t3 dose( depending on blood test outcome) my next steps will be to try vencamil T4 if I can get my hands on it. My biggest win would be if I can “work out” the best dose to manage big days without crashing. I do gym only once a week now, would love to go back to twice/week and also be able to do the big hikes in Lake District again 😓 Any T3/T4 hiking tip would be greatly received 🙏🏼

[FallingInReverse in reply to redsquirrel68]

Great reply!

As I noted above, split dosing was necessary for me to get through a day without a nap, but once near replacement dose I don’t notice any difference all at once or split or any time of day.

I’m in 112 Levo, and was on 10 t3 for a long time, recently reducing to 7.5 when the ft3 result went over range.

Not sure what your blood tests are but when I was 50 Levo and 10 t3 I had a year to go before I got to feeling “good.”

The visual charts at the bottom of this page: thyroidpatients.ca/2020/07/...

guided me. I found the visual representation of the post t3-dose peaks helpful and accurate for me.

As for hiking… I am a believer that when you hit your personal replacement dose (for me it is near/close to 60-70% through range for both ft4 and ft3) then exercise becomes possible without a boomerang. My very last frontier is more strenuous/regular exercise too!

It’s springtime finally so getting active outdoors is much easier!