Urgent! Need test results advice

Hi sorry to say urgent but only just got my blood results and I've got my first Appt with an endocrinologist tomorrow morning.

previous results at end of Jan 2016 were,

serum free T4 level   11.9 pmol   range 12.00-22.00 

Serum free T3 level   5.2 pmol  range 3.10-6.80 

Serum TSH level  0.02  mu / L  range 0.30-4.20 

New results are,

serum free T4 level  16.2 

serum free  T3 level 9.6  

serum TSH level  0.01  

I'm feeling better,  weight is coming off me with no effort. I tweaked my meds a bit. I'm taking levothyroxine 100 mcg a day and 3 days a week adding 25mcg, also have bought some T3 and am taking 25mcg a day.  Is there such a thing as an optimum set of results?  Do I need to tweak some more? Any help would be greatly appreciated.  Thanks  x

14 Replies

  • Did you take T4/T3 before your blood test?

  • No I didnt

  • SueOathall,

    If you took T3 before your blood test that will probably account for  FT3 being over range.  If you took T3 after your blood draw you are overmedicated and should reduce T3 dose substantially.


    I am not a medical professional and this information is not intended to be a substitute for medical guidance from your own doctor. Please check with your personal physician before applying any of these suggestions.

  • Thanks for u your reply.  But if I'm over medicated on T3 why do I feel better?!  I'm confused! 

  • I'm glad you feel better and most Endos do go by ranges. 

    If you are on T3 the doctor whose links I shall give had different ideas and so do other doctors who were trained before blood tests. The main priority was the patient had improved. Excerpt:

    My reason for this different protocol is simple: the TSH, free T3, and free T4 tell us only how the pituitary and thyroid glands are interacting. Of course, the test levels may also tell us something of the influence of thyroid hormone over the hypothalamus in its secretion of TRH, another hormone that influences the pituitary gland's secretion of TSH.

    Tissue measures of thyroid hormone tell us what is most important, that is, how the patient's tissues other than the pituitary and hypothalamus are responding to a particular dosage of thyroid hormone. To accomplish this objective, with long distance patients, I mainly use the basal body temperature, basal pulse rate, speed of the Achilles reflex, and the voltage of the electrocardiogram tracing.


    Go to date November 9, 2005 to read the whole q/a below. Excerpt:

    When he and I did a telephone consultation with you, he agreed to put me on Cytomel. I now take 100 mcg per day. I'm doing your protocol as you describe it in Your Guide to Metabolic Health. I take vitamin supplements daily and exercise at least three times a week. Since I started the protocol and Cytomel, I've regained my life. I have no more pain, no migraines, no swelling, no tingling, no insomnia, and I'm no longer cold all the time. The list of improvements goes on and on. For example, I've lost 65 lbs. I feel great. I suffered for 10 years of my life without a correct diagnosis, so needless to say, I don't want to go back.

    The problem I'm facing is that my TSH is very low and my T3 is high. On occasion, I feel that my heart is pounding or I feel anxious. Other than these symptoms every once in a while, I don't feel overstimulated. But because of these symptoms and the lab results, my doctor wants to take me totally off T3 and send me to a local endocrinologist. I've inquired at the endocrinologist's office and learned that he doesn't believe in using Cytomel or your protocol. What can I do? There must be other options than just taking the Cytomel away completely. I feel good now and live an active lifestyle. I don't want that taken away. Please help. I'm desperate not to go back to the way I was before.

    Dr. Lowe: The improvements you describe are typical of what we hear from patients using high-enough doses of Cytomel. Because of your improvements, and because your symptoms of possible overstimulation are occasional, taking you completely off Cytomel seems to me radically improper. 

    For someone taking 100 mcg of T3, we expect your pattern of lab results—a low TSH and high T3. However, your TSH and T3 levels are irrelevant to whether you're overstimulated or not. Two studies we just completed confirm other researchers findings: these tests are not reliable gauges of a patient's metabolic status. Many patients taking T3 have TSH and T3 levels like yours but still have severely low metabolic rates. Their metabolic rates become normal only when they increase their dosages further. Their metabolic rates become normal and they have no detectable overstimulation.

    In some cases such as yours, the patient's Cytomel dose may need to be reduced. But symptoms such as occasional heart pounding and anxiety are usually not due to a patient's Cytomel dose. I say this because when Cytomel is solely responsible, symptoms of overstimulation are consistent, not occasional.


  • Thank you

  • SueOathall,

    You're feeling better because FT3 is higher but now it is too high and you should reduce dose to keep FT3 <6.8.

    I didn't feel over medicated when FT3 was 8.4 but my hair started coming out in clumps.  It stopped shedding 7 weeks after I reduced dose and I didn't experience any hypo symptoms.


    I am not a medical professional and this information is not intended to be a substitute for medical guidance from your own doctor. Please check with your personal physician before applying any of these suggestions.

  • How much should I reduce it to ?

  • Sueoathall,

    I think halving dose to 12.5mcg would probably be sufficient.


    I am not a medical professional and this information is not intended to be a substitute for medical guidance from your own doctor. Please check with your personal physician before applying any of these suggestions.

  • Okay thanks.  I'll try that.  Thanks for your help x 

  • Weirdly, taking T3 seems to encourage the body to make more T3 from the levo it's being given. So it might be that a reduction in levo would work too. 

    Try Clutter's suggestion first. But if you find it leaves you feeling worse, stick to 100mcg of levo every day with the added 25mcg of lio. That additional 75mcg of levo a week might be tipping your FT3 results over the top. 

  • Thanks

  • Have you considered that you may have thyroid hormone resistance (impaired sensitivity to thyroid hormone). This is a genetic condition which means that the body needs high levels of T3 to function normally.

    You seem to need high levels of free T3 to feel well and your family history of depression and thyroid issues (possible genetic cause) would support this possibility.

    I will send you a personal message about a book on this.

  • Thanks that's interesting and well worth considering.  Thanks for the message

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