I recently have hd my meds put up by 75 over quite a short period, I am now on 175 mcg of levo. The last increase was a month ago and was on my insistance as I was feeling unwell. Ive just had a call from the doctor (after a blood test) to advise me that my T4 is too high and that i should come down in dosage. My levels were...TSH 0.02 (0.34 - 5.6); T3 5.1 (3.8 - 6.0); T4 - 36.4 (7.9 - 20.0). Iron and D3 are good. The dr is saying that i may be heading for hyper. i have insisted that i feel good on the current dose and she has suggested that i go to alternating my dose between 150 - 175.
Does anyone have any experience of this and / or anything to say or advice to give? Thanks in advance. Im a bit rattled as Im feeling good and my T4 seems very high.
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morena
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It's an interesting one this. FT4 is what it says on the tin - *free* T4. T4 that's just sloshing around, not being converted to T3. In theory, the fact that your FT3 levels aren't also above range suggests there isn't a problem. But it probably won't be a theory your GP shares.
Thanks Lilymay. Actually Im warming to my GP...she did actually say that the FT4 wasnt the most important, and that the most important thing was the way i felt. She also commented that my T3 was good and that was important. She's very good at putting the facts and giving me choice. Ill have a look at the link you sent.
Did you take your t4 the day you had blood drawn? That can cause the level to show high. Always skip your dose the day you will do a blood draw. I often skip 2 days of t4 before a blood draw since it stays in our bodies so long.
I never miss taking my meds and take it at night so it would have been in my system for at least 8 hours. As it is slow acting i dont see the point in missing it. Plus, as they are wanting to see whats going on NOW it seems silly to cut it out. I would take it at some point so my levels would always reflect that. I dont understand why people skip meds before a blood test.
i have just had a similar thing....but i actually did feel sick and had facial pain and bp up...so he has asked me to reduce by 25 per day...(Levo).....just waiting now for things to calm down..thought I was going crazy......i wish..i really do there was a definitive range of levels..evryone seems to cope with such variation......but it is hormonal and therefore very individual......how long does it take to get levels down after reducing Levo..roughly?
ok I didnt know that. But Im still confused about thelevel of T4 being high after taking it. My understanding is that it is very slow acting so wouldnt show up for at least 24 hours.
Im not reallly having a problenm with the GP...I think if I point blankrefused to lower my dose she would let me try it and see. My problem is really that my T4 is so high and given the levels it apparently needs to come down, but Im confused as i feel well. She seems to think I could still go into hyper and that my T4 levels will keep increasing. Im going to try alternating the dose175/150 and see how i feel on that,
The levothyroxine level rises in the blood quickly - peaking around two hours after taking the tablet.
However, the peak of T3 that comes from taking T4 (i.e. after it gets absorbed and converted to T3), is usually around 48 hours after taking the tablet. The effect of that "wave" of T3 can take up to several further days to have its full impact.
If doctors actually understood what happens to the level of FT4 in the blood after taking levothyroxine, they could at least make some sort of allowance for it. But they don't. So the only action most of us have available is to ensure we do not take our levothyroxine for at least 12 hours before a blood test. (After 12 hours or so, the level will have dropped back somewhere more representative of your average FT4.)
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