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Latest results on T4 \T3 combo . TSH high ??

Hi all.

Maybe someone can help with my latest results please?

These were on T4 -50 MCG & T3 10 MCG

TSH 11.06. ( 0.35-5.50)

Free T4 11.0 (10.0-19.8)

Free T3 3.2. (3.5-6.5)

My TSH is for the first time high at 11.06 and have been feeling hypo again.

Endo s suggestion is to increase T3 by 5 MCG and retest in 6 weeks otherwise he'll raise T4.

I'm not expecting any miracles on that small increase and suspect I need quite a bit more but probably still a combo as T3 only was really not successful for me .

Explained to him still feeling awful, no energy, aches, get up & go got up & gone etc etc and asked again about trying NDT.

As expected got that" its really not recommended "as I'd' have to buy something of the internet' that 'really isn't regulated and you've have no idea how much and what you're taking ' brick wall there then ! Grrrrr

6 Replies

Your results show you need more but someone will come along with advice. We aren't all the same but my tsh is 0.05, t4 19 and t3 is out of range at 9.7,my docs don't mind that bit , won't continue to prescribe t3 but don't mind if I buy elsewhere. I am on 150mcg t4 and 25mcg t3. I feel well and not over medicated. Maybe your end is frightened of t3 but sure does look like you need more , he's not giving the combo a fair chance!


Your dose of thyroid hormones is obviously far too low when your TSH is so high when you are on meds.

Your Endocrinologist I doubt is aware of the latest 2010 research findings and the therapeutic dose of T3 you are taking (10mcg is too low), i.e. he should have prescribed 20mcg of T3 for 50mcg of T4 (should be 60mcg). This is an extract from an article which had been testing various doses of T4/T3 in patients.

"Journal of Orthomolecular Medicine Vol 28, No 2, 2013


Dose Selection in T3/T4 Study RCTs

The second logical basis for a conclusion

is the actions taken, i.e., the doses given to the

subjects. Most subjects received T3 below its

adult starting dose of 25 mcg/day.


The subjects in RCTs received T3 in some ratio to the

withdrawn T4. The various RCTs used T4:T3

ratios of 14:1, 10:1, and 5:1. Subsequent re-

search by the US National Institutes of Health

(NIH) found the therapeutic equivalence was


So a therapeutic dose is 3:1. Ask him to increase the T3. Even so, it's still not a high dose and you might need more hormones to feel much better. At present your combined T4/T3 is equal to approx 90mcg of levo.


I have no thyroid, but need 112.5 T4 and 30 t3 to feel well. I recently increased by 5mcg as I wS feeling v cold, but felt myself go a bit fast so 5mcg can make a difference. however I agree that bloods suggest you are under medicated. Sandy x


Thanks Sandywandy , that's a much bigger dose you're on and i know we're all different but I've been suspecting for a while I'm way too low.

Will have to gradually increase it myself as I can see it taking years otherwise and I don't think they realise how much we suffer in the meantime!

A x


Amanda, TSH >10 is overtly hypothyroid. You need more T4 and/or T3. 5mcg T3 is equivalent to 15mcg T4 and that is not going to make much difference to such high TSH.

The goal of Levothyoxine and Liothyronine is to restore the patient to euthyroid status which for most people means TSH just above or below 1.0, FT4 towards the top 75% of range and FT3 in the top third of range.

Read Dr. Toft's comments in Treatment Options in the link below.


I agree Clutter , thank you , to think that he thinks an increase of 5 T3 is going to make a difference when I'm so low is ridiculous!

Its all going to have to be my doing again trying to sort it !

A x


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