My stubborn T4 finally on range but still high T3

Hi guys, my last labs arrived and I just wanted to share with you for updates.

Labs 11/21/2016 8:45 am my last dose was taking 24 hs before the lab. I was on 1 1/2 grain of NDT + T4 75 mg (levothyroxine)750mgTSH: 0.0 0.40-4.50 mIU/L

FT4= 1.4 0.8-1.8 ng/dL

FT3= 4.4 2.3-4.2 pg/mL

Vit D= 28 30-100 ng/mL

TESTOSTERONE= 310 250-827 ng/dL

My stubborn T4 FINALLY raised to awesome normal levels after raising from 50mg to 75mg of levothyroxine. (T4= 0.9 former lab to 1.4 actual ) I knew that's the combination of NDT + T4 was what I was needing it. And in regarding my T3 I replaced my old 12.5 mcg of T3 from my former lab to 1/2 of NDT on my actual lab.

FORMER LABS: 08/29/2016 9:12 am My last dose was taking 24 hs before the Lab. I was on 1 grain of NDT + 12.5mg T3 + T4 (levothyroxine) 50 mg:

TSH: 0.01 0.40-4.50 mIU/L

FT4= 0.9 0.8-1.8 ng/dL

FT3= 3.5 2.3-4.2 pg/mL

Cortisol (bloodwork)= 10.4 mcg/dL

8.10 am 4.6-20.6 mcg/dL

4-6 pm 1.8-13.6 mcg/dL

PROLACTINE: 5.2 2.0-18.0 ng/mL

QUESTIONS:1) Do you think I still need to drop that extra 1/2 NDT grain to get normal T3 levels? And doing that, will my T4 will drop a bit also since it also contains T4?

I was happy losing some weight and I think is because my T3 is high. I am going to do a stupid question:

2) Do you think I should keep that extra 1/2 NDT that's keeping my T3 high, lose some weight and then drop it until I drop several more pounds? Or Actually I would lose even more weight after that T3 will drop and reach a normal range?

3) Also, I started on NAC two weeks ago. Do you think is the NAC making me lose weight or is the high T3?

4) My former labs reflected a normal T3 levels (3.5), even when I was on 1 grain of NDT + 12.5mg T3 + T4 (levothyroxine) 50 mg. Yet my actual labs shows a even higher T3 (4.4) even when I replaced 12.5 mcg of T3 for 1/2 of NDT + 1 1/2 grains of NDT + 75mgs of Levothyroxine. Why is so that?

Thank you and sorry for my lame questions.

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9 Replies

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  • Hi, I think that if you feel good with a highish t3 then just stay on it. They are only reference ranges and not set in stone. That is just my opinion and I am not medically trained. It's how you feel that is most important.

    Jo xx

  • Xanderusa,

    FT4 is usually lower when taking NDT or T3+T4 than when taking Levothyroxine only. Some people have FT4 below range. T4 is a storage hormone for conversion to T3. High levels of T4 aren't required when you are taking T3 direct. Lowering either NDT by 1/4 grain or Levothyroxine by 12.5mcg will bring down FT3.

    VitD is optimal around 50ng/ml. I would supplement 5,000iu D3 daily for 2-3 months and then reduce to 5,000iu alternate days and retest in May. Take vitD 4 hours away from thyroid meds.

    ______________________________________________________________________________________________

    I am not a medical professional and this information is not intended to be a substitute for medical advice from your own doctor. Please check with your personal physician before applying any of these suggestions.

  • My advice would be to only change one thing at a time. It looks like since your last bloods you dropped T3 and added an extra half grain of NDT.

    You dont mention if you feel well or have had any improvement on the new dose. So I'm not sure what you're goal is. Are you hoping to get your blood tests looking perfect, or are you trying to reduce symptoms. If you felt good on it, either of these two sets of bloods would be fine.

    If you drop the half grain of NDT, your numbers will drop back to or below what they were in the former test, because you'll be taking less hormone in total. If you hope to get to in between the two, you could try dropping a quarter grain.

  • Thank you all for your thoughts. I want to lose weight desperately. And for the first time in many time i am experiencing slightly weight loss. I am still undecided if it is because the high ft3, or the NAC that i am taking, or the right range of mythe ft4?

    I have restless.. legs at night, neck stifness, muscle pain, lack of energy at mornings mostly. I am also getting rid of lyme disease with MMS and it is working very slowly even tho.

  • If you are feeling more optimistic why not stay on those doses. You are not that far off and when testing FT3 I think it is extremely variable. When did you take your last dose before drawing blood? Some say it peaks at four hours and since the half life is only twelve hours in length it can be difficult to get an exact figure. You could at least wait till your next testing before you make any change. Your adrenals have to adjust when raising thyroid hormone. Once you are optimal, other problems may disappear. Try to get all the nutrients your body needs.

  • Who says 2.3 < FT3 < 4.2 pg/ml is "normal"? The lab you use. My lab says 2.77 < FT3 < 5.27 pg/ml is "normal". Are you aware there are various "normal" ranges, and labs do not tell you how the sample of people for the "normal" range they are espousing, was selected? My doc used to use a lab that espoused 2.3-4.2, but when he switched labs, the range moved up. And yes, my FT3 is above 4.2 with no ill effects.

    Focus on how you feel - THAT is the important issue. I am assuming that you are on a comprehensive supplement program. However, I do think you should try to get that 25(OH)D up to ~50.

  • I wouldn't drop NDT because you are getting other hormones from that - like T2 and T1 as well as the two we are familiar with T4 and T3. I would reduce the Levo very slightly , e.g. miss out one day a week to begin with (T4 "accumulates" and average over its half life - one week) and see what effect that has.

    But basically, like many have said here, the main thing is, how do you feel? If the answer is "good" then don't mess it up. It may be impossible to feel good AND please the doctor with your blood test numbers - don't even try, it nearly killed me.

  • I see, but how can the FT3 will be reduced since there is no T3 on Levothyroxine? I'm confused on that.

  • The Levo supplies (only) T4 and your thyroid or peripheral organs (like your liver) converts the T4 to T3. Perhaps you have very good conversion which is adding to the T3 that the NDT is supplying.

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