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Thanks for sharing your story. I find that I have to adjust the T3 hormone seasonally - I seem to go hyper every March. I reduce a whopping 1/4 of a 5mcg pill a few days a week and it makes the difference.

Also - I have noticed since going on generic T3 Lilothyronine I have more FT-3 fluxuations and have had several uncontrollable rapid heart rate events - even with not over 3/4 range FT-3. Never ever had this on brand Cytomel but die to excessive Brand Cytomel cost I deal with it
 
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Discussion Starter · #22 ·
Thanks for your post! I am sharing as much of my experiences, even the miserable ones like this one, in hopes of potentially helping others with the information.

may I ask….how are you cutting these into quarters? I took a half this morning and needed about a quarter at 1:30, I had to bite into a half.

interesting info about seasons, I noticed that on the higher dose as well and I think it equated to 5mcg.

Can I ask what your dosing schedule looks like, and if anything else has set off a need for more or less, like workouts?

thank you!
 

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Discussion Starter · #23 · (Edited)
Figuring out my new dose of T3 is really hard. When my T4 was low, it wasn't really an issue to add or subtract a half of a 5mcg pill. Right now I'm taking a half in the morning with my levothryoxine and it almost feels too much, then I do a second dose of about a quarter of a pill later in the day. Low doses of liothyronine is really, really challenging.

So I have a big question....if I only seem to be needing 3.75mcg-7.5mcg daily of liothyronine (with the 7.5 sending me hyper), and the tiny doses seem to really have an impact, do I need to lower my levothroxine so I can still take a small amount of T3 without such an impact? It seems like the higher the dose of T4, the less T3 I need but the stronger it feels when taking it. Then, any changes, like physical activity, how I cut the pill into half/quarters, timing of the doses, all seems to have a bigger impact.
 

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Are your Ferritin and D levels optimal? I had alot of issues adding T3 hormone when my Ferritin and D levels were low.

After addressing these I had no issue
 
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Discussion Starter · #25 ·
Labs indicate I’ve overmedicated on T3 because my T4 number came up so quickly and I didn’t decrease liothyronine fast enough. Right now I’m supposed to just take the levothyroxine only and take up to 5mcg in a day of liothyronine as needed, but I’m having a hard time knowing how to dose that. Urgent care wouldn’t do blood work for me today but did an EKG and all is ok there. 5mcg of liothyronine yesterday pushed me hyper, it was awful.
 

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Discussion Starter · #26 ·
Just a quick update that I’ve had to stay off T3 since Friday because I was overmedicated on it too long. I’m taking it very easy this weekend so as not to burn through too much thyroid hormone, I have some appointments next week and hope for labs to see where I’m at. My free T4 is definitely better on 88mcg, now I just need to figure out how to get the liothyronine dialed in safely. Its been an awful process and confusing because it’s been difficult to get in touch with providers and get labs ordered, I feel pretty alone in this. I am thinking about adding .25 of a 5mcg pill in the mornings to see how I tolerate it if labs show I need it. If I can’t get labs and feel terribly hypo, I may try it but Hope I don’t have to without support from labs data.

My reason for upping the T4 was because my free T4 was usually .7-.8, meaning if I had any issues or missed a dose, it would be easy to crash quickly.
 

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Discussion Starter · #27 ·
Here I am, reading my own post for help getting back onto T3. Being overmedicated last week made me scared to take this medication I need.

I increased my levothyroxine so that number would be a bit better than the usual .7-.9 I usually get (.8-2.2), going from 75mcg daily to 88mcg. I worked down from 25mcg daily of liothyronine, but didn’t monitor my signs and symptoms very well. Truth is, feeling optimal for so long I haven’t had to remember all those little details. Now, after this experience, I have a binder of everything I’ve documented.

At urgent care Saturday (five days ago), i was in with over medication symptoms, and the endo they consulted with suggested I stop the liothyronine. I do need it, but I felt it was good advice to clear what I believe was excess in my system. Liothyronine is 95% absorbed within four hours, but what I just learned is that it has a half life of 2.5 days! This means that amount of T3 taken is reduced by half by that point and tapering down. I’m no doctor, but it seems to me that means everything I had taken for 2-3 days was still having an impact on me.

I stopped liothyronine for three days exactly, and got labs.

10/13/21
FT4 1.2 (.8-2.2)
FT3 2.7 (2.8-5.3)

Yup, my Free T3 crashed, and I was feeling pretty yukky. Problem was, I am now anxious about taking it because I felt so awful the week before. I took 2.5mcg that afternoon and all I wanted to do was sleep. I got guidance from my doctor to take 2.5 2x per day, but that made me nervous so I went into research mode.

I know my hypo and hyper symptoms, and some of them kind of cross over which is why this can be hard. But I think watching my heart rate has been really helpful, my FitBit tracks it so well I can go back and see what it was doing a week or even a year ago. For me, it seems important I not start to go over 63bpm for the day. I’m at 58bpm today, feeling cold, tired and brain foggy, and my adrenals kick in when I exert myself. So my HR may spike for a bit but unless I’m really nervous about it, it settles quickly back down to 60s. Also, GREAT site for info, I am looking at BP a bit differently now, this is true that my systolic was high but diastolic normal Saturday when overmedicated (159/74).

After my doctor visit today I’m hypo enough she wants me to add another 2.5mcg dose during the day. I did so by testing my reaction to half of it, all seemed ok, so I took the other half within about 20 minutes. I’m keeping an eye on my heart rate and symptoms, and just trying to take it one day at a time. Feeling better every day!
 

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Discussion Starter · #28 ·
Another day, this one hasn’t felt as good as yesterday. I had to do some house chores this morning and it was probably too much, I should at least wait about 3 hours after my liothyronine dose to be a bit more active, and otherwise rest a lot.

Currently on 88mcg levothyroxine daily, and at 2.5mcg liothyronine 3x a day. I have some hypo anxiety kicking in which increases my heart rate and makes me worry about taking my next dose. I ran a bunch of numbers before dose 2 today - 60bpm for the day per FitBit. Feeling cold, tired and have air hunger (where I kind of forget to take breaths, it’s weird but it’s one of my signs). Helpful metric for me today was understanding my BP and “pulse pressure” as described at the Tired Thyroid website. A widened pulse pressure may indicate hyper, as does a higher systolic (top) number. An increased diastolic (bottom) number may indicate anxiety. So I calculated my pulse pressure, when hyper (159/74) it was 85. Tuesday and Wednesday it was 69. Today it has varied from 50-66, so even though my seated heart rate was high 70s/low 80s at the time I was supposed to take the second dose, I took it and started to feel more relaxed, within an hour or so it was back in the 60s/70s. I still feel tired physically but better mentally at least.
 

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Have you ever had your adrenals tested with 4 point saliva testing?
 
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Discussion Starter · #30 ·
Have you ever had your adrenals tested with 4 point saliva testing?
i haven’t yet, when I get my free T3 up a bit and am feeling a bit better I will work on that. I was optimal before I started this and have regretted doing this quite a few times. But my free T4 was low and I didn’t like taking 7 thyroid pills a day. I’m hoping to land at maybe 2-3 pills of liothyronine plus the one levothyroxine per day,
 

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Discussion Starter · #31 ·
Thanks for sharing your story. I find that I have to adjust the T3 hormone seasonally - I seem to go hyper every March. I reduce a whopping 1/4 of a 5mcg pill a few days a week and it makes the difference.
@Lovlkn just curious what your symptoms are when going hyper, and if that happens each spring, what are the hypo symptoms you get in the fall that let you know you can stop reducing? I think I read you’re on 2 1/2 pills (12.5mcg) liothyronine daily, correct? Thanks for any insights you’re willing to share!
 

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Alot more energy, heart palps and anxiety
 
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