should I take t3 as well as levothyroxine

[vivienneferreira]

TSH - 5.42 mIU/L (0.270 - 4.200)

Total T4 - 110.5 nmol/L (59.000 - 154.00)

Free T4 - 14.65 pmol/L (12.000 - 22.00)

Free T3 - 4.77pmol/L (3.10 - 6.80)

Reverse T3 - 22 ng/dL (10.000 - 24.00)

Tg Antibodies - 436.900 IU/mL (0.000 - 115.00)

TPO Antibodies - 216.4 IU/mL (0.000 - 34.00)

B12 - 377.8 pg/ml (191.000 - 663.00)

Folate - 4.92 ug/L (4.600 - 18.70)

Vit D - 64.94nmol/L (50.0 - 200.00)

Ferritin - 126.4 ug/L (13.000 - 150.00)

CRP - 5.4 mg/L (0.000 - 5.00)

hiya grey goose here's my results

[jimh111]

I wouldn't take T3 yet, you may get better on an adequate dose of levothyroxine. I believe you are on 50 mcg but you will probably need 100 mcg - enough to get your fT4 up to around 20 (the fT3 will probably fall a touch as fT4 rises).

People, especially doctors, get confused by the TSH reference interval. TSH rises exponentially as fT4 (and fT3) falls. Expressed another way log(TSH) varies inversly with fT4. TSH does not rise in a linear fashion, it rises exponentially. This means that it will take the same amount of thyroid hormone for TSH to fall from 6 to 3 as it would for 2 to 1. Although your lab's TSH reference interval is (0.270 - 4.200) the 'mid point' is about 1.0 when you factor in the exponential nature of the reference interval.

Sorry about the mathematics. Most of the healty population have a TSH between 1.0 and 2.0. The TSH distribution is a little asymetric, with more of the population having a TSH towards the lower part of the reference interval. Patients on levothyroxine usually require a TSH a touch lower than the healthy population. This is because they are missing the small amout of T3 produced by the thyroid gland and so need a little more levothyroxine to compensate, to bring T3 levels up closer to normal.

So I'd wait until you have been on a suitable dose of levothyroxine for a few months and if that doesn't work ask for some T3.

[vivienneferreira in reply to jimh111]

thanks it is very confusing isn't it I was on 50 but told the doc I know its not enough and got raised to 75

[vivienneferreira in reply to jimh111]

my doctor seemed quite scared of upping my dose incase it went over and out of control but I don't think she needs to worry on that dose I have noticed a few improvements, I'm not as bloated and my weight seems a little less and I'm not constipated but then I've cut out gluten so could be that

[jimh111 in reply to vivienneferreira]

I wouldn't cut out gluten, or anything else, until you have good thyroid hormone levels. That way you can determine if your problem is due to lack of thyroid hormone or something else such as gluten intolerance. The danger is that you restrict yourself when you don't need to. I like to change one factor at a time, giving it time to work, that way you can identify what is wrong.

[vivienneferreira in reply to jimh111]

yes that's true I've seen so many things I should possibly avoid such as dairy and kale

[greygoose in reply to vivienneferreira]

Why would you want to avoid kale? I know a lot of people say that, but it's nonsense. Only avoid dairy if it upsets you. That is a golden rule with most things - except soy. You should never, ever, under any circumstances, ingest any form of unfermented soy. But the rest, if it feels good, go with it.

I agree with jim, it's much too soon to say you absolutely need T3. You need an increase in T4. Many doctors say they are afraid you will tip over into 'hyper'. That is because they have no understanding of how it works. It just doesn't work like that. You wouldn't be 'hyper', you would be slightly over-medicated. In which case, you just reduce the dose a little bit. It's not rocket science. But obviously much too complicated for the average GP. lol

[adin in reply to jimh111]

Interesting opinion, my fT3 is low and fT4 is high(hit the roof) and I have hypo symptomns on this dose(125mcg). I don't know why when I tried to increase the dose to 137 mcg(for rise fT3) i became breathless & tight chest after two hours distance at administration and jittery(in the morning).

[greygoose in reply to adin]

But vivienne's FT4 isn't high. It's as low as her FT3. Therefore, it's impossible to say whether she's converting or not. If you have a high FT4 and low FT3 (do you have the actual numbers?) you probably aren't converting.

Lots of things can make you breathless - low B12 or low iron, for example. And, you need those two to be optimal to be able to convert the T4 to T3. So, if you haven't had them tested, it might be a good idea.

[Glynisrose]

These are merely numbers, how do you feel? That is more important than numbers.