T3 Query

[Loub37]

Hello, I would just like to take this opportunity to wish everyone a merry Xmas & a happy new year. Also whilst I'm on here, I would like to ask a question but before I do I will post my latest blood test results.

CRP 5.40 < 5.0

ferritin 50.5 20-150

TSH 1.21 0.27-4.20

T4 total 136.0 64.5-142.0

free T4 20.15 12-22

free T3 4.33 3.1- 6.8

Anti thyroid peroxidase 359.1 <34

anti thyroglobulin ABS 29.9 <115

vit D 111 deficient <25, insufficient 25-50, consider reducing dose>175

B12 1038 deficient <140, insufficient 140-250, consider reducing dose>725

foliate 42.61 8.83-60.8

Something puzzles me about T3. My latest results is 4.33 at which I feel exhausted on exertion & have gained another stone in weight over the past year but last December when I was building up the dose of levothyroxine, after having been off it for 10 months my T3 was 4.96, which wasn't too bad. Then in May this year, it was 5.25 which I thought was pretty good although my dose of levothyroxine was too high (0.03) with symptoms, so I reduced the dose from 125/150 alternate days to 125 with the current posted results but my T3 seems to have plummeted which I thought seemed rather a lot considering how good it was previously.

Does anyone have any thoughts?

I have got some T3 to take & was wondering how I should take it? Can you take with levothyroxine & also should I lower the dose or maintain it at 125?

Thanks in advance for all your help.

Lou x

[shaws]

Your TSH is on the high side. Preferably it should be 1 or lower. So a small increase in levo might bring up the FT3 as well.

[Loub37 in reply to shaws]

Thanks for your reply Shaws. I lowered the dose because I was feeling unwell on 125/150. I lowered it to 125 daily instead & feel better until I start doing anything! T3 was definitely higher on 125/150 but I still had awful exhaustion. I feel like I've hit a brick wall!

Lou

[SeasideSusie Remembering]

Loub37 My thoughts only, and I am not medically trained, just basing on my own experience.

Firstly, your ferritin is too low for thyroid hormone to work properly. It needs to be a minimum of 70, generally half way through range is suggested, and I've seen it said that for females it should be 100-130. So you need to get your ferritin up either by supplementation or by eating liver regularly (which worked very well for me as I can't tolerate iron supplements).

Secondly your high TPO antibodies are positive for autoimmune thyroid disease aka Hashimoto's and you need to try and reduce the antibody attacks. Many members have found that adopting a strict gluten free diet helps enormously, as does supplementing with selenium L-selenomethionine 200mcg daily, plus a suppressed TSH (so there's no need to worry about your low TSH, it's unimportant when on replacement thyroid hormone despite doctors freaking out about it).

Your current thyroid results show that you don't convert particularly well. Good conversion takes place when FT4:FT3 ratio is 4:1 or less. Yours is 4.65 : 1. So adding some T3 could be beneficial and may be worth a try. You can add it to your levo but start low (a quarter of a tablet) and go slow, don't increase too quickly. Keep an eye on your results and adjust Levo and T3 as necessary. FT4 will usually lower when on T3, and it's generally suggested to keep FT3 within range.

[Loub37 in reply to SeasideSusie]

Thanks for your reply SeasideSusie. Yes I have got to work on the ferritin. I didn't get on particularly well with iron, so your tip comes in handy! I was able to convert T3 a few months ago to 5.25 but my dose of levothyroxine was too high. I started feeling unwell & so reduced the dose. The T3 has plummeted which I find odd.

Lou

[SeasideSusie Remembering in reply to Loub37]

As all your other vits and mins are good, it's possible that optimising your ferritin will help, particularly with the exhaustion as that is a symptom of low ferritin.

[Loub37 in reply to SeasideSusie]

Thanks SeasideSusie. I am definitely going to sort that one out as I know it can cause problems. I could feel myself becoming very tired once I dropped the dose of levothyroxine but the symptoms were hard to tolerate.

Lou

[Musicmonkey]

There's also the possibility that if, as you say, you don't convert well, that the higher levels of Levo created rT3 meaning that the conversion lowered still further and made you feel less well.

You could add a small dose of T3 and monitor symproms and re-test bloods after 6 weeks.

I'm not a medical expert just a fellow sufferer.

[Loub37 in reply to Musicmonkey]

Thanks for your reply Musicmonkey, that is an interesting thought as I think thats where all my troubles started 2 years ago. I felt the dose was either too high or too low & I couldn't get it right, so it could be the answer.

Lou

[Musicmonkey in reply to Loub37]

Loub37 if you add T3, I would reduce T4 because if the assumption is correct that you are unable to convert it effectively, you will be able to get your T3 directly and in theory shouldn't need as much Levo.

[Loub37 in reply to Musicmonkey]

I have some T3 I purchased a little while back, so will have a go with that I think. The only thing that really puzzles me is why my T3 was a 5.25 earlier in the year when I was taking a slightly higher dose of levothyroxine & then should fall so dramatically when I only lowered the dose slightly. It was also higher than it is right now last year when I was building up the dose.

Lou

[Musicmonkey in reply to Loub37]

It is a puzzle! Did you have your blood tests under the same cconditions, i.e. same time of day, same time since last dose, fasting, etc.?

[Loub37 in reply to Musicmonkey]

Yes all exactly the same Musicmonkey. That's why I can't understand my lack of conversion now. Even my vit D was lower back then & my iron was higher. It's a mystery to me, but one thing is for sure, I feel a lot worse now.

Lou