The CT3M, created by UK patient Paul Robinson, is another way to help raise your low cortisol levels (as proven by a 24 hour saliva cortisol test) without the use of hydrocortisone (HC). But note: it seems to work best for those who only have a morning cortisol issue. If your cortisol is low at other times as well, this may not be the treatment for you.

It’s also not a stand-alone treatment. We have learned since its introduction that most will need to be treating any other issues, such as methyl blocks, sex hormones if problematic, lowering inflammation (very important), good nutrition, neurotransmitters and more.

The T3 needs to be direct, NOT slow-release. Turns out that NDT can work for this, too, because of its T3 content, and it’s best to swallow it for the early morning dose to release the T3 more immediately. If you have HARD tablets, chew them up first. Use an acid in your drink like a small amount of Apple Cider Vinegar or lemon juice.

You canNOT have hypopituitary or Addisons for this to work. If you have Diabetes or blood sugar issues, you’ll need to adequately treat those for this to work. To rule out hypopit, do an Insulin Tolerance Test. To rule out Addisons, do a Synacthen/ACTH Stimulation test. 

**KEY POINTS CONCERNING PROMOTING BETTER ADRENAL FUNCTION WITHOUT HC: 

  • No one should “assume” or “guess” they have low cortisol. It’s critical to do a 24-hour adrenal saliva test to show what’s going on. If saliva shows you’ve got low morning cortisol, you are a candidate for the CT3M.
  • Important fact one: Cortisol starts its rise approximately four hours before you wake up, and is working hard during that time. And that is part of what wakes up for the day in the morning, by the way. So if you are an 8 am waker, your adrenals start to kick in around 4 am.
  • Important fact two: Just like ANY organ in your body, your adrenals are made up of cells. And ALL cells in your body need T3. Your brain needs T3. Your kidneys need T3. And the adrenals need T3–especially during that four hour window before one wakes up. And, says Robinson, you can’t really expect your adrenals to work well if the mitochondria that make ATP for those cells and the cell nuclei have an inadequate level of T3 thyroid hormone.
  • With the above in mind, it made sense that if adrenals are struggling, they can need T3 in that early morning 4-hour window in order to function better. How to do it? A T3 dose of 10 mcg (or one grain NDT swallowed) is usually started about 1 1/2 hours before one wakes up, and data taken right after waking up–pulse, BP and temps. (Some sensitive individuals start on 5 mcg or half a grain NDT.) Then give the beginning dose a week see if it produces a positive response in any of the above, or symptoms such as waking up better. If not, patients raise that dose by 2.5 – 5 mcg T3 (or go to 1 1/2 grains NDT), while still at the same time, looking for that positive response.  Many patients report 12.5 – 15 mcg T3 giving a positive response; it’s individual. Once a clear positive response is found, the same dose is moved earlier by 30 minutes i.e. to the to 2-hour mark before waking. A half hour move gives a continued but more subtle improvement, says Paul. (Some patients feel that a 15 minute movement earlier, rather than 30 minutes, is better!!) Patients then hold up to a week to see if more is needed at that new time. Do not go too fast, as you need to give your adrenals TIME to respond, says Paul. The worse your adrenal fatigue has been, the slower you need to go.  Some find the 2 hour time to be perfect; some are 2 1/2, etc. . **Note that T3-only may be your best bet for the early morning dosing if you have a bad RT3 problem.
  • If you are using Armour or any hard-tableted NDT, chew it up before swallowing, or simply swallow it. Do not do the early morning NDT sublingually! Also have an acid in your drink to promote better absorption, like lemon juice or small amount of Apple Cider Vinegar
  • If you get TOO much of a response at a certain time you have moved earlier to, then you move forward to the previous time. So, if for example, 4:30 am produces TOO much of an adrenal response, as indicated by data or symptoms, and you were doing better 15 – 30 minutes later, you move back to that later time.
  • Many end up on around 12.5 -25 mcg T3. Other T3 or NDT doses are continued throughout the day, as needed. This is an average; it may or may not be your right amount.
  • NDT or T3?  Robinson feels that some will need to use T3-only for their circadian dose to stop the competition from the T4, or the buildup of RT3. Some patient experience has found a combo of T3 and NDT to work well.
  • How long to get a full response? Robinson has seen the adrenals “pick up virtually straight away”, but patient experiences show that several months can be needed.
  • Can you be on HC when you start the T3CM?  How do I wean HC when I start?  Yes, but patients found out that they needed to wean HC fairly quickly, after getting a good response, to counter the high cortisol they can end up having from the combination of your HC and the T3CM. Symptoms of too much cortisol can include nausea, high heartrate or BP, high blood glucose, etc.  Additionally, staying on HC when doing the T3CM can inhibit the work of the method–HC suppresses while the T3CM is the opposite. HC is often weaned by taking the first dose later and later in the morning, while dropping 2.5 at a time. Patients then end up only three doses of HC, and weaning those. Blood pressure/heartrate/temps are watched carefully. For many, once their have weaned down to 10 mg daily total of HC, they are able to drop that totally. Most are totally off HC in a month. Patients doing the T3CM give themselves at least two weeks off the HC to assess how they are doing and before making any changes. Many who were on HC, and now off, restart with 10 mg T3 (or one grain NDT) at the 1 1/2 hour mark. As far as Medrol, weaning needs to go VERY slow, say those who are working on it.
  • What if I’m on Florinef? If on Florinef with HC when starting the T3CM, Florinef is weaned first, 1/4 tablet at a time (plus wean SR potassium proportionately if you were on that), then patients start weaning HC when off Florinef. If high blood pressure shows up while weaning Florinef, some have started the HC wean before they are off Florinef as a result.
  • What if one has high morning, and low the rest of the day?  What  if one has issues with even the lowest dose 1 1/2 hours before waking? Dosing the T3 or NDT staring 3 1/2 or 4 hours before waking “may” help, but not sure.
  • Side effects or problems with using the CT3M?  Apparently so, report several patients. And these have even occurred when it’s being followed very correctly. Some patients report worsening problems while doing it. Some report it doesn’t raise their noon low cortisol at all (which is why it seems to work best if only the morning is low). Some report getting good results, only to see them fall sooner than later. Some report is did absolutely nothing for their low aldosterone. You have to find out for yourself, since others soar on the CT3M.
  • Supplements needed:  1) high potency B complex  with 50 mg of B1-B6 in it twice a day (B1 key for mitochondria) 2) B12 500 ug or 100 ug (even if no detected B12 issue) 3) vitamin C 500 mg 4-6 times per day in divided doses – for adrenals 4) vitamin D 2500 IUs (even if no 25 hydroxy vitamin D bad result) 5) a good chelated multi mineral with all trace / macro minerals in it 6) chelated magnesium 400mg twice a day- enables the sodium potassium pump in the cells to work right.
  • When your adrenals kick back in, you may find you don’t need as much T3 or NDT. 

DID YOU KNOW YOU CAN USE THE CT3M SIMPLY TO WEAN OFF HC?? Yup. Some patients want to be off their HC in order to redo saliva testing (which shouldn’t be done while on HC). And using the CT3M is a great way to wean off–it does it faster than weaning off HC alone (which by itself, would need to take several months, as compared to one month on average when using the CT3M), besides continuing to promote good cortisol. Once off HC, you can stop the CT3M…wait a few weeks, then redo saliva.

To order his book,  go here: http://www.stopthethyroidmadness.com/books-on-thyroid It’s mostly about the use of T3-only for those who can’t use other forms of thyroid treatment, or for those who choose to be on T3-only, but Chapter 16 covers this use of T3 for the adrenals. His handbook “The CT3M HANDBOOK: Recovering Adrenal Health using the Circadian T3 Method” is specifically about the CT3M.

Detailed info on weaning off HC and Florinef when doing CT3M here. More from Paul here.

Groups to join: the Facebook Recovering with T3 is one, or the Yahoo Neo forum T3CM for adrenals is another. Remember that you need to do saliva testing FIRST. 

From Janie: Note that it will also be important to discover and treat inflammation, since the latter can suppress your HPA axis, no matter how well you do the T3CM.