rT3 halved under liothyronine (T3), fT3 & fT4 lower, what next?

[Cataceous]

can cytomel by itself be used to treat hypothyroidism

This passage from STTM claims it works in some cases:

When optimal on nothing more than T3-only, patients report they achieve a free T3 at the very top if not slightly over. Free T4 will naturally be quite low and patients have not found that to be a problem as long as they are multi-dosing.

Does this mean you have to completely suppress endogenous production to raise fT3?

 

[Vince]

This passage from STTM claims it works in some cases:

Does this mean you have to completely suppress endogenous production to raise fT3?

When on the T4/T3 combination, just like with Natural Desiccated Thyroid, patients have noted that optimal equals a free T3 towards the top part of the range, and a free T4 right around mid-range. Why only around mid-range for free T4? Because over time, patients started to see an increase in RT3, the inactive hormone, if they went above mid-range or higher.

Dosing with T3-only (or with low-dose NDT, or the combination of T4/T3) - Stop The Thyroid Madness

 

[Gman86]

This passage from STTM claims it works in some cases:

Does this mean you have to completely suppress endogenous production to raise fT3?

I would say it’s going to be different for everyone. What mostly matters is having a good level of free T3, while simultaneously having a very low level of RT3. I would imagine that while on T3 only therapy, each individual is going to have different levels of free T4, once FT3 and RT3 become optimal. While on T3 only, I would just focus on FT3 and RT3, and not pay much attention to where your FT4 is.

Becoming optimal on T3 only is possible, it’s just not ideal. You have no reserve, so if u miss doses of your T3, you’re most likely going to feel it. As long as you can multidose your T3 throughout the day, and not forget doses, it should theoretically work well.

 

[captain]

That would be if you believe that blood levels of thyroid directly correlate with how you feel. If you take a large dose of T3 you will feel it long after blood levels have come down. There is more to the taking of multiple doses through day than supporting levels through the day.

 

[Gman86]

That would be if you believe that blood levels of thyroid directly correlate with how you feel. If you take a large dose of T3 you will feel it long after blood levels have come down. There is more to the taking of multiple doses through day than supporting levels through the day.

You’re probably right. The body is a very complicated machine.

 

[Robotics]

Wow, just goes to show how important knowing your RT3 level is. Your Free T3 level basically didn’t budge, yet you’re noticing a positive difference now that there is less RT3 blocking you T3 receptors.

They are right, every doctor is different, in regards to lab timing. Here’s what they recommend on the STTM FB group.
View attachment 7534

So if you take your T3 in the morning, you should take it later that day if you have bloodwork the next morning to fit within that 12-17hour range? That would be in the evening, which would make it tough to sleep. interesting, what is the thought process?

5 days of vitamin D, selenium and magnesium seems a bit much, any idea why they are recommending that? the only thing I heard of interfering with the lab tests is biotin.

 

[Gman86]

So if you take your T3 in the morning, you should take it later that day if you have bloodwork the next morning to fit within that 12-17hour range? That would be in the evening, which would make it tough to sleep. interesting, what is the thought process?

5 days of vitamin D, selenium and magnesium seems a bit much, any idea why they are recommending that? the only thing I heard of interfering with the lab tests is biotin.

Honestly not sure about their recommendations on vitamin d, selenium and magnesium. I personally am not gonna stop taking those things for days before bloodwork. So I would just disregard that info. I’m still going to take vitamin d and magnesium up until the day before.

So with T3 I don’t think you have to worry that much about it interfering with sleep. I remember reading one post on the STTM FB group where someone recommended taking a dose of T3 before bed to help with sleep, and the person responding that they tried it and it worked amazingly. I specifically remember them thanking the person because it helped their sleep dramatically. So I don’t think it works like stimulants do, such as caffeine or adderall

 

[Vince]

Honestly not sure about their recommendations on vitamin d, selenium and magnesium. I personally am not gonna stop taking those things for days before bloodwork. So I would just disregard that info. I’m still going to take vitamin d and magnesium up until the day before.

So with T3 I don’t think you have to worry that much about it interfering with sleep. I remember reading one post on the STTM FB group where someone recommended taking a dose of T3 before bed to help with sleep, and the person responding that they tried it and it worked amazingly. I specifically remember them thanking the person because it helped their sleep dramatically. So I don’t think it works like stimulants do, such as caffeine or adderall

I would have to agree with you, your T3 med not affecting your sleep. I have taken T3 in the morning and afternoon and it's never affected my sleep. I would guess if you overdose your T3 med then it may affect your sleep.

 

[Robotics]

I would have to agree with you, your T3 med not affecting your sleep. I have taken T3 in the morning and afternoon and it's never affected my sleep. I would guess if you overdose your T3 med then it may affect your sleep.

I would have to agree with you, your T3 med not affecting your sleep. I have taken T3 in the morning and afternoon and it's never affected my sleep. I would guess if you overdose your T3 med then it may affect your sleep.

your right, now that i think about it i don't quite feel the buzz like i used to on the first few weeks on t3. So it probably wont be an issue for me.

 

[Gman86]

your right, now that i think about it i don't quite feel the buzz like i used to on the first few weeks on t3. So it probably wont be an issue for me.

Just so happens that there was a thread yesterday on there STTM FB group where someone asked if taking T3 before bed disturbed sleep, and there was about 36 comments where people were reporting that they take either part of their T3 dose, or the entire thing before bed, and they sleep like babies.

Just checked it again and it now has 113 comments with basically every one saying it improves their sleep. I don’t think I’ve seen one comment where it hurt someone’s sleep. Almost seems like it’s supposed to be taken at night, opposed to the morning, according to the results people are getting from taking it right before bed

Here’s the FB group name, and the specific thread title if anyone wants to check it out.

 

[Vince Carter]

I may try the T3 at bed time but will have to be on a weekeing in case it keeps me up. I've been using a steady 20mcg when I start my day and then another 20mcg around 12 noon and I do think that i've had some improvement in my energy or just not feeling wiped out or yawning excessively. Not energized or wired or jittery.
Ive been tinkering with T3 just to see if I could push my borderline Reverse T3 down a little bit. I can usually in tests see my FT3 @ 3.9 on the 4.4(max) scale so I don't have that problem per se but my RTS is usually ~16

 

[MarcoFL]

I may try the T3 at bed time but will have to be on a weekeing in case it keeps me up. I've been using a steady 20mcg when I start my day and then another 20mcg around 12 noon and I do think that i've had some improvement in my energy or just not feeling wiped out or yawning excessively. Not energized or wired or jittery.
Ive been tinkering with T3 just to see if I could push my borderline Reverse T3 down a little bit. I can usually in tests see my FT3 @ 3.9 on the 4.4(max) scale so I don't have that problem per se but my RTS is usually ~16

Just my 2 cents but with a 16 RT3 not sure your FT3 at 3.9 is not very high!. Maybe if you had a 10 RT3 it would be.

 

[Sean Mosher]

If he gets his T3 up a little higher, would he not be able to add in a small daily dose of NDT?Currently I use 1grain NatureThroid with 12.5mcg T3 twice a day.
I believe (though I'd have to double check) that my RT3 was around 22 at the time I started this.

 

[MarcoFL]

I would not add any until it clears out down to the 10 or less. All the T4 then converts to RT3 just block out FT3 from the cells. Just do not ask a endo! they say under 24 is fine even with a 2.8 FT3

 

[Gman86]

I have this exact issue. RT3 was 11. Went on NDT only, went up to 22. Felt worse than before starting thyroid medication. Tried lowering NDT to 1 grain, and adding in T3, but just didn’t feel right still. Im gonna just try T3 only to get my RT3 down into the single digits, and then see if I can add in maybe a half grain of NDT, without raising my RT3. If half a grain doesn’t increase RT3 much, will try 1 grain, and that should be plenty of T4, if I can tolerate it. If I can’t tolerate any NDT at all, it’s not the end of the world. There seems to be a ton of people in the FB group on T3 only. Apparently it’s ideal to have a good level of T4, but not necessary to feel good. It helps to have the reserve, so if you miss doses you don’t feel it as much, but as long as you are a person that can remember/ have the ability to dose T3 2-3 times per day, you should be fine. Not sure if there’s technically any benefit to having good T4 levels other than just having a reserve to pull from at all times.

 

[captain]

I don't think there is any worry about reserve. Prescribing info for Cytomel from Pfizer. Administer CYTOMEL orally once daily and individual dosage according to patient response and laboratory findings. http://labeling.pfizer.com/ShowLabeling.aspx?id=703