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Discussion Starter · #1 ·
Since my total thyroidectomy in 2016 I have always taken my levothyroxine in the morning, an hour before eating.

Since starting on liothyronine in 2018, doses have changed and timing has a little, but the most consistent timing has been fairly equal doses at 5am, 10:30am and 4pm, which was usually 10mcg, 10mcg and 10mcg.

I am curious how others time their doses, especially the liothyronine. How much do you take with what timing, and how did you arrive at that - was it from your doctor? Mine was just spacing it out evenly over the day, without taking too much in a shorter period. Now I'm taking quite a bit less and wondering if I can take it successfully in one or two doses daily, instead of over three. I would think the morning dose is the most important, since it's usually 12 hours or a bit longer.

Thanks!
 

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Here is an interesting writeup that goes into much detail about T3 and it's short term and long term effects on blood levels, heart rate and TSH suppression. Take a look at the graphs and see if a less frequent dose schedule makes sense. I'm thinking no, but I'm just a patient.


I've been Hypo for 30 years now. I tried a combo of T4 and T3 20+ years ago due to poor T4-T3 conversion. I remember doing multiple doses of T3 per day and being on a bit of a roller coaster ride that I had difficulty tolerating, mostly due to forgetting to take it at the right time. I subsequently switched to the (old) Armour (lots of T3) and it seemed better. However, over all this time, and trying the various changes scientifically, nothing works (for me) like my healthy thyroid did and the problems continue.

Cytomel T3 is generally "immediate release" and from what I understand, there are now Sustained Release versions of T3. Some places claim to use it to treat chronic fatigue (I have severe fatigue issues that don't seem to fit the CF diagnosis). I've not tried SR-T3 but I would like to.

Contrary to dosing instructions, I tend to do better taking NP thyroid (contains lots of T3) with food, as I think it slows absorption somewhat, leading to less of a crash before lunch.
 

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Discussion Starter · #3 ·
I've been Hypo for 30 years now. I tried a combo of T4 and T3 20+ years ago due to poor T4-T3 conversion. I remember doing multiple doses of T3 per day and being on a bit of a roller coaster ride that I had difficulty tolerating, mostly due to forgetting to take it at the right time. I subsequently switched to the (old) Armour (lots of T3) and it seemed better. However, over all this time, and trying the various changes scientifically, nothing works (for me) like my healthy thyroid did and the problems continue.
Hi and thanks for your reply! Wondering if you ever had ferritin and/or cortisol tested, as that can contribute towards difficulty tolerating T3. I can tell you from first hand experience that it was easier to take more when my T4 was lowered to get rid of very high reverse T3. At times i was up to 10mcg in a single dose period, today I nibbled on a quarter of a tablet and could feel it as my whole dose. note that I’ve always taken T3 with or without food, even Greek yogurt and I’ve heard the calcium can interfere with absorption.

My dosing today was 2.5mcg at 5am, I waited until I felt I needed more which was definitely 1:30pm, when I took one quarter of a 5mcg tablet. Trying to get through one day at a time.
 

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Can I take liothyronine and levothyroxine at the same time?
 
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Discussion Starter · #5 ·
Can I take liothyronine and levothyroxine at the same time?
I hope so, I’ve been doing it for four years and have had many optimal labs. :) My most standard practice is:
Levothyroxine and liothyronine 5am, nothing to eat or drink except water for 1 hour
Liothyronine 10:30am (food/beverage ok)
Liothyronine 4pm (food/beverage ok)
 

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I take my Unithroid and my first T3 dose around 2-3am. My second dose is taken approx 3;30 pm
 
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Hi and thanks for your reply! Wondering if you ever had ferritin and/or cortisol tested, as that can contribute towards difficulty tolerating T3.
Yes, I have generally low cortisol, AM anywhere between 4 and 7. Passed the ACTH stim test, with a normal response up to 20. However, I had low Cort at start of the test, felt good when cortisol levels increased. Crashed the next day and ended on on Prednisone, 10mg/d.

Ferritin is well into the normal range.

I think I am going to try a T3 only protocol. I have massive problems with fatigue and some people have had good results.
 
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