Increase in NDT and blood show no improvement

I have been advised by my new Endo to raise my NDT from 2 grains to 3 grains. And I have had bloods done and my Free T4 and T3 have not improved, but my TSH has gone right down, he did folate, ferritin and B12 again has anyone got any ideas please?

Results and ranges

Free T4 11.8 (12.0-22.0)

Free T3 5.4 (3.1-6.8)

TSH 0.10 (0.27-4.20). Was 1.89

Vitamin B12. 343 (190-660)

Folate 5.8 (5.0-10.0)

Ferritin 74 (13--150)

My Endo would like my FT4 higher and has recommended another 1/2 grain increase

I take two ferritin tablets a day.

6 Replies

  • How long ago did you increase from 2 to 3 grains?

    You really need to get the B12 and folate up. I would recommend 5000 mcg sublingual methylcobalaming daily. Plus a B complex with methylfolate, rather than folic acid to bring the folate up.

  • Hi Greygoose, I started the increase 6 weeks ago, the blood test I had done last week show lower levels than when I was on 2 grains last year

  • Well, jumping a whole grain is a big increase in one go. So, maybe it will take longer for the blood tests to catch up.

    However, I Don't think you're going to get that FT4 any higher, because the body just doesn't hang on to it when you're taking T3 as well. Because it just doesn't need it anymore. Your endo ought to know that!

  • O did the increase at 1/2 tablet for two weeks then upped it to 1 after that, been on 3 now for a month

  • OK, well, I still say that you are not going to get that FT4 any higher. It's low because you're taking T3.

    But, if you still have symptoms, then there is room for an increase to get your FT3 a bit higher. But that will lower your TSH even more. Don't know how your endo will like that! lol

  • T3 is the active thyroid hormone which regulates the metabolism and therefore the symptoms. With a free T3 in the top part the range you should not have any hypothyroid symptoms.

    T4 is the inactive form and needs converted to T3 to become active.

    Your results suggest that the body is trying to maximise the T3 level by converting as much as possible of the T4 to T3, causing the lowish free T4.

    I am not sure why your endo wants your free T4 higher. Is it because you are still having hypo symptoms?

    If so these results and your continuing symptoms could be caused by thyroid hormone resistance, also known as impaired sensitivity to thyroid hormone. This is a genetic condition so if there are others in your family with fibromyalgia, chronic fatigue, depression or thyroid issues this would support this possibility. With this condition the body needs very high levels of T3, often above the top of the normal range.

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