Taking T3-only medication

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Prerequisites

• Stable temperatures indicating sufficient adrenal support

• Iron saturation minimum 30%

• small dose may be tolerated with iron saturation as low as 25%

• work to improve iron status while titrating T3

• if T3 causes anxiety, discontinue or reduce until iron improves

Dosing

• Four doses a day

• Five-hour intervals

• First dose at waking

• Final dose at bedtime

Usual starting dose

• 5 mcg (5 mcg tabs) or 6.25 mcg (1/4 of 25 mcg tab)

• Dosed waking and bedtime

-or-

• If replacing thyroid hormone extract, use the amount of T3 currently

being taken, spread among four doses

Increases

• One or two doses at a time

• Five days of stable temperatures before each increase

• Temperatures may decrease and/or wobble after each increase

Intolerance to T3

• Too high a dose for available cortisol and/or iron

• Thyroid hormone increases cortisol clearance

• Insufficient cortisol can precipitate adrenaline

• Can happen with very small amounts of thyroid hormone

• Symptoms appear to be, but are not, hyperthyroidism

• Can include

• anxiety

• palpitations

• breathlessness

• dizziness

• high heart rate

• increase of fatigue

• overall hypothyroid symptoms

Hypothyroid symptoms not resolving

Thyroid resistance caused by

• Deficiencies or imbalances of

• iron

• cortisol

• aldosterone

• glucose control

• sex hormones

• vitamin B12

• vitamin D

• electrolytes

• Elevated SHBG (sex hormone binding globulin)

• FT4 not suppressed allowing conversion to RT3