Thyroid UK
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Should t3 be increased before 8 weeks

Been given t3 on monday told to stop taking levothyroxine and to take 10mcg in morning and 10mcg in evening until I go back to endo in 8 weeks .endo says if im not feeling better by then its not my thyriod causing extreme tiredness.i am concerned when I read on here most people have the t3 increased until they find optimal level over a number of weeks .my fear is im not taking enough t3 and so when I go back in 8 weeks he is just going to say it didnt work and put me back on t4 , this cant be right can it.

10 Replies

You are correct. Everyone's body is different in the way the use the meds. Some get well on a low dose but others need it very high.

20mcg of T3 may well not be enough for you and he should increase it about every 6 weeks at least till symptoms go. Your Endo is probably dosing according to the TSH when it should be symptoms.

This is an excerpt and if you cursor down to read this question/answer

November 9, 2005

Question: I am a 41-year-old woman who lives on the east coast. About a year ago, my doctor tested me by your protocol and lab tests. When he and I did a telephone consultation with you, he agreed to put me on Cytomel. I now take 100 mcg per day. I'm doing your protocol as you describe it in Your Guide to Metabolic Health. I take vitamin supplements daily and exercise at least three times a week. Since I started the protocol and Cytomel, I've regained my life. I have no more pain, no migraines, no swelling, no tingling, no insomnia, and I'm no longer cold all the time. The list of improvements goes on and on. For example, I've lost 65 lbs. I feel great. I suffered for 10 years of my life without a correct diagnosis, so needless to say, I don't want to go back.

This is another link and when you read it you will probably know more than the Endo,

Some of the links within these links may not work as it is an archived site.


tactano, you are 'so' right :(

my son has not had ANY benefit from T3 until he started 50mcg, he felt NOTHING before, like he was popping sugar pills! if you are like him then yes it's all a waste of time! (or like me, I take 160mcg daily of T3!!!)


Seems a deadline like that tactano may perhaps at some level be as much about 'disproving' the inability of T3 to help in your situation, or being seen to have complied as it is about getting you well.

Situations like that are not ideal, but not uncommon it seems. Quite a lot depends on what exacly he meant by allowing eight weeks.

It's sometimes necessary to be careful how you phrase your feedback in that sort of situation - or even to think of possibly moving to another doctor if the situation seems clearly to suggest that stones may be left unturned.

An eight week trial might alternatively prove the basis of a big step forward - and given the problems some of us have have experienced in accessing a trial of T3 (many years of effort and €100s in fees) it's not an opportunity to be sniffed at.

The required dose can be highly variable by all acounts. At the other end of the scale to ND 20mcg daily with T4 wasn't quite the final answer in my own case, but taken with T4 was enough to end my severe hypo symptoms and restore a very reasonable quality of life.

There was an immediate and obvious positive effect in my case, but equally the full benefit took months to filter through - it seems reasonable when we've been hypo for a long time that the body may take a while to find a balance again.

One concern about an 8 weeks one dimensional deadline in principle (in addition to the issue of optimising the dose) is that is it'd be a pity if it was to deliver a false negative. i.e. if it turned out that something else is needed to let the T3 do its job. (purely an example - but maybe adrenal work)

:) Wish I knew ND how you can manage to take 160mcg of T3 daily. How the body handles it without problems that is - it'd be an enormous dose if it was all being used. It'd blow my head off - i'm up to 40mcg T3 lots through the second half of the day and down to 50mcg of T4 - but add another 5mcg of T3 to that and my pulse starts to climb uncomfortably and so on.

The pity in all of this sort of thing is that it's pretty clear that in an ideal ideal world a doc would follow a (not necessarily one size fits all but symptom and other data led) protocol to prepare a patient for and carry out any trial of T3 - one which would maximise the chances of success while minimising the chances of a false negative....


1 like

Ian, I take 165 mcg a day, divided up into 2 doses. I get the extended release version (from overseas), so I don't geta huge hit all at once. It just goes to show that every single person is different. PUlse rate is normally around 64 beats per minute and temperature is a bit low, but apart from that, I feel great.



Hi T3 should be increased on 6 weekly blood tests, TSH, T4 and Free T3, until at the optimum for you. If you do not feel any better then, depending on bloods, if not seeing endo, e mail her/him via their secretary, in letter form. They are then more likely to get back to you.

Best wishes, Jackie


I go back to see endo in 8 weeks , I was justvconcerned that he said if I dont feel better on this then it is not my thyroid, he did go on to say that we need to look at lots of things said he would check adrenals , said my calcium was low and was checking my vit d.


Hi Ask for a new referral! Choose carefully , then ask, having had one referral easy to get another one.However, if you wait for a rubbish appointment and letter may be harder. A good endo, looks at many things ,a lot of the body governed by endocrinology.

You want some one confident enough, like all my best consultants, to only use bloods as an aid, not everything, how you feel just as important, symptoms etc.. I even had a long lecture from cardio once, "Bloods do not matter", now he realises they do for me!

Good hunting.



tactano, I agree with you but don't know how much T4 you were taking so did he replace it fully with enough T3? But remember the half life of T3 is only about twelve hours, more or less, and is almost gone in a few days unlike T4 which accumulates over two weeks or thereabouts. Sorry about not giving exact statistics but the point is that you may not find out if you are overdosing (or reaching optimal dose) on T4 (on one raise in dose) for a couple of weeks when you achieve your total level from the previous two weeks on T4. But T3 would tell you in just a few days.

It seems with T3,.... the raise to an optimal level could be achieved much faster.


Hi I was on 125mcg of thyroxine but now on 20mcg of t3


this is happening to me too, I was on 125 mcg Levo, now on T3 only, if I go over 20mcg of T3 I go through the roof! is a nightmare, feels like I am on a massive stimulant!


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