When patients are first started on the treatment, it is best for them to be educated well, with 2 weeks worth of instructions, and to be prescribed at least 2 weeks worth of medication. This prevents them from having to make extra phone calls and extra trips, which can be inefficient for both them and the staff. After patients are started on the T3 therapy, they should be seen back in the office in 2 weeks.
Note: In cases where patients come in taking T4-containing medicine and are instructed to wean the T4-containing medicine before the T3 therapy is initiated it may be best to schedule the following visit for 3 weeks instead of the usual 2.
After 2 weeks of being on a therapeutic trial, it is much easier to predict what course a patient’s treatment is likely to take, because the patient’s initial response greatly narrows the scope of likely scenarios. Predictable parameters include:
- Projected length of treatment
- Number of cycles that may be necessary
- Range of T3 dosages that may be necessary
- Expected outcomes, etc.
At that 2 week appointment, if the patient is doing well and it seems that the patient is on a predictable course, then the next appointment might be scheduled for 4 weeks (this is true for 85+% of patients). If at that 2 week appointment, it is not as easy to predict the patient’s likely course, or how the patient is likely to do, scheduling the next appointment for 3 weeks would be better (very rarely, one may want to schedule the next visit less than 3 weeks out). Thereafter, the return visits might be scheduled for every 4 weeks (extending to every 6 weeks and then perhaps every 8 weeks as indicated).
This rate of office visits is in contrast to the every 6 months to every year appointments that are often scheduled for patients being treated with T4-containing medicines. Thyroid therapy need not be so static as many people consider it to be. T3 therapy is very dynamic. With T4 therapy, it takes the body over a week to convert half of the T4 given by mouth to the active hormone T3. But with T3 therapy, all of the active hormone is available immediately. That changes everything. That puts the therapy on the order of minutes, hours, days, and weeks (not months and years). If the treatment is well managed a lot can happen in a short period of time.