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T3 level unsteadiness can result in decreased clinical improvement, before it results in side effects.

T3 level unsteadiness can result in decreased clinical improvement, before it results in side effects.

Sometimes, when the patient’s temperature is averaging normal, and the patient is still not feeling as well as one would hope, it is due to unsteady T3 levels. This is evidenced by such a patient’s appreciable clinical improvement (within about 45 minutes) with a T4 test dose (p129), and/or over a week or two of increased compliance with the dosing times. And sometimes patients can notice not feeling quite as well on a given dose than they were previously, even though their temperatures are still averaging normal. Such patients can often associate the slip in their clinical status with a time that they were having trouble taking their doses on time, or during a time of destabilizing stress (e.g. significant emotional stress or mental pressure). Increased compliance with dosing times and/or a T4 test dose might restore their clinical improvement, but sometimes it doesn’t. It is easier for T3 levels to get unsteady, and also to stay unsteady, when the patients are on higher doses of T3 therapy. When clinical improvement cannot be restored in the present cycle, then it is usually best to wean off the T3 therapy (to let things steady down), and start again (Q13).