New bloods.

[clubby29]

Hi all, help with bloods please:

March 16 : FT4 23.8 FT3 5.4 TSH 0.05 Total T4 141. 175 levo

June 16 : FT4 18.9 FT3 5.4 TSH 0.01 Total T4 123. 150 levo 18 T3.

Went to private endo, no issue with me taking a little T3 apparently some people do better like this. concern about TSH as expected , he said it is possible to have a TSH in range even if you do take T3. Not sure why my TSH has dropped but my FT3 is the same, I have tried taking the last piece of tab so I have 3 pieces during the day and 1 at bed time with my levo but it gave me a racy ticker. Feel better for having a little T3 less heady, less foggy, less tinnitus. The question is where now: less levo and more t3? Endo also asked if I had considered a CT scan for pituitary tumor, he wouldn't commit to saying that was what I needed but he did tell me it could be sorted fast and for only £600. Gotta luv them Guys

Any thoughts welcome.

[greygoose]

It would really help people to answer your questions if you gave the ranges. Otherwise, the numbers are meaningless.

Yes, it is possible that people have a TSH in range when taking T3, but these people normally have a pituitary tumour or something. If you take any form of T3, your TSH is going to be very low because you no-longer need the TSH. I don't know why these people can't get their heads around that. The pituitary secrets TSH to stimulate the thyroid gland to make more hormone, when T3 is low. If you start taking T3, the pituitary senses it before the other cells, and lowers the TSH because it believes it is no longer necessary.

Your TSH is suppressed because you are taking T3. That's all. And, if your endo knew anything about how the thyroid works, he would know that.

You don't say how much Levo and how much T3 you're taking, nor how long you've been taking it. But it could be that the blood chemistry hasn't caught up yet, and the T3 will rise given time. But, you obviously weren't converting your T4 very well at all to have such a high T4 and low T3. I would guess you need less T4 and more T3, as you said. But, you really need to put those ranges!

[clubby29 in reply to greygoose]

Hi sorry for not posting ranges: FT4. 12-22, FT3. 3.1-6.8. TSH 0.2-4.2.

Amounts are in the post and I started adding T3 at the beginning of April.

[greygoose in reply to clubby29]

Yes, I should have said that you can have your TSH in range when taking T3, but your T3 would be too low for you to be well.

[Clutter]

Clubby29,

It is possible to have TSH in range when on T4+T3 but you would have to reduce either T3 or Levothyroxine dose to raise TSH. Your combined dose 150mcg T4 + 18mcg T3 is suppressing TSH but FT4 and FT3 are within range so you aren't over medicated. FT3 5.4 is usually around the top third of range and is usually fine for the majority of patients. Having FT3 top of range makes some patients feel over medicated. You've experienced an improvement in feeling "less heady, less foggy, less tinnitus" since reducing T3 dose so why would you contemplate increasing it again?

A pituitary adenoma usually presents with high TSH and high FT4. I'd want to know why the endo suspects a pituitary tumour before parting with £600.

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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.

[clubby29 in reply to Clutter]

Hi thanks for reply, I did wonder if endo was just on the sell.Going to see NHS endo next week will see what he says about scan.

[dizz911]

Hi,

My bloods presented initially with low but within range TSH, below range FT4 and below range FT3. This signalled a possible pituitary problem and I underwent a pituitary MRI with contrast.

The MRI revealed a 4mm adenoma. Twelve months later, a follow up MRI showed it to be 5mm. If you have a suspected pituitary problem, the MRI with contrast is THE scan to have as otherwise very small lesions can be easily missed.

My meds are 125mcg Levo and 20mcg liothyronine, and (unsurprisingly) my TSH is now suppressed. But I feel well 😊

[clubby29 in reply to dizz911]

Hi just got my appointment for the 11th and it is with contrast, so all good. So just another round of wait and see. Lol