Taking T3-only medication

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• 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
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
• If replacing thyroid hormone extract, use the amount of T3 currently
being taken, spread among four doses
• 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