Results with T3 and 50mg T4: Hi there. Can I have... - Thyroid UK

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Results with T3 and 50mg T4

Hi there. Can I have your thoughts on my latest bloods. My GP only prescribes T4 so self medicating. I have been taking 10mg T3 in morning and 10mg T3 at 2pm and then 50mg of Actavis T4 at bedtime. My T4 seems low but is this a problem? I am unable to lose weight, very constipated, arthritis in my knees (arthroscopy due soon) and have a large crash at 2pm and need 2 hour sleep. Thank you.

CRP 1.00 <5.0 mg/L

Ferritin 111.4 20 - 150 ug/L

Thyroid Function

TSH 1.43 0.27 - 4.20 IU/L

T4 Total L 63.4 64.5 - 142.0 nmol/L

Free T4 L 10.03 12 - 22 pmol/L

Free T3 4.32 3.1 - 6.8 pmol/L

Reverse T3* 15.0 10 - 24 ng/dL

Reverse T3 ratio 18.75

Normal >15 Ratio

Borderline 12-15

Low <12


Anti-Thyroidperoxidase abs 10.0 <34 kIU/L

Anti-Thyroglobulin Abs H 971.9 <115 kU/L


Vitamin D (25 OH) 54

Deficient <25 nmol/L

Insufficient 25 - 50

Consider reducing dose >175

Vitamin B12 367

Deficient <140 pmol/L

Insufficient 140 - 250

Consider reducing dose >725

Serum Folate H >45.4 10.4 - 42.4 nmol/L


13 Replies

chriscross66 Going through your results, your vitamins and minerals show some deficiencies.

Vit D is recommended to be 100-150nmol/L and yours is too low at 54. You can supplement with D3, 5000iu daily for a couple of months then reduce to 5000iu alternate days. Retesting a couple of times a year is recommended by City Assays who do home fingerprick blood spot tests so I suggest you retest in 6 months and stay within the recommended limits.

When taking D3 we also need it's co-factors K2-MK7 and Magnesium. Vit D aids the absorption of calcium from food and K2 directs it to bones and teeth rather than arteries and soft tissues and magnesium helps by converting the Vit D in the supplement to the active form in the blood. D3 and K2 are both fat soluble so should be taken with the fattiest meal of the day. Magnesium comes in different forms, you can check them out here and see which is best for you . As magnesium is calming it is best taken in the evening.

B12 is far too low at 367. Anything under 500 can cause neurological problems and it's recommended to be at the top of it's range, even 900-1000. You can supplement with Solgar or Jarrows sublingual methylcobalamin lozenges, 5000mcg daily for a couple of months then reduce to 1000mcg daily as a maintenance dose. Let them dissolve under the tongue to get directly into the bloodstream, don't chew or swallow as stomach acid destroys B12. As they're sublingual they can be taken without food.

When taking B12 we also need a B Complex to balance the B vitamins. Look for one containing methylfolate which is natural, rather than folic acid which is synthetic and requires our body to convert it and not everyone can do that.

Ferritin is very good.

As for your thyroid results, considering you're taking T3 your FT3 is quite low and that could be higher in it's range. Low FT4 isn't normally a problem and quite common when taking any form of T3 (synthetic or in NDT).

One thing that stands out is your Thyroglobulin antibodies are very high which means you are positive for autoimmune thyroid disease, aka Hashimoto's. This is where antibodies attack the thyroid and gradually destroy it. You can help yourself by trying to reduce the antibody attacks and you can do this in a few ways.

1) Adopt a strict gluten free diet. Gluten contains gliadin (a protein) which is thought to trigger autoimmune attacks so eliminating gluten can help reduce these attacks.

Many members have found going gluten free helps enormously.

2) Some people find they also need to be dairy free.

3) Supplementing with selenium also helps reduce the attacks, L-selenomethionine 200mcg daily is the usual dose.

4) Keeping TSH very low or suppressed also is supposed to help reduce the attacks.

Some reading about Hashi's so you can understand what it's all about:

If you get your vitamin and minerals up to optimal levels, address your Hashi's, and optimise your thyroid meds you should hopefully see an improvement in your symtpoms, and being optimally medicated should help with weight loss.

Don't start all your supplements at the same time. Start with one, give it a week or two and if no adverse reactions then add in the second one, give it another week or two and if no reactions add in the third, etc. This way if there are any problems you will know what has caused it.


Thank you for such a lengthy and helpful reply. I will follow up on all your advice. I have ordered some thiroyd tablets but maybe I should get my vits levels optimum before introducing this. I just feel like I would rather not be putting Levothyroxine into my body. Thank you again. Much appreciated


chriscross66 I can understand people wanting 'natural' but there are still quite a few synthetic fillers in NDT including Thiroyd so no different from Levo in that respect.

The ratio of T4 to T3 in Thiroyd might be right for you, if not there is more flexibility by adding T3 to Levo.


Maybe mumbo-jumbo, but supposedly the T4 in Levo isn't bio-identical and NDT is better for brain function.

For my current requirements, I've found NDT to provide the T4:T3 ratio wanted most easily. To nudge the T3 a bit higher, my most accurate option would be a combination of Levo, T3 and NDT, leaving the 25 ug T3 tablet whole. Horses for courses!

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Hidden I'm not great with rT3 but it's 15 in a range of 10-24, surely not a problem?

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I don't know what the asterisk is for Eljii, I've not really looked into rT3 that much, and when I see 'ratio' I wonder ratio to what? It's why I don't comment on rT3 :)

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Thank you for replying. My reverse T3 was the same level in July.


I think your Reverse T3 ratio should be 4.32 x 100 / 15 = 28.8 which would be considered OK.


I had my last tests with Blue Horizons and the previous ones with medichecks, taken at a hospital.


As already mentioned, we are so lucky to have knowledgeable individuals like SeasideSusie who so kindly takes the time to reply to our posts. She also gave me comprehensive information, thanks again.

Hope you feel better soon Chriscross66. Sorry can't help as I'm a newbie.


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