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Do not taper without a doctor involved

The reason for the lack of a positive inotropic effect (PIE) in RA can be readily understood if we assume that the negative staircase phenomenon is overcoming any PIE by an increase in cAMP in right atrial cardiomyocytes outside the sinus node (Stemmer and Akera 1986)

After a set period of time of daily use, you can check your thyroid antibodies to see if you experience any benefit

Clin Pharmacokinet (2017) 56:138190

Subcutaneous injection delivers the highest systemic bioavailability and is preferred for anti-inflammatory, tissue-repair, and gene-modulation benefits