T4 and t3 combo

Hi all, some questions:

I've been looking at the various studies on t4 and t3. On the plus I can see that I may not have enough t3 as the thyroid produces some itself and that if I have gone through a lot physically it might take a while to regain the right t3 level from conversions whereas taking a little t3 gets into your system more quickly.

On the negative I can see that it's more of a loose cannon as its half life is so short.

Has anyone trialled it and found it no better or more unpredictable?

Do you have to have tests of t3 and t4 before they will prescribe?

I've an endo appt at thyroid clinic at the end of November. IVe got auto immune thyroiditis which was found at age 20 though I suspect of suffered a little growing up. I'm now 37. I'm quite naturally skinny; weight gain or loss from thyroid is only ever from 8 to 8.5 stone so I do wonder if small changes can have more magnified results if that makes sense. A change of 12.5 has often been needed so I wonder if t3 might be too chaotic?

Tia

7 Replies

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  • Haggis, you need an FT3 test to determine what your level is. High FT4 and low FT3 indicates a conversion problem and some T3 in addition to T4 can be beneficial. If your FT3 is good in range you probably don't need T3. Even if FT3 is low you may still have trouble getting it prescribed. Some endos/hospitals just won't.

    thyroiduk.org.uk/tuk/testin...

    My endo wasn't bothered about my below range FT3 and I'm thyroidless so can't convert any T3 in the thyroid gland. It wasn't until I self medicated with T4+T3 for a few months and had significantly improved during that time that he agreed to prescribe T4+T3. T3 improved my FT3 but, more importantly to me, calmed the intolerable adverse effects I experienced on T4 only. I prefer T4+T3 combination to T3 only.

  • Thanks clutter.

    I have to have the Tsh below 1 and t4 upper range to feel ok. But it doesn't always seem to remain constant. I m guessing though that this is normal and its a matter of being firm with drs and vigilant about symptoms and getting tests of I have doubts.

  • Haggis, you will have to if you have a doctor who is trying to dose you according to your TSH.

    TSH fluctuates throughout the day so try to have your thyroid bloods at roughly the same time each blood draw. Early in the morning TSH is highest so that's a good time if you're hoping to get a dose increase. TSH also fluctuates seasonally and many people need to slightly increase dose during the winter and slightly decrease it in the spring/summer.

    There's an interesting graph in this thread which shows how TSH and FT3 fluctuate healthunlocked.com/thyroidu...

  • Ah I did always wonder if it seasonally fluctuated!

    I used to be ultra good about getting tests in the morning, it's harder with a toddler!

    My next is before 9 am. I've been taking thyroxine at night as I take Sertraline in the morning. I used to take the thyroxine after a morning blood test, should I skip the evening dose and take the next day post test?

  • Ah I did always wonder if it seasonally fluctuated!

    I used to be ultra good about getting tests in the morning, it's harder with a toddler!

    My next is before 9 am. I've been taking thyroxine at night as I take Sertraline in the morning. I used to take the thyroxine after a morning blood test, should I skip the evening dose and take the next day post test?

  • Yes you should put off taking your evening dose until after your blood test. Then take your evening dose as usual.

  • Thanks, did so, fingers crossed results don't confuse things as I don't believe I'm on enough Levo. But this is because I'm taking sertraline which I didn't know messes it all up!

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