Help with my latest blood results

[Benjamin1]

Hi, ive just had my latest blood results i would appreciate some advice please.

My T4 was 13.6, T3 6.4 and my Tsh 0.01 i have been taking 125mg of T4 & 20mg of T3 daily. Today i had a meeting with my consultant who said my T3 is too high and she has now recommended i either reduce my T3 to 10mg per day and keep taking 125mg T4 or i can stop taking the T3 and do alternative days of taking 150mg T4 then the next day 125mg T4. I am feeling tired and get daily headaches and sore eyes any advise or recommendations would be greatly appreciated.

[Clutter]

Benjamin1, You haven't included ranges so I'm guessing that FT3 6.4 is slightly over range. I'd plump for reducing T3 to 10mcg. Overmedication can cause tiredness and headaches so you may find they improve. If 10mcg turns out to be too little you could try 15mcg.

Dry gritty eyes is common in Hashi and hypothyroid patients and high pollen can make it worse. Ask your pharmacist for preservative free drops. If you find them helpful and need them daily ask your GP to prescribe them.

[Benjamin1 in reply to Clutter]

Thank you Clutter. The range for the T4 is 9- 19, T3 2.6- 5.7 and Tsh 0.4 - 4.9 so my T3 is over. Thats probably the reason why i feel so tired. My Ferritin is 31 so i have been taking ferrous fumerate twice a day with vitamin c. Hopefully i will feel better soon as i cant take the hot sweats !

[Stourie in reply to Benjamin1]

I hope you didn't take your meds before your blood test as that raises t3 quite significately. There should be 24 hours at least for all meds before blood is taken. xx

[Benjamin1 in reply to Stourie]

No i waited until after my blood test before i took meds xx

[Eddie83]

Please specify units when you post results. There are at least two major measurement/units systems in use.

TSH=0.01 is way too low. From my experience, I conclude you could be better off decreasing your T4. I found that pushing T4 too high produces unpleasant symptoms (anxious, jittery, etc.) and drops TSH too low; and my doc has other patients like me who cannot push FT4 way up into its range. That is why many of us are on T3+T4 or T3+NDT; we don't fit the good-converter one-size-fits-all model of conventional T4-only endocrinology. Which seems like a silly idea, because a thyroid gland in good working order produces both T3 and T4.

You can figure a reasonable T3+T4 dosage regimen by using some basic numbers:

F: T4-only full replacement dose, 1.7mcg/kg body weight

P: T3 power factor, about 4, multiplicative factor applied to T3 dose to get how many mcgs of T4 are roughly equivalent. I.E. 1mcg T3 is approx. equivalent to 4mcg T4.

R: T3:T4 ratio, usually in the range 1:4 - 1:10

For example: I weigh 76kg and am on T3+T4=15mcg+75mcg. So F=1.7*76=129mcg, my T4-only full replacement dose (which I cannot tolerate). The T4-equivalent for the T3+T4 dose I am on, is 75mcg+15mcg*P=75+15*4=135mcg. Note that 135 is close to 129. I have R=1:5 and that is a good ratio for me, because if I independently vary T3 from 15 to 19, or T4 from 75 to 88, I will go into a hyper state in 1-2 days (T3) or 7-10 days (T4).

[Benjamin1 in reply to Eddie83]

Thank you for your reply. The consultant was concerned with my Tsh being so low, she has requested a bone scan for me. What she did say was that my piturity gland is working and that its possibly because my fertitin levels went so low that it had taken my thyroid levels out of sink. Thats why she gave me two options, first option to remove the T3 and just have T4 with alternate doses of 150mg & 125mg. The second option was to continue on the T3 but to reduce down from 20mg to 10mg and also continue on 125mg T4. Either way its trial and error, i was on 150mg T4 for many many years and felt fine, its only the past two-three years ive felt rough but it may have had something to do with my ferritin level of 7.

[Eddie83 in reply to Benjamin1]

Speaking from the perspective of a celiac who has now been GF for 12 years ... do you think there is a possibility your ferritin is low due to digestive issues? Crohn's, IBS, & Celiac are all associated with nutritional deficiencies. Males with normal digestive function don't often develop iron deficiency, except when they aren't absorbing well. Leaky gut (Genova offers a test for that) is associated with these digestive conditions.

[Benjamin1 in reply to Eddie83]

Im not sure but i have an appointment next week with a consultant regarding my low ferritin, although my Dr didnt see a level of 7 as low. I have since been taking Ferrous Fumerate twice a day and have felt better since my levels have come up to 31. I am female and have pernicious anemia and am a non red meat eater.