It depends on whether or not the patients’ temperatures are yet up to normal. If the patients’ temperatures are up to normal, then the cycle should not be weaned until the patients’ compensation times have passed by at least a day or two (in other words, until their temperatures have been captured). This is to ensure full benefit of the cycle (c9, Q8).
Patients who have gotten their temperatures up but who have not demonstrated a predictable compensation time, however, may need to stay up on that cycle for 3 weeks to see if their temperatures have been captured. This is because the longest compensation times are around 3 weeks, and if the patients don’t compensate within 3 weeks they’re probably not going to compensate. Now if the patients’ temperatures haven’t come up to normal, and the maximum dosage (Q8) has been reached, the patients may begin weaning the cycle right away. There is no added benefit in staying up on the cycle for 3 weeks in this circumstance. There’s no point in waiting to see if their temperatures are captured when they aren’t even normal (remember if the patient’s temperature isn’t up within a few hours of an increased dose, it probably isn’t going up on that dose no matter how many weeks it’s continued). It’s important that progress not be delayed unnecessarily.
Patients do not necessarily need to be weaned off a cycle immediately after it is clear their temperatures have been captured. In fact, usually if the patients are feeling very well they do stay up on that plateau for a time depending on the circumstances (c8). Not uncommonly patients will say: “This is the first time that I have felt well in 20 years, so if it’s all the same to you, I’d rather not wean down off the medicine right now.” They are often concerned that they will start feeling badly again. But there is often so little breakthrough of the patients’ symptoms that after a few months they seem to forget what it feels like to have those symptoms, and begin to gain confidence that they will be able to wean off the medicine and stay normal. This confidence is bolstered by them getting tired of taking the medicine every 12 hours, and tired of paying for it, and so the treatment is usually self-limiting with the patients becoming motivated to wean off.
Of course, if a patient begins having side effects or complaints, it may be necessary to wean the T3 at that time, even if the temperature hasn’t come up.