The higher the dose of T3 therapy, the harder it is to keep T3 levels steady. So at some point during treatment, it may be felt that the current degree of symptom resolution is sufficient for now, and that it might be best to leave well enough alone for the time being, rather than to risk destabilizing things while attempting to further resolve the symptoms. To illustrate, I will review briefly an analogy I often give patients:
Let’s suppose a person traveling to a distant city stopped along the way in an intermediate city, and really liked it there. He could stay there for three weeks if he wanted to. But he is not going to get to his final destination of the distant city until he gets back on the road and continues his journey. Likening this to the progress of T3 therapy, the distant city represents the ultimate goal of the patient’s body temperature patterns remaining more normal and the patient’s symptoms remaining resolved even after T3 therapy has been discontinued. If on the way to that goal the patient notices a remarkable improvement (and not necessarily complete symptomatic improvement) he may remain at that T3 dose and in that cycle of T3 therapy for a period of time if he prefers, and if he is without complaints. He may even remain at that level and in that cycle indefinitely (for as long as a year or more). However, the patients that do accomplish the ultimate goal of T3 therapy usually accomplish it by going up and down on the T3 therapy, getting closer and closer to normal on less and less medicine until the ultimate goal of being normal off medicine is accomplished.
So even though a patient may feel well on a certain dose in a certain cycle indefinitely, he may not be able to obtain the ultimate goal of remaining well off medicine until his system is better corrected. Better correction may require him to “get back on the road” by continuing to increase and decrease the medicine through the process of cycling until he gets closer and closer to normal on less and less medicine until the process is complete. Thus, as long as a patient is not having any problems or complaints, when a patient goes up and when a patient goes down on T3 therapy is largely a matter of preference according to the doctor’s and patient’s priorities.