Increase Levo or Add T3?

I am a 45 year old male that was recently diagonsed with Hashimotos based on the following labs and typical hypo symtoms:

TSH - 2.4 (.35 - 4.94)

FT3 - 3.2 (2.3 - 4.2)

T3 - 98 (58 - 159)

FT4 - .75 (.7 - 1.8)

T4 - 4.1 (4.5 - 12.5)

TP Autoantibodies - 42 (5 - 25)

Thyroglobulin Ab - 376

My doctor put me on 75 mg of Levothrtroxine a month ago. After waiting a full month, my follow-up labs were as follows:

TSH - 1.4 (.35 - 4.94) - Decreased to seemingly good range

T3 - 95 (58 - 159) - DECREASED from 98

T4 - 4.8 (4.5 - 12.5) - Increased slightly but still at low end of range

TP Autoantibodies - 60 (5 - 25) - Increased

Thyroglobulin Ab - 422 - Increased significantly

Upon me telling him that I haven't felt any better, possibly a little worse, my doctor has given me 3 options: Do nothing, increase T4 from 75 mcg to 100mcg, or stay at 75 mcg and add a little T3. I chose to increase T4 to 100 mcg and see how how that helps. I have also agreed to go on a completely gluten free diet for the next 30 days to see if it might help bring down my antibodies.

After nearly 3 weeks at 100 mcg, I still don't feel any improvement, but plan to have my blood drawn again in a couple weeks.

However, I would be curious on opinions and/or perspectives from folks on this forum as to what they would recommend as my next steps. Should I add more T4, add in some T3, or just ask to go on NDT, or something else?

Thanks very much for any input!

9 Replies

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  • Firstly you clearly have a reasonably clued up doctor to have diagnosed you early

    2nd it takes quite a while to get better when your hypothyroid because its taken years to develop

    I would grab the T3 without question

    However what is vital is he tests

    Ferritin

    Folate

    b12

    Vit d3

    as they are all interrelated and must be optimum at HALFWAY in their ranges otherwise your body cannot make use of the levothyroxine and convert it into the T3 your body cells need to function

  • I agree wholeheartedly! When you've been on here for a while, you'll realise that NO-ONE turns down the offer of T3 if they're Lucky enough to be offered it! :)

    But I would say that B12 needs to be even higher than mid-range, because the ranges are often very stupid. About 1000 I would say.

  • Thanks for your reply. I hope that, once I get my labs back, that he will still give me the option of adding T3, even if I have to decrease the T4 a little bit.

  • Hi there milnerb1.......

    I recommend everything that reallyfedup has said.

    We don't have anything in common ( ...74 yr old Granny ! )......

    However,after many years under medicated on 50 mcgs T4 I finally found these good people here who gave a lot of help and I have now followed the path that you are on ,gradually increasing to 100 mcgs T4 and then when asking my GP about T3 was thankfully referred to an Endo,who believed in FT3 testing and duly prescribed some T3 for me.

    If you have a GP who will prescribe T 3 I would give it a try.It can make all the difference if you aren't converting your T4 properly.I was only given 10mcgs T3 and had to reduce t4 to 75 mcgs,but it's a start and can be reassessed as you go along.

    The first thing I noticed was more energy and increased motivation,even on this low dose.

    You mention going Gluten Free .....does that imply that you have muscular aches and joint pain? It is one of my worst things to deal with but gluten free helps.

    I hope it will help you and wish you good luck.

    Others will hopefully be along to give you more help.

  • Thanks for your reply. I have some aches and joint pain but some of the pain may be from working out too hard and slow recovery. My doctor is great though. He is a rare GP that understands lower carb and Paleo eating and functional health. Thanks again.

  • Milner

    Treasure your GP but also remember your not fit enough to be working out yet

    its taken months or years to become hypothyroid and just as long to recover

    Give your body time to heal but remember for many people its the synthetic drugs like levo and t3 that can cause joint pain

    As my lot all prove

  • Ok. Thanks very much. I'm actually doing Crossfit 2-3 days per week, so may be making the situation worse. Regarding the synthetics, I would ultimately like to get to using NDT instead of the synthetics. But my doctor seems to prefer the synthetics (at least for now) because he said there are less variables and it is easier to dial in. If I don't feel better on T4/T3 though, he might be open to letting me use a NDT.

  • most doctors are very ill informed on NDT deliberately by the edicts of BTF BTA RCP who all have a vested interest in both the thyroid tests and the synthetic stuff

    Theres been far more problems and recalls with synthetics than ever there has with NDT but they try to hide that

    What does he think the body does in a normal state ..............its not constant

    plus NDT contains T1 T2 T3 T4 and calcitonin

    My husband , daughter and 3 of 4 granddaughters are all only well on NDT

    On levo or T3 they are in agony

    Only 1 granddaughter is fine on levo ...............theres an easy research project for the scientists to prove why but they are not interested

  • Your doctor is totally wrong about NDT. There are no variables. It's far better regulated than synthetic T4, and has far fewer recalls. I don't know what he means by 'easier to dial in'. lol

    Do remember that exercising - any exercising - uses up your T3. So, the more exercising you do, the less T3 you have. Low T3 is what makes you hypo and gives you symptoms - see the connection to your aches and pains? You also need T3 for every other bodily function, every single cell in your body need T3 to function correctly so, the more you exercise, the worse you are making yourself.

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