Thyroid - T3/T4 Dosing

[ABCul8ter]

Hi everyone! First time posting here but have been reading through the forum for a few months now. I have been experimenting with different thyroid meds since 2018 (after IVF messed up my thyroid in 2017). Started out with cytomel 5 mcg twice a day and I felt fantastic, lost weight, all the feel good symptoms. But that was when I was reading Stop the Thyroid Madness and Facebook groups. I was convinced I had to go on NDT to lower my TPO antibodies. It did but I started gaining weight again and never felt great. Tried several meds since. Fast forward to 2021 and I quit all meds and started eating pro metabolic. By summer of 2021, I gained a lot of weight and felt awful. Autoimmune issues got worse and I went back on thyroid meds. 30 mg of Armour once in am seemed fine but not great. Bumped up to 45 and I started experiencing heart palps and hair loss. Tried to go back down to 30 but symptoms persisted. Stopped all together and symptoms went away but started to feel like crap. TSH is around 3 and FT3 and FT4 are at the very bottom of the range. Reading through some posts, I asked my doc if I could try 5 mcg cytomel in am, 5 mcg cytomel in afternoon, and 15 mg Armour in evening. But now I'm realizing, it should be just T4 in the evening? Armour in the evening probably wouldn't work right? Would something like Tirosint in the evening be better instead?

 

[joyintheworld]

Hi everyone! First time posting here but have been reading through the forum for a few months now. I have been experimenting with different thyroid meds since 2018 (after IVF messed up my thyroid in 2017). Started out with cytomel 5 mcg twice a day and I felt fantastic, lost weight, all the feel good symptoms. But that was when I was reading Stop the Thyroid Madness and Facebook groups. I was convinced I had to go on NDT to lower my TPO antibodies. It did but I started gaining weight again and never felt great. Tried several meds since. Fast forward to 2021 and I quit all meds and started eating pro metabolic. By summer of 2021, I gained a lot of weight and felt awful. Autoimmune issues got worse and I went back on thyroid meds. 30 mg of Armour once in am seemed fine but not great. Bumped up to 45 and I started experiencing heart palps and hair loss. Tried to go back down to 30 but symptoms persisted. Stopped all together and symptoms went away but started to feel like crap. TSH is around 3 and FT3 and FT4 are at the very bottom of the range. Reading through some posts, I asked my doc if I could try 5 mcg cytomel in am, 5 mcg cytomel in afternoon, and 15 mg Armour in evening. But now I'm realizing, it should be just T4 in the evening? Armour in the evening probably wouldn't work right? Would something like Tirosint in the evening be better instead?

Girl you can have an easy fix. you're doing it all wrong...too much to type but you need to get with Dr. Amie Hornaman...she will fix you ...promise. worth every penny!

 

[ABCul8ter]

Girl you can have an easy fix. you're doing it all wrong...too much to type but you need to get with Dr. Amie Hornaman...she will fix you ...promise. worth every penny!

Gosh, I hope I'm an easy fix lol. I've been trying to have a baby for 6.5 years. I'm 40 and I've never been pregnant. I've been to 5 different fertility doctors and 4 different functional medicine doctors and haven't had any luck. I had 3 laparoscopic surgeries by 3 different doctors and countless procedures. Still unexplained infertility. I have Hashimoto's, severe belly bloat, terrible acne, 5 days of spotting before my period, adrenal issues. The list is really long. I haven't been able to find anyone to fix me yet!

 

[joyintheworld]

Gosh, I hope I'm an easy fix lol. I've been trying to have a baby for 6.5 years. I'm 40 and I've never been pregnant. I've been to 5 different fertility doctors and 4 different functional medicine doctors and haven't had any luck. I had 3 laparoscopic surgeries by 3 different doctors and countless procedures. Still unexplained infertility. I have Hashimoto's, severe belly bloat, terrible acne, 5 days of spotting before my period, adrenal issues. The list is really long. I haven't been able to find anyone to fix me yet!

promise...she's where you want to start. look her up and book a discovery call...she's fearless and will fix you.

 

[ABCul8ter]

promise...she's where you want to start. look her up and book a discovery call...she's fearless and will fix you.

Thank you for the suggestion. I checked out her page and some of her downloads. I don't think she would be the right fit for me. She promotes a keto diet which would not work for me and I have not done well in the past with the supplements she encourages.

 

[LuMonty]

Hi everyone! First time posting here but have been reading through the forum for a few months now. I have been experimenting with different thyroid meds since 2018 (after IVF messed up my thyroid in 2017). Started out with cytomel 5 mcg twice a day and I felt fantastic, lost weight, all the feel good symptoms. But that was when I was reading Stop the Thyroid Madness and Facebook groups. I was convinced I had to go on NDT to lower my TPO antibodies. It did but I started gaining weight again and never felt great. Tried several meds since. Fast forward to 2021 and I quit all meds and started eating pro metabolic. By summer of 2021, I gained a lot of weight and felt awful. Autoimmune issues got worse and I went back on thyroid meds. 30 mg of Armour once in am seemed fine but not great. Bumped up to 45 and I started experiencing heart palps and hair loss. Tried to go back down to 30 but symptoms persisted. Stopped all together and symptoms went away but started to feel like crap. TSH is around 3 and FT3 and FT4 are at the very bottom of the range. Reading through some posts, I asked my doc if I could try 5 mcg cytomel in am, 5 mcg cytomel in afternoon, and 15 mg Armour in evening. But now I'm realizing, it should be just T4 in the evening? Armour in the evening probably wouldn't work right? Would something like Tirosint in the evening be better instead?

I'm not uniquely qualified here and I can only relate my experiences and those I've managed to help. I have cheese or milk with thyroid to make it absorb more slowly; calcium supplements had a dubious effect, but calcium is what slows absorption of thyroid. I've made the mistake of not doing that lately and I ended up tossing and turning all night. My mom didn't have any problems with T3 but she was on T4 only for several months first (her thyroid was removed). As for bloating, my wife and I had that issue on only thyroid but it went away after adding progesterone. For me, I use adamantane, a dopamine agonist, to keep prolactin down and insulin sensitivity up. I mention it because it completely stopped my hair loss. However, if it increases energy requirements too much it could have a bad effect due to stress increase.

If you find any of this particularly useful I can get into more specifics. I hope it gives you some ideas.

 

[Beastmode]

Hi everyone! First time posting here but have been reading through the forum for a few months now. I have been experimenting with different thyroid meds since 2018 (after IVF messed up my thyroid in 2017). Started out with cytomel 5 mcg twice a day and I felt fantastic, lost weight, all the feel good symptoms. But that was when I was reading Stop the Thyroid Madness and Facebook groups. I was convinced I had to go on NDT to lower my TPO antibodies. It did but I started gaining weight again and never felt great. Tried several meds since. Fast forward to 2021 and I quit all meds and started eating pro metabolic. By summer of 2021, I gained a lot of weight and felt awful. Autoimmune issues got worse and I went back on thyroid meds. 30 mg of Armour once in am seemed fine but not great. Bumped up to 45 and I started experiencing heart palps and hair loss. Tried to go back down to 30 but symptoms persisted. Stopped all together and symptoms went away but started to feel like crap. TSH is around 3 and FT3 and FT4 are at the very bottom of the range. Reading through some posts, I asked my doc if I could try 5 mcg cytomel in am, 5 mcg cytomel in afternoon, and 15 mg Armour in evening. But now I'm realizing, it should be just T4 in the evening? Armour in the evening probably wouldn't work right? Would something like Tirosint in the evening be better instead?

Women tend to do better with T3 by itself. Might be worth cutting back on the t3/t4 combo for a bit to see how that helps. Also, if you're not taking your pulse and body temp consistently, you're playing a guessing game. It's the foundation of Peat's work when it comes to using metrics that are useful. Take your time with it and don't expect miracles right away.

Progesterone is quite important to get pregnant and maintain one, so as you're getting your thyroid levels good (i.e- good pulse and body temp) on a consistent basis, it might something to explore on here and Peat's website. It was a gamechanger for my wife while pregnant.

 

[ABCul8ter]

I'm not uniquely qualified here and I can only relate my experiences and those I've managed to help. I have cheese or milk with thyroid to make it absorb more slowly; calcium supplements had a dubious effect, but calcium is what slows absorption of thyroid. I've made the mistake of not doing that lately and I ended up tossing and turning all night. My mom didn't have any problems with T3 but she was on T4 only for several months first (her thyroid was removed). As for bloating, my wife and I had that issue on only thyroid but it went away after adding progesterone. For me, I use adamantane, a dopamine agonist, to keep prolactin down and insulin sensitivity up. I mention it because it completely stopped my hair loss. However, if it increases energy requirements too much it could have a bad effect due to stress increase.

If you find any of this particularly useful I can get into more specifics. I hope it gives you some ideas.

Thank you so much for sharing your experience! I have always been told to wait 30 minutes to an hour before eating after taking thyroid. But I've seen that it helps so many in this forum. I drink raw milk every morning so I'll have to give it a try! As for progesterone, I have used it for the past 7 years for infertility. I actually stopped in August 2021 after really bad symptoms of face swelling and hives (may be related to my Hashi's - still not sure) which unfortunately I am still dealing with and haven't had a chance to add it back in to my regimen. Progesterone suppositories were the only thing that stopped my premenstrual spotting. However, creams and drops did not.

 

[LuMonty]

Thank you so much for sharing your experience! I have always been told to wait 30 minutes to an hour before eating after taking thyroid. But I've seen that it helps so many in this forum. I drink raw milk every morning so I'll have to give it a try! As for progesterone, I have used it for the past 7 years for infertility. I actually stopped in August 2021 after really bad symptoms of face swelling and hives (may be related to my Hashi's - still not sure) which unfortunately I am still dealing with and haven't had a chance to add it back in to my regimen. Progesterone suppositories were the only thing that stopped my premenstrual spotting. However, creams and drops did not.

Yes, I suspected as much. I had to use a large loading dose of progesterone to get estrogen down. Spent a week "out of commission" if you get my drift but it was worth it. During that time, I did have lots of nausea, more hives than usual, that sort of thing. I can't say exactly how it would go for you so follow your gut. I used 100mg a day, suppository, for a week and a half. In my case, it controls my sleep apnea and allergies so I took the anti-androgenic trade-off and resumed but that's a whole different story. I have "uncategorized potentially autoimmune symptoms" (my previous doctors were useless) so it's not clear how much my experiences will relate to yours, but I can say that I'm much less "slightly sick all the time" and better than that when I can keep my sleep in order.

Typically I have my thyroid with my espresso in the morning since I have a lot of milk with it. Lots of stress sweating otherwise, so I definitely recommend milk to slow down the absorption. When I wasn't having milk I was trying to microdose the T3 and T4 throughout the day and it just never worked.

 

[ABCul8ter]

Women tend to do better with T3 by itself. Might be worth cutting back on the t3/t4 combo for a bit to see how that helps. Also, if you're not taking your pulse and body temp consistently, you're playing a guessing game. It's the foundation of Peat's work when it comes to using metrics that are useful. Take your time with it and don't expect miracles right away.

Progesterone is quite important to get pregnant and maintain one, so as you're getting your thyroid levels good (i.e- good pulse and body temp) on a consistent basis, it might something to explore on here and Peat's website. It was a gamechanger for my wife while pregnant.

Thank you! I might just try that again because T3 only was what really helped me 4 years ago and I haven't tried again since. I don't take pulse and body temp but I have measured my BBT (basal body temperature) every morning. Lately, my temps have gotten above 98 F after I ovulate which is surprising for me since I stopped supplementing progesterone. I have to figure out the best way for me to get back to using it. I was using it during my luteal phase the past 7 years. In April 2021, I started using a small dose of progesterone drops rubbed into my skin every day and then a slightly higher dose after I ovulate. I think this messed things up a bit for me and I discontinued progesterone all together. Progesterone suppositories worked well for me but they are prescription and I really didn't like using it since it had peanut oil in it. I tried compounding with coconut oil but it wouldn't even melt. Lately I've been wondering if my progesterone levels are fine but it's my estrogen that's too high in relation to my progesterone. And I swear ever since I gained weight, the estrogen is just stuck in my belly and thigh fat and will not budge no matter what I do.

 

[mostlylurking]

Thank you! I might just try that again because T3 only was what really helped me 4 years ago and I haven't tried again since. I don't take pulse and body temp but I have measured my BBT (basal body temperature) every morning. Lately, my temps have gotten above 98 F after I ovulate which is surprising for me since I stopped supplementing progesterone. I have to figure out the best way for me to get back to using it. I was using it during my luteal phase the past 7 years. In April 2021, I started using a small dose of progesterone drops rubbed into my skin every day and then a slightly higher dose after I ovulate. I think this messed things up a bit for me and I discontinued progesterone all together. Progesterone suppositories worked well for me but they are prescription and I really didn't like using it since it had peanut oil in it. I tried compounding with coconut oil but it wouldn't even melt. Lately I've been wondering if my progesterone levels are fine but it's my estrogen that's too high in relation to my progesterone. And I swear ever since I gained weight, the estrogen is just stuck in my belly and thigh fat and will not budge no matter what I do.

Several thoughts:
I've experienced complete blockage of my thyroid medication if I drink milk within an hour of taking it. The calcium blocks the thyroid med. If you search for "calcium and thyroid meds" you will find the info. The milk didn't slow the absorption down for me, it completely blocked the thyroid med and I got no benefit from it at all. I take prescription Acella NP natural desiccated thyroid which has been a life saver for me as it actually works. I did not have this problem with calcium blocking the thyroid med until I got really sick from thiamine deficiency/functional blockage. Then the calcium/thyroid med problem started. I've been on prescription thyroid meds for over 40 years. The calcium problem happened fall of 2020 (same time as the thiamine problem). The thiamine functional blockage also blocked my ability to utilize T3 so it rose to dangerous levels (while I experienced hypothyroid symptoms) and my thyroid med had to be reduced almost to half of the dose that had worked for 6 years.

High dose thiamine hcl plus the lower dose of thyroid med got me straightened out again. Thiamine deficiency blocks metabolic function and the symptoms are similar to severe hypothyroidism.

I've had a long history of estrogen dominance. I take about 40mg progesterone/day. It is dissolved in vitamin E oil. I take it orally and vaginally. I mix it with a little melted coconut oil for the vaginal application. I rub the oral dose into my gums. It is my understanding that applying it to the skin doesn't work very well; you only get maybe 20% of the benefit. I take the progesterone daily as I'm postmenopausal. I got a prescription compounded for progesterone dissolved into high quality vitamin E oil, which is about the same as using over the counter Progest-E (available on line).

The peanut oil sounds pretty awful. Progesterone dissolves in high quality vitamin E oil, but not in peanut oil. Makes me wonder what else they used in the mix.

Have you read Ray Peat's articles about estrogen and progesterone? Here's a link you can use to search for these topics: PeatSearch: a Ray Peat-specific search engine - Toxinless Use the search cell on the left.

Also, here are links to three Ray Peat interviews about progesterone and estrogen that I found to be extremely helpful:

• Politics & Science: Progesterone Part 1
• Politics & Science: Progesterone Part 2
• Politics & Science: Progesterone Part 3

The thighs seem to be the place where the body stores polyunsaturated fatty acids (PUFA). PUFA is highly estrogenic and should be avoided at all costs. This means not consuming any vegetable oils, like corn oil, canola oil, peanut oil, etc. and not eating anything that contains PUFA, which means no nuts, no seeds, no grains, and NO AVOCADOS. Even olive oil contains too much PUFA so should be restricted to maybe 1/2 teaspoon/day. Use the search engine above and search for "fats" to learn more.

I hope you find this information helpful.

 

[Risingfire]

Do you check your pulse and temps? Especially am when waking up

 

[Beastmode]

Thank you! I might just try that again because T3 only was what really helped me 4 years ago and I haven't tried again since. I don't take pulse and body temp but I have measured my BBT (basal body temperature) every morning. Lately, my temps have gotten above 98 F after I ovulate which is surprising for me since I stopped supplementing progesterone. I have to figure out the best way for me to get back to using it. I was using it during my luteal phase the past 7 years. In April 2021, I started using a small dose of progesterone drops rubbed into my skin every day and then a slightly higher dose after I ovulate. I think this messed things up a bit for me and I discontinued progesterone all together. Progesterone suppositories worked well for me but they are prescription and I really didn't like using it since it had peanut oil in it. I tried compounding with coconut oil but it wouldn't even melt. Lately I've been wondering if my progesterone levels are fine but it's my estrogen that's too high in relation to my progesterone. And I swear ever since I gained weight, the estrogen is just stuck in my belly and thigh fat and will not budge no matter what I do.

It's not a bad idea to take your pulse at the same time and see what your body temp and pulse do (i.e- 30 min after breakfast) to see if and how they change.

Peat has a patent for progesterone called Progest-e that most here trust as it's the "real" stuff and absorbs well into system.

If you believe your progesterone levels are good, but estrogen is high, consider some of the basics like a carrot salad daily, eating enough protein (100 g works for most women work well) and it helps the liver remove the excess estrogen safely. Keeping irritating foods down to a minimal.

I think most people don't do enough at the beginning to maximize lowering "stress" on the system in all areas.

 

[Jsaute21]

Thyroid dosing can be a nightmare especially when busy in life and not being scientific enough. I’m guilty of this on several occasions. Can any one share some successful dosing strategies? @ecstatichamster @Hans @Lokzo - @haidut do you dabble with t3/T4 supplementing anymore?

 

[Kayaker]

Several thoughts:
I've experienced complete blockage of my thyroid medication if I drink milk within an hour of taking it. The calcium blocks the thyroid med. If you search for "calcium and thyroid meds" you will find the info. The milk didn't slow the absorption down for me, it completely blocked the thyroid med and I got no benefit from it at all. I take prescription Acella NP natural desiccated thyroid which has been a life saver for me as it actually works. I did not have this problem with calcium blocking the thyroid med until I got really sick from thiamine deficiency/functional blockage. Then the calcium/thyroid med problem started. I've been on prescription thyroid meds for over 40 years. The calcium problem happened fall of 2020 (same time as the thiamine problem).

Just T4, or also T3?

 

[mostlylurking]

Just T4, or also T3?

I was taking natural desiccated thyroid (NP thyroid by Acella).

 

[Kayaker]

I was taking natural desiccated thyroid (NP thyroid by Acella).

I saw literature that calcium blocks the absorption of levothyroxine. Not sure about natural T3 or T4.

 

[mostlylurking]

I saw literature that calcium blocks the absorption of levothyroxine. Not sure about natural T3 or T4.

Well it happened to me.

 

[tankasnowgod]

I've been going through some of the older threads on Vitamin A posted here, and this one might be especially relevant, since it found that a dose given to women was able to lower TSH and T4 and raised T3, which suggests that it improved conversion of T4 to T3-

The Effect Of Vitamin A Supplementation On Thyroid Function In Premenopausal Women

http://www.ncbi.nlm.nih.gov/pubmed/23378454 Abstract OBJECTIVE: Vitamin A and its retinoid derivates play an important role in regulation of normal growth and development. Vitamin A has been shown to regulate thyroid hormone metabolism and inhibit thyroid-stimulating hormone (TSH) secretion...

raypeatforum.com

 

[ecstatichamster]

to dose you start very slow and increase every few weeks, using temperature and heart rate, and aim for coming to 98.6F to 99F during the day, but you want to get there in 3 or 4 months. That is really the key, going slowly and increasing slowly.