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I've had Hashimotos since I was a young child and I'm 49 years old now. I've been dealing with a dose that is too low for a while now by compensating with an extra 1/3 of a (generic synthroid) pill when needed. When I explain to my wife who is a pharmacist, that I feel better within a couple of hours of taking the extra dose she does not believe that is possible. I know its possible because I've had a lot of chances to test it in 40+ years, although I do have to say when I was younger there didn't seem to be as much of an immediate impact from taking the pill. I've found an interesting article on the kinetics of T3 supplementation showing that peak concentration occurs after only 2.5 hours and a significant change in heart beat rate occurs after only 5 hours. What I'm having trouble finding is the scientific evidence for what I experience with T4 supplementation. Does anyone have any information or thoughts to add on the speed at which T4 can impact hypo symptoms?
 

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The relief from Synthroid happens fast. After recovering from a severe illness, I was profoundly hypothyroid for about 30 days, and my very first dose of Synthroid resulted in rapid resolution of some symptoms. I felt better within hours. While my result is a data point of one, blood level graphs show that crushed tablets, taken properly (with water on an empty stomach) reach full Free-T4 in about 120 minutes. That's pretty fast.

I've suffered with Hashimoto's for the last 25+ years and have given up on T4 entirely. I'm doing the T3 protocol with great results. I don't want to say I'm 100% normal, but I no longer have a wide range of symptoms that Synthroid never helped.
 

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I think that it can be felt quickly, however, your TSH takes quite a bit of time to settle. I know when I was taking different doses on and off (like 88 and 100 alternating days), I felt different each day.

The dance between TSH and the processes in the body take a long time to smooth out. This is why they test TSH 6 weeks after a dose change. Free T4 and Free T3 tests can be a bit different, but they also adjust to the body processes over time.

Basically, it can be fast acting for certain parts of our body processes, but slow acting for other processes. Patience is important when it comes to this. For most people, finding the right dose can be pretty narrow. Once found you could be OK unless your thyroid is completely destroyed. It took me a few years to find the right dose, but now I'm doing quite well and have been on that dose for a few years now.
 
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