Of late I've felt I've had a lot of hypo symptoms even while medicated and had some blood tests done yesterday. Results are:
TSH: 0.3 (0.5 - 5.5)
T4: 13 (range 12 - 24)
T3: 4.8 (range 3.5 - 6.9)
I'm on 200/175 on alternate days and feel confused with the above. I'm really unsure how to interpret them.
This year has been a struggle trying to regulate my medication (I've been on thyroxine for a year now after a year of illness and finally diagnosed with hashi's). I've been so exhausted of late and just keep gaining weight.
Can anyone help? I was thinking before maybe I needed some T3 but do the results show it's fine?
Thanks all
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pennyrose
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Pennyrose, I think the addition of some T3 could be very beneficial. Your FT4 is at the bottom of range and you are struggling to convert sufficient T3, the active hormone required in every cell, as evidenced by your low FT3 which will ideally be >6.05.
T4 is usually reduced by 50mcg for each 20mcg added.
Thanks so much, I've got the dr toft article, I'm just concerned they will try and decrease meds based on my low tsh. I guess I bite the bullet and ask for a trial of t3? Although I feel a lot better than I did over a year ago I'm still only a shell of how I used to be/feel x
Pennyrose, TSH is low because you are taking a hefty dose of thyroxine. FT4 is low because you are converting all of it to T3 leaving the T4 storehouse empty.
Hi Clutter my recent results are very similar taken in May TSH 0.1 (0.35-4.7) free T4 11 (7.8-21) and free T3 4.9 (3.8-6.0), this was while I was taking 100mcgs of Levo and 20mcgs T3 liothyronine. When I saw the Endo I told her still did not feel good, weight gain etc etc, she reduced my T4 down to 50mcgs and upped my T3 to 30mcgs. I still do not feel good and I get a real slump of terrible fatique in the afternoon. I take my 20mcgs T3 and my T4 around 9.00 am and then my T3 10mcgs around 2-3pm. What am I doing wrong. I feel so tired and run down. Taking all minerals required.
Marmaris, How dare you blame yourself... that's the doctor's job You aren't doing anything wrong, the dose just isn't right yet. The reduction in T4 may have been too much or you need more T3. I'd increase your 2nd T3 dose to 20mcg or take your 2nd 10mcg dose midday to 13.00 and take a 3rd 10mcg dose 4/8 hours later. You'll still have to play with timing to avoid slumps until your cells are nicely awash with T3 when slumps should become a thing of the past.
Hi Clutter thanks for that I think you are right. She initially was going to up me to 40mcgs then changed her mind to 30mcgs. I think that Endo's panick and with my Tsh being so supressed and then taking T3 she said any higher it would become undetectable. I know that looking back in my records when I was on just T4 only my tsh was always suppressed and the surgery ringing me once to see if I was ok as it was suppressed at 0.1 to 0.5, that was before T3. I have been tweaking 20mcgs at 9.00 am and taking 12.5 of cynomel (need us use them up) so a little bit more then I may even tweek an evening of 10mcgs aswell. Total may be over 40mcgs or just. What do you think?
Marmaris, If 32.5mcg isn't resolving your symptoms then I think you need more. Increasing by 10 or 12.5mcg may help and isn't a risky increase. If you feel buzzy either skip the next split dose or reduce the 2nd and 3rd doses.
My understanding is that the molecules in T4 and T3 are too large to be absorbed effectively sublingually and they need to be absorbed via the gut.
If you feel better but your TSH becomes suppressed you'll have to stand your ground with your endo. Some people need a low or suppressed TSH to feel well. If the endo scaremongers about osteoporosis and atrial fibrillation tell her you're willing to have a Dexa scan and ECG to allay her concerns.
A GP just called (not the guy I seen recently as he is on a cruise in the Baltic's) and she was nice to begin with but based on my tsh wants to reduce my dose.
I explained that I was feeling unwell and under active, that I haven't been able to stabilise my thyroxine does in 13 months and I asked about a trial of T3. She said that I was over-active and should reduce my dose. Again, I pressed to her that my T4 level was at the bottom range of normal but she said it's normal and I'm over-active.
I'm not reducing my dose. I'll wait until Baltic boy is back from his cruise and push with him. I just cant understand why they treat us this way, it's really upsetting! I kept telling her I feel awful, knackered, keep gaining weight. It doesn't matter to them!
Pennyrose, your GP patently doesn't understand the workings of thyroid and wants to dose you according to the lab ref range. If you were hyperactive your TSH would be suppressed or undetectable and your FT4 and FT3 elevated above range. Your TSH is below range but not nearly suppressed <0.04. Book an appointment to see Baltic boy when he returns.
Thanks so much! Was trying to explain to her that I've done a little bit of research/listened to everyone on this site but she was so adamant about the TSH!
Turns out Baltic Boy still in the country so have a call with him tomorrow.....hopefully it will go better than today. I don't like getting angry....
Pennyrose, We wouldn't have to get angry or use fora and Dr. Google if doctors listened to patients and took account of clinical symptoms rather than treating their lab results
But listening is too hard! Why not look at a reliable blood test result like TSH and see what's happening at a cellular level. Wait, what, it doesn't?!
Hi Clutter having a bone scan soon, requested by my Gyno, had ECG in the past all fine. I have read several articles (only yesterday), that taking T3 is fine sublingually. Each to is own. I have started to take T3 dose earlier after morning one at around 1 pm to stop the afternoon slump. Then a further 10mcgs around 10.30pm. Seemed ok with that yesterday. All trial and error. Like I said my TSH was always suppressed on T4 only.
Glad it seemed to work, Marmaris. I don't notice peaks and troughs. I take 20mcg T3 whatever time I wake up and just before I go to sleep. Perhaps I'm nicely awash at a cellular level as I've occasionally forgotten the 2nd dose without adverse effect.
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You aren't doing anything wrong, the dose just isn't right yet. The reduction in T4 may have been too much or you need more T3. I'd increase your 2nd T3 dose to 20mcg or take your 2nd 10mcg dose midday to 13.00 and take a 3rd 10mcg dose 4/8 hours later. You'll still have to play with timing to avoid slumps until your cells are nicely awash with T3 when slumps should become a thing of the past.
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