How much T3 do i need?
Number of doses a day updated (updated 01/15).
This is where it starts to get delicate. If you've stayed with me so far you may have thought "this sounds like it could be me, I want to try that". You have sold the idea to your Dr and then he says "I don't know how to dose this". Some of us gave up with the Dr and have imported the T3 from overseas and self medicate, Even if you can get the prescription it can be cheaper to buy T3 that way then from a USA Pharmacist.
First of all, BEFORE starting T3, we strongly reccomend that you have a full iron panel, guidance on the required iron levels is here but feel free to post the results on the RT3 Yahoo group and ask for interpretation and you graph your temperatures for a few days looking for the average to be within 0.2F from day to day. If temperature has a greater variation than that you need Adrenal support, a 4 times a day saliva test before you start supplementing would help people advise you of the doseage and timing to follow. Click here for discussion on adrenals That link includes details of the temperature test and links to adrenal information and lab tests. Please read it BEFORE starting T3.
If your Iron is a bit low you can start T3 and supplement iron at the same time aiming to get iron to the required levels by the time your T3 has got up to 50mcg a day. If your iron is very low you will need to supplement iron heavily and may get adverse effects on taking more than a very small amount of T3. From my experience you can feel the benefits of iron supplementation in as little as a week or two, keep supplementing though if you start T3 soon after starting iron. (updated 12/12).
OK, Warnings over, onto the T3 dosing.
The starting dose depends whether you are on any thyroid replacement already and whether that contains T3 or not. The timing depend if you are on HC or not:-
If you are not on any thyroid replacement or are on Synthroid, Levoxyl, Oroxine, Levothyroxine, Eltroxin Thyroxine, or any other med containing T4 then click here
If you are already on Armour, Naturethyroid, or anything else containing T3 click here
Once you get started you are going to need to increase frequently for the first couple of months. This is because you are chasing the decay in your T4 levels, and hence the reduction in your own T3 production with the increase in applied T3. Click here to help decide if you need an increase
Most of us need to spread the T3 out, not because it won't stay at a steady enough level in the system, but because it "uses up" Cortisol getting into the cells and if your body cannot produce Cortisol fast enough then temperature drops and you slump.
This typically involves doses 4 (or occasionally 5) times spread through the day.
If you are already on HC dosed 4 times a day it is very simple, take the T3 at the same times as taking your HC. Only one time to remember. (updated 01/15). Every 5 hours
If you are NOT on HC and your adrenals are a little shaky you can be better off eventually moving to a "5 times a day"" schedule. (updated 01/15). Try 4 times a day first though as most people do well on that.
I use a simple way of keeping track whether I have missed a dose, I count out the number of tablets I am planning to take that day into an empty bottle and carry that round with me dosing from that bottle. If I am in doubt how many I have taken I just count how many are left and work it out from there. I also keep a few spares in my car and my computer bag, just in case I go out forgetting "the bottle"
Typical dosing times based on 4 times a day are
My dosing times based on5 times a day are:-
Bed time as I put the light out.
That is based on NOT taking HC, if you were taking HC then just take it 4 times a day with a relatively even dose each time (not a tapered dose like HC) (updated 01/15).
When you start at a low dose the 25mcg tablets break into quarters with care your initial dose increases can be by filling in blank time slots.
Once they are all filled in with quarter tablet doses you can start increasing them to half tablet doses one at a time starting with the morning dose.
Once you are on half a tablet at each slot again you can start increasing to a whole tablet at each starting in the morning.
I was very dubious about the bedtime dose, and many people on the Yahoo group have expressed doubt. In my case it's because I was on Natural Thyroid and found that if I took that later than 2PM it affected my sleep. T3 does not have this effect with me, in fact it improves the quality of my sleep by helping me sleep better and have less disturbed nights than I was on Natural.
Following the pattern of increases that I've talked about here and going up initially by 6.25 every 3 to 5 days and then by 12.5 every 5 to 7 days (depending on whether you feel you need/can tolerate an increase) you will probably end up on around 75mcg at around the 8 week mark. By this time your T4 levels will have decayed to an insignificant level and you will be able to adjust dose every 3 to 5 days to try and clear hypo symptoms.
Warning, one of our readers who tends towards high cortisol found that she was never able to tolerate more than a 6.25mcg rise per week. You may have to keep raising in 6.25mcg increments if you find 12.5 is too much. It varies a lot between people.
Most people end up needing a dose of 75 to 125mcg of T3 AFTER their resistance has cleared. If they have severe resistance and increase the dose to clear hypo symptoms in this "waiting time" then they could end up twice that dose and not be hyper. If you go above 75mcg a day in this interim period be very careful to check pulse every morning, especially after 10 weeks, as you may suddenly find resistance clearing and end up hyper with a high temperature and fast pulse.
If this happens then drop your dose to nothing or maybe a quarter of what you were on and take your pulse each time you would have taken a tablet, if it's high skip it, if it's near normal then take half what you would have done normally.
You will be going through the dose finding process again but this time without T4 in the way so you should be able to find a stable place within a week or so at somewhere between half and 2/3 of what you were on before to feel "non-hypo". This should be a long term stable dose needing a little adjustment between summer and winter but no other changes due to your body.