Confused about why some people recommend that the free's both be in the upper part of their respective ranges and other people insist that the free t4 be in the middle of it's range and the frre t3 in the upper range????
I need to know the reasons why for both recommendations🙃🙃
Helllllp PLEASE!😟😟😟
I don't think prople insist on certain levels for T4 and T3 - they are mostly comments when people post their results and still have symptoms.
Also based on experiences as to where people feel optimally treated and well. You need adequate levels of FT4 in order it converts into enough FT3 for you to feel well.
As we are all so individual - some feel fine with mid-range results .....
That's why I found that when on my block and replace treatment (I'm not taking any thyroid meds now) I found keeping a diary of how I felt on each amount of thyroxine and what my blood levels were at the same time was really useful in pinpointing exactly how I was feeling on my medication.
It's very easy to think you feel great or you feel awful but it is good to be able to see what you were taking at the time.
I didn't write much, only a couple of lines but it was enough. It really helped at a point when I needed an increase in my levothyroxine and I had to argue my case with my GP who wasn't keep to interfere with what my endo had prescribed.
Interested to hear you're not taking any thyroid meds. now How did that come about and how do you feel?
Oh that's because I have Graves Disease - an overactive thyroid with antibodies. The treatment takes about a year and you are given a big dose of carbimazole to chemically zap your thyroid then when it reaches a certain stage (I became really hypo at this point which I don't think was the plan!) anyway, it reaches a point where you start to take an ever increasing dose of levothyroxine to replace your own thyroid production. In my case all this took about 11 months. When you reach a certain point you are told to stop all medicines - just like that. One day I was taking 40mcg carbimazole plus 100mcg levothyroxine, the next day and from then on I took nothing. After that you just wait and see what happens - hopefully nothing. I've been in remission fir three years now but I've heard of people who have been in remission fir a lot longer than that who have had a relapse so my fingers are always crossed.
For a while after I stopped it felt a bit odd and I think my body had been so used to being really hyper that it took a bit of time to get used to being 'normal', now it just feels normal for me.
So pleased for you, lovely to hear a success story.
That is what i am concluding about myself.
I actually think i do better with results below mid-range...🙃
In truth, only free T3 really counts, especially if your medication contains T3. Free T4 low in rage rarely correlates with optimal T3 levels. When I look at results my prime interest is in T3. If it's not high enough it's worth looking at T4. if T4 is high in range with lower T3, it's a conversion issue. If they are both low it's a matter of under-medication. (We are talking frees here, total measures are unimportant)
Yes...that is exactly what my problem is.
My free t4 is high in range and free t3 is mid range.
I am on 12.5 cytomel along with 100 synthroid now.
I was on 125 synthroid but my ft4 was just a tad above range on that dose so i lowered it to 100....fearing that too much t4 could increase reverse t3, is that right?
However, i am feeling hypo on my current dose.
Should i just increase the cytomel to maybe 15-20 mcg?
I will keep the t4 dose at 100 mcg.
FYI: i am a person without a thyroid gland due to a thyroidectomy years ago.
Thank you.
Gardenofeden,
I'm also thyroidless and feel fine with FT3 just over halfway through range. If you are feeling hypo on your current dose increase the T3 dose to 18.75-25mcg but do check that FT3 remains within range.
Not for me, for me FT4 ia important! At some point I was on 100T4/20T3 combo and 50T4 and that was a bit much, shown on symptoms and tests (TSH normal, FT4 above max, FT3 upper third, TT3 85% max) therfore was advised by endo to ditch the 50T4. In a week or ten days I've crashed quite significantly and tests have shown decent FT3 but FT4 right below min threshold and higher TSH but closer to min threshold than max one.
Therefore, for me, FT4 is valid and needs to be addressed.
After that episode I've added 25T4 and it was consistently fine, just to change it with 25T4/5T3 and was even better - that is my current dose (125T4/25T3, starting from 175 T4 only -main issue was fatigue and cognition issues)
I am without a thyroid gland so yes, t4 is an absolute MUST for me too!
I think that adding t3 makes my blood sugar go crazy.
If i add and any t3 to my t4, i will use a low dose....anything more than 5-10 mcg makes me go into sugar lows, i must immediately eat carbs to feel better, which i think has caused me to gain weight.
Sorry to be the person reviving an old thread, but like you Gardenofeden and Caesard I need some t4 or I am not fit for anything.
Though some people seem to feel fine w low t4 - which is great! - it is just *not true* that t4 is 'unimportant' in general and only t3 matters if you're taking t3/t4 combo.
When I have tried to reduce levo (wanted to see if I felt better on t3 alone) I was a shuddering wreck for a couple of days until I couldn't take it any more and added in the usual levo. The anxiety was unbelievable. This has only happened to me when I try to reduce t4.
It's the optimal part of the range where most people feel best and the body has enough hormone to function at its best.
For both free t4 and free t3?
Or just free t3?
Yes
Gardenofeden,
FT3. It doesn't matter what FT4 is if you are taking T4+T3.
what if you are just taking T3?I have blood results next week.My first on T3-only.
I am without a thyroid gland so yes, t4 is an absolute MUST for me too!
I think that adding t3 makes my blood sugar go crazy.
If i add and any t3 to my t4, i will use a low dose....anything more than 5-10 mcg makes me go into sugar lows, i must immediately eat carbs to feel better, which i think has caused me to gain weight.
For me personally, I have not felt so well for 30+ years. I'm currently only on T3, so my free T4 is extremely low and my free T3 is high. The docs are unable to comprehend these readings and don't like it, they want to reduce my T3 dose but I'm sticking to my guns with them. Best wishes x
These results are like mine. My T4 is just below normal range, and T3 is high. I feel pretty good so have decided to leave it alone.
The most important thing is how you feel. We were once told by a very reputable specialist that my daughter should increase her T3 as much as she needed. Once she started to get hyper symptoms she should stop. She gradually increased her dose until she reached 125 mcg a day. That was 12 years ago and she remains on that dose to this day. T3 supported her for many years, and still is, as she recovers. However, it was NOT the complete answer and most of her symptoms remained, and it wasn't until we found the real reason behind her thyroid problems, thanks to a brilliant doctor in the USA, that her symptoms began to diminish. You don't have to listen to any unsubstantiated theories from others about what the optimal levels within fictitious ranges should be. Listen to your body! If you still feel unwell look for different answers. Thyroid test results can be a red herring and extremely misleading. Jane x
Hi Jane,
Thanks for sharing. Can you tell us what your daughter had that was not thyroid related?
Thanks
j
Hi, With pleasure. She had chronic infections for over 20 years including mycotoxin illness, Lyme Disease, HHV6 and candida leading to MCAS, methylation and nagalase irregularities. This complex mix resulted in inflammation which impacted on every organ and cell in her body including of course thyroid function. She was extremely ill by the time she saw the doctor in the USA, but thankfully he is gradually unravelling the complexity of the illness. I will gladly send you more information by PM if you wish. Jane x
Thanks for sharing!! Much appreciated.
Yes, that would be great, except I don't know how privaled messaging works. Bit of a rookie🤔
Thanks
J
Hi, I'll send you a private message. You should see it come up on whichever device you are using. Let me know if you don't receive it. Jane x
Could you pm the USA doctor name as I have a daughter with similar issues. I'm in Texas thank you
Certainly - on its way. Jane x
I was told by my endo that I was 10 x overmedicated when I was on 60mcgs and feeling terrible. He said that our bodies only need 6mcgs of T3!! Idiot! Can tell he's not hypothyroid - he's keeping people sick.
It would seem incredible, were it true, that we have virtually no liothyronine tablets of less than 20 micrograms.
(Yes, I know about the four USA 5 microgram tablets - Mylan, Perrigo, SigmaPharm and Pfizer Cytomel - but am not aware of any others in any other country.)
Also, what an amazing coincidence that 6 micrograms is one quarter of a 25 microrgam tablet. And we in the UK don't get them (as standard). Looks like a lazy conversion from something that was written in a 25 microgram country.
I just go by STTM - my t4 is below range and my t3 is high. So Im told Im pooling and must correct it. But I've decided to just leave everything as it is, as I feel good. Other people say their results are the same on NDT, and others have different results. Confusing.
Kathy, The fact that you are feeling well means you are not pooling. You just have to interpret the meaning of the test results along with the symptoms or no symptoms of the person. I did well on T3 only so I wasn't concerned with the FT4 level.
FreeT4 needs to be in the middle of the range and T3 at the top because you won't feel well if they are not. T4 is the storage hormone and T3 is the active hormone that works.
Put simply, the FT4 about 60% of the range and FT3 about 75-80% of the range is where most people feel their best. If everything is rising as they should if the FT4 is at say 60% of the range, the FT3 will be at 75-80% of the range.
If they don't then there's an issue somewhere either a nutrient issue, not enough FT3 getting into the cells. Where your levels are tell a story somehow, it's just that most practitioners don't understand it. Hope that helps in simple terms...
You also need to focus on how you feel as the best indicator of how things are for you, it's very individualistic not set in stone, just like shoe sizes, one doesn't fit all...
If you are perfectly healthy, having both frees in the upper part of their ranges would probably work. However if your health is still far from perfect - if you still have the long lingering effects of leaky gut - then you may be one of those people (like me) who actually feel BETTER when FT4 is low in range. While I was suffering from the lingering effects of celiac enteropathy, I could just barely get my FT4 into the bottom of the range; if I tried to get it higher, I would get bothersome anxiety and generally unwell feelings. If I shoved FT4 too high, my body would protest, instead of converting it to T3. Basically, it's all about what works for you - what makes you feel well. I've always known I could tolerate high FT3 because I was on T3-only, with success, for over a year. I still have FT4 low in range, though now that I know I'm converting better, I am going to be trying to get it higher.
I actually have IBS so if my free T3 goes high in range do you think that could worsen my symptoms or should I just lower the free T3 and increase free T4
So long as your FT3 is in-range, that should help you because proper T3 level in the gut assists digestion. I know that FT3 high in range did not worsen enteropathy symptoms for me. However, pushing FT3 overrange can produce puzzling symptoms that are not obviously hyperthyroid, so being aware of where you are in the range is important. Keep in mind that taking high doses of T3 all at once can cause blood level spikes, so if you can convert T4, keeping your T3 dose relatively small is preferable.
Thank you.
I think when i was on 125 synthroid ONLY...my free t3 was 4.9 (range 3.5-6.5)
My free t4 was at top of range @ 25 (range 10-25).
Do you think my free t3 was a tad too low?
Should i try to add 5-10 mcg of t3 (cytomel) to my 125 synthroid?
Should i lower my dose of synthroid to get it mid-range....or is it ok to keep it high, as adding t3 may lower it a bit?
Thx
Your FT3 is 47% up in range. Which isn't bad, but many people here would want to see it nearer the top. If you want to add in a little T3, you should probably reduce your T4. With a T3 power factor of 3, 5mcg T3 would be roughly equivalent to 15mcg T4. So if I were doing it, I would reduce Synthroid to 112mcg, wait 4-7 days, then introduce T3 2.5mcg. See how that goes for a few days, then if you are doing ok, go to T3 5mcg. If you aren't getting a clear benefit with 5mcg, then I would reduce T4 again in a similar manner, before going as high as 10mcg T3. FYI, I have been on T3+T4 at 15+75 for quite a while, but recently dropped to 10+75 because my FT3 was over range. I am going to be increasing T4 a little, and monitor the results with a FT3 test because that is the bottom line on feeling well.
Thx Eddie😊
Do u think i might have a conversion problem?..or is that only true if my free t3 was below range?
The fact that your FT4 was 100% up in range, but your FT3 was 47% up in range, says to me that your conversion is good, but not excellent. However all that really matters at this point, is whether you actually feel better if you add in a little T3. If it doesn't make you feel better, then you are saved the annoyance of having to take an additional pill!
Ok.
Well i guess i was worried that a free t4 high in range could somehow increase my chances of producing too much reverse t3.
I live in Canada and my doctor will not test my rt3.
I have added as much as 12.5 t3 to 100 t4 before and it caused weight gain!
So i stopped the t3.
Why would i gain weight???
Argh. I sent you a long reply and it disappeared. I am baffled as to why 12.5+100 would cause weight gain compared to T4-only of 125. Testing is probably the only way to figure that out ... the only other question being, did T3+T4 make you feel different (better?) and do you think that altered your eating patterns?
Personally, I would not push my FT4 as high as you have because I *would* worry about rT3. I am baffled as to why T3+T4=12.5+100 would cause weight gain compared to T4=125. How long were you on the 12.5+100, and how did you feel (compared to T4=125) while you were on it? I'm assuming you did not have comprehensive testing before you were on it, or while you were on it.
Do you desire to add in T3 because you feel like you have low energy, and want to see if you can increase your energy? Do you feel your brain function is not as good as you would like, or is there something else that you are hoping to get from T3?
While you were on the T3+T4, do you have any recollection of whether or not it affected your food intake?
Hi.. sorry i was out walking my spoiled dogs...i really appreciate your comments!
You really make a lot of sense!
To tell you the truth...the addition of 12.5 t3 seemed to make my blood sugar unstable.
Meaning, i felt weak, shaky and hungry a few hours after i took my cytomel.
I felt hypoglycemic.
If i didn't get carbs in me, i am sure i would pass out!
Very unstable!
My doc took a fasting glucose test and all was good.
When i am on t4 only i don't feel these crashes as much.
Perhaps i metabolize t3 differently than most???
I think i might try 112 t4 and add a little cytomel.
Thx for your input!😊😊😊
Does unstable blood sugar usually cause weight gain?
Also, if i may ask, do you still have a thyroid gland?
Chat soon!
Taking a moderate dose of T3 when you are close to euthyroid, can destabilize things! Over the last 3 test cycles, as my conversion has improved, my non-fasting blood glucose has dropped from 99 to 89 and then to 80. (My FT3 was actually over-range for that last reading.) When I noticed my FT3 was over-range, I dropped from 15mcg to 10mcg T3, and I do feel more stable. This makes me suspicious that a dose of 12.5 is too much for you! I suspect I could go hypoglycemic if I tried to push my T3 dose above 15mcg. It sounds like 5mcg T3 might be sufficient to give you that little extra boost.
Yes, I still have a thyroid gland in my neck, but it became spare baggage quite some time ago, thanks to Hashi's.
Would you happen to know if unstable blood sugar/crashes cause weight gain?
Search says hypoglycemia can cause either weight gain or loss. I think it was causing me modest weight gain until I reduced my T3 dose.
Wow!
Same here!
I have been on soooooo many different doses of t4...t4+.t3 for the past 16 yrs...and every single time i fiddled around with t3...up goes my weight😕
I was always told i should experience weight loss, by forums such as this or by my doctor😛
Tomorrow i will increase my t4 to 112 and lower my cytomel.
Or should i stop cytomel all together, cold turkey, to see how i feel on 112 t4 only for a few weeks?
Were I in your position, I would stay on T4=112 for a couple weeks to see how I feel.
Yes it does. Your insulin land glucose levels should be kept stable. Switching to a Paleo aka Ketogenic diet will help with this.
Sounds like you might benefit from NDT which has T3 and T2 and T1 plus calcitonin so is a closer match to what the thyroxine the body naturally produces.
How much T2, T1 and calcitonin does desiccated thyroid actually deliver to a person taking it?
Does porcine calcitonin work the same as human calcitonin?
I don't know as the quantities of T2 and T1 are not listed.
So how do you claim there is any effect from it?
I have read on several different sites that T1 and T2 are merely byproducts of t4 to t3 converstion and have no purpose.
Whilst I agree that T2 and T1 are produced by conversion (from T3 and rT3 to T2, from T2 to T1), I am of the opinion that at least T2 is important. Have a look at the considerable number of papers which at least mention it:
ncbi.nlm.nih.gov/pubmed/?te...
The issues in my book are:
How much T2 and T1 is present in desiccated thyroid?
Can T2 and T1 be delivered in sensibly usable quantities to the required location from desiccated thyroid?
My guess is that the amounts of T2 and T1 are low (and uncontrolled so, potentially, variable at least from batch to batch and make to make). And that the amount that can be and is delivered is so low as to be almost insignificant.
If there is proper evidence in any direction, I'd like to see it.
I'm not claiming anything. NDT has T4, T3, T2 and T1 and calcitonin, similar to human hormone. The effect depends on the individual. Many people feel better on NDT than synthetic T4 only, as we often read on here.
It is possible to heal leaky gut. See Dr Josh Axe website and the Autoimmune Epidemic Docuseries airing now for free. It isummarise all the latest research from 85 Drs and scientists. Presented by Dr Tom OByryan. James Maskell of The Evolution of Medicine is also airing it this weekend.
I think the usual target recommendations given for Free T4 and Free T3 are for people who have a thyroid gland which still has some function and are taking Levo.
But it can only ever be a guess, and everyone has to start somewhere. The actual levels that people feel well with are highly individual.
Some reasons that I can think of that might alter the levels of Free T4 and Free T3 that are optimal for different people.
1) Having a thyroid gland - the degree of damage will be different from person to person.
2) Having different levels and types of thyroid antibodies.
3) Not having a thyroid gland obviously changes lots of things.
4) Having gut problems affecting absorption of meds, vitamins, minerals.
5) Having low, good, or high levels of cortisol, adrenaline, aldosterone and any other factor in adrenal health you can think of.
6) Being male, being female before, during or after the menopause.
7) Having low, good, or high levels of sex hormones like testosterone.
8) Having a healthy or unhealthy pituitary and/or hypothalamus.
9) Having other health conditions which increase inflammation.
10) Being on Levo only, Levo + T3, NDT only, NDT + T3, NDT + Levo, T3 only
That's all I can think of for now. But all of these potentially alter the levels of thyroid hormones which are right for different people, and the recommendations suggested here are just that - recommendations which might or might not work.
Exactly.
My problem is i have no thyroid gland so i never know if my free t4 should stay nice and high as a reserve hormone, as i have no gland to compensate...😑
Would anyone on here be somewhat of an "expert" on the topic of treating those without a thyroid gland?
Clutter doesn't have a thyroid gland. I'm sure there are loads of others, but my mind has gone blank - sorry!
Thx.
Hopefully Clutter see's this!😉
Gardenofeden,
I commented earlier on the thread. There isn't a magic formula, if you don't feel well try increasing your T3 dose. You don't have to have FT4 high in range when taking T3.
I am without a thyroid gland so yes, t4 is an absolute MUST for me too!
I think that adding t3 makes my blood sugar go crazy.
If i add and any t3 to my t4, i will use a low dose....anything more than 5-10 mcg makes me go into sugar lows, i must immediately eat carbs to feel better, which i think has caused me to gain weight.
Sorry...this comment was meant for someone else who feels crazy without t4😐
Confused
Carbimazole Confusion
TSH -DOES IT MATTER A LITTLE?😕confused.
Different ranges - confusing
