Thyroid UK
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WHAT IS THE MAX DOSE FOR T3

I would like to know what people are actually taking, My endo thinks im the only person in the universe that has taken 120mcg of T3

He is spitting feathers at me

Please dont be shy

Your secret is safe with me- and the rest of the community x

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Hello reikimaster,

My daughter is currently on 125mcg but has been as high as 200mcg. Dr. Lowe told her to raise her dose slowly until her symptoms ceased. Once she got to 200 she was still experiencing hypo symptoms, still had slow pulse, low temperature and low blood pressure. She has NEVER experienced any hyper symptoms! It wasn't until her adrenals and gut problems were addressed that she was able to bring down her dose.

Someone was on here the other day who stated she was taking 150mcg.

Jane x

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I take 120mcg too.

I wish Endo's would consider the fact that

a) We have no desire to be hyper and

b) Physical signs e.g body temperature, pulse etc would indicate that we're not hyper!

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too true.

why wont they listen

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Hi,Personally and with advice I do not allow my FT3 to be above range, I have always found that to be OK for me.

Jackie

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that's ok Jackie and it is good that you have found what works for you, even more 'extraordinary' that your bloods can tell to such extreme detail how well you are....

for me it's the other way round, 'I' know if I am well, the bloods are done purely to keep the NHS 'happy', if it wasn't for that I would not even 'bother' to have blood drawn LOL :D

by the way.....there is nothing 'wrong' if the fT3 is over the range (in people on T3 only anyway) and indeed it will be in many people on T3 especially if on dosages of 100mcg or over. fT3 results will obviously vary at what time the blood is taken in respect to what time the T3 was ingested. I know that if I have my blood taken within 12 hours from my last dose then the fT3 will be over range....'always', at least on my current dosage.

Dr Lowe has said many times that for patients on T3 dosages of 100mcg or over the TSH will always be suppressed and the fT3 over range most likely.

Shaws posted a link to a web-archive of questions and answers from dr lowe's old website, I'll paste it here in a minute, in there he says the above.

My endo prescribed me 150mcg T3 daily by the way, reikimaster......endo is not even 'blinking' about my dosage, he does not think it is high, though he knows there is not many of us on NHS prescription on dosages higher than 60mcg and even less higher than 100mcg.

x

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Here is the link posted by Shaws in another thread, links to Dr Lowe's archives, see question: November 9, 2005 (you may also find similar info in other question and answers, I have not re-read it all yet)

web.archive.org/web/2010122...

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nobodysdriving Without disputing your views, it is important to remember that the thyroid bloods are just one series of blood tests and how you feel too. However, as is well known the thyroid effects a lot of things.,, bloods are a good way of finding out, without putting one`s life in danger.

Jackie

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that's fine, I understand we are all different :)

Just to point out, 'my views' are 'views' which are supported by many doctors (one of them Dr Lowe above) and are evidence based x

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nobodysdriving,We all have different views.My views are also the views of many good doctors. However surely that is the point, not one answer is " correct",or none of us would have problems with thyroid treatment. I am not interested in scoring points! I give my own views based on very good advice and personal opinion. I do not say that other people are wrong it so happens that in the past I have seen well recogniseed, well known , private doctors for thyroid treatment. It was unsuitable for me but that does not mean it was "wrong", There is no right and wrong. It is all down to how one feels and how one wishes to feel better which yes, does include blood tests..

Jackie

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I think we are both saying the same thing :) xx

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Indeed, it looks like we are all on the same path. Find what works for each of us and share our successes and failures from what we have experienced rather than what we have read or what we have been told by people not in our bodies <g>!

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I have to admit that I do find blood tests useful. I am on NDT and have similar symptoms when over-medicated and under-medicated, which is obviously rather confusing when it comes to changing doses :D

At least the blood test results can then give me confidence over whether I need to increase or decrease... x

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The trouble is that too many of us are ruled by Doctors slavishly following blood tests when they are showing only a small part of the picture. I'm like nobodysdriving in that my blood results bear very little relation to my state of health. They're just a test that I have to pass to keep the medical profession happy.

I have been much better served by following my own instincts and judging how much to take when I feel the need. For too many years I was kept undermedicated and hypothyroid by numbers on a sheet of paper. There is no danger of me taking too much because being hyper is worse than hypo for me.

I'm not saying caution is not needed but I do think the dangers of self-medicating and taking higher doses is often overstated.

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Brava! I still feel that doctors are our employees but want to feel like they are our bosses. When will we get over this brainwashing? You are the best monitor of your body and what is right for you. We wouldn't go to the loo on a doctor's schedule, nor would we ask permission!

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Im so happy you found your endo- send him my way please- if only mine would listen.

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Hi Nobodys! I think the most important thing to do is measure by how we feel. A blood test only measures that particular moment the blood was taken, just as taking your temperature reflects only that moment. Your temp and your blood changes from moment to moment.

Some of us are a bit resistant to thyroid. My single bedtime dose was up to 125-150 starting in June (I think) of 2011. I felt WONDERFUL. My RT3 is minimal, my T4 is almost non-existent, and my T3 is high.

The way to evaluate any treatment is how you feel. If it is working, keep it. If the protocol doesn't work or you stop feeling "right" then it is time to change.

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A very small quantity (20mcg in my case) of T3 makes all the difference with my T4. Too high a proportion of T3 seems to cause a cycling into a slightly hyper state at intervals, more T4 leaves me feeling like a bus ran over me.

At the rule of thumb level (which seems to be way off for some) a replacement hormone dose is typically calculated based on body weight, and then may be adjusted for other factors.

So for example this calculator globalrph.com/thyroid_calc.htm figures 1.6 - 1.7 mcg of T4 /kg of body weight. Check this before using it or anything like it - here's other numbers about, they tend to vary a bit and I've no idea if this one is a good one.

It's fairly common then to use another rule of thumb to convert T4 to a T3 equivalent. Please check it again, but the number that comes to mind is that 1mcg of T3 is roughly equivalent to 4 mcg of T4. By that measure if you were taking say 200mcg of T4 in total, and wanted to replace 80 mcg of that T4 with T3 you would need around 80/4 = 20mcg of T3. This would be taken with the 200 minus 80 = 120mcg of T4. i.e. by this measure 200mcg of T4 is roughly equivalent to 120mcg of T4 + 20mcg of T3.

I've never seen the x4 principle used in the T3 only context (some of those going that route will be better placed to comment) but presumably if you wanted to switch from 200mcg of T4 to taking T3 alone - the amount would be 200/4 = 50mcg of T3 and no T4.

Please do not use these numbers without verifying them - my recollection may be off. A quick search on some of the thyroid websites should bring up firm information of this sort.

In practice there's many other factors that influence the required dosage, with the result that these roughly calculated numbers can be way off.

Because there's a risk they may be too high it's normal to start low and gradually work the dose up until the bloods and/or symptoms (usually the former these days unfortunately) look OK - very cautiously you are old or have other illnesses like heart trouble..

Some seem to end up needing to take far more T3 than these numbers might suggest - possibly because they are unable to absorb and/or properly use the full amount for some reason. There's been mentions about of needing excess T3 to reset some processes that cause hypothyroidism.

The seeming risk with this and the reason many doctors (including it sounds like yours) will probably run scared from dosing large amounts of T3 is that it does seem to be possible for some of the problems requiring excess T3 to suddenly resolve - leaving the patient with too much hormone in circulation.

Hyperthyroidism and worse it seems can very quickly follow. (no idea what the reality has proven to be) It seems for this reason that it's advisable to watch carefully for this and be ready to rapidly reduce the hormone dosage if there's any suggestion of such a situation arising...

ian

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That T4 calculator is odd. It goes straight in with a calculated full replacement dose - more than I am taking after over two years! But in every other way it at least at first look makes some sense.

Agreed that converting T4 to T3 at a 4 to 1 ratio seems to be quoted and used (as a reasonable estimate) when going from levothyroxine to desiccated thyroid.

But if you have someone who is genuinely not converting T4 to T3, you have a different situation. They would be expected to have high T4, likely be taking a relatively large dose of T4, and have a low or very low T3. Taking the equivalent of their T4 as T3 could result in a very significant overdose.

Which is pretty much what you said!

But all these are based on averages and means and other "typical" patients. An individual may need a very different amount.

There have been cases where patients have been on 800 or more mcg of T4. Which could suggest 200 mcg of T3. But if due to a tumour which is providing a "sink" for excessive thyroid hormone, that would resolve if the tumour is removed. And that has been observed. But this is very, very rare.

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Ian what a good post.I do so agree with you. Bloods tests should not be in isolation but they are keeping me alive. A lot of conditions do not show in any other simple way.The body does change due to all sorts of circumstances. Bloods at least give some indication of this. If one is just treating and suffering from thyroid disease that does not mean another condition cannot develop.Also ,all sorts of things effect the thyroid. blood tests are a good way of finding out. I believe in how one feels and blood tests. We have modern scientific methods to indicate this and should let them helps us decide what is best for us.

Jackie

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Ta guys. Bear in mind that i'm only pointing up the existence of these rules of thumb - they do seem to vary quite a lot, and even if well framed can only be very coarse approximations.

The bugbear with all of these methods and with the standard blood testing seems to be the the presumption that there is a 'normal'. I'd have to say that I'm a lot keener on a more holistic view - one that takes account of symptoms, bloods and everything else relevant - and then proceeds cautiously.

Dogma and rules are like law - they only fit some mythical individual and by definition are sub optimal in the majority of cases. The unfortunate consequence is that they tend to blind people (bureaucrats can't even distinguish between rules and reality - the mark of the bureaucrat is that they will strongly resist any attempt to do so) to reality which is much more variable. (:) the mark of the fearful punter is that they keep on clamouring for more laws instead of taking responsibility for themselves)

Worse than that some doctors head for the old reliable diagnosis of 'depression' instead of proceeding with some judiciously chosen and carefully run trials to test beyond this. Understandably perhaps given the readiness of the profession to dump on anybody doing so.

Seems to me like it's mostly about protection of the vested interest that is the stock protocol....

Whatever the case it's absolutely clear that stock thyroid replacement is built on the presumption that a norm exists - one that's coming more and more into question.

The issue Rod (and you seem to be way ahead of anything i know on T3) i guess is that when it's gets into scenarios involving resistance and other factors these fairly crude rules too have to go out the window....

What is interesting is that what was called Wilson's Syndrome way back in the mid 90s by some offering treatments that involving taking excess T3 (and carefully monitoring pulse and basal body temperature to catch the onset of hyperthyroidism) took enormous flak from outraged doctors - but in SOME cases is looking more and more like a valid (if not risk free) treatment mode.

This isn't to recommend it to anybody, but I'm pretty sure it's one of numerous other factors that (accidentally) kicked me into decent health...

ian

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I take 165, divided up into 2 doses, 12 hours apart. I'm taking it in its extended release form, imported from the USA, so possibly not a good comparison for you.

Jane

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Are you feeling great? Terrific! Could you PM me your source in USA?

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I take 60 split 3 times a day.

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I'm being told very different things on another thread I've posted on here...i am up to 82.25mcg of T3 only and was feeling great until i dropped the 50mcg of T4 i was taking along with it suddenly (my own stupid decision) but many people on here are saying that 82mcg of T3 is far too high and i may be overmedicated. utterly confused by it all but i guess you go with how you feel overall...right?

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Yes I agree . I'm on substantially more to be honest . X

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