Thoughts on my labs?

[Learner1]

Interested in your thoughts on my labs... I have Hashimotos, am on gluten free diet, my vitamin D, folate, and B12 are all high normal and selenium and iodine are normal. Ferritin is high, but due to other issues. My adrenals are a work in progress, am on hydrocortisone, adrenal support, and appropriate nutrients.

In October, I had hyperthyroid symptoms and FT4 was at top of range and FT3 was 6. Today's results:

TSH .006 (.45-4.5)

FT3 2.9 (2.0-4.4)

FT4 .75 (.82-1.77)

rT3 7.9 (9.2-24.1)

Currently on 50mcg T3 and 50mcg T4. I cannot take NDT due to allergens in all versions.

My doc says to increase T3 by 12.5 mcg. I'm wondering about T4, though.

Thoughts?

Thanks!

[Clutter]

Learner1,

FT4 is low because you are taking much more T3 than T4. Low FT4 isn't a problem if your FT3 is good. Increasing T3 dose by 12.5mcg should raise FT3 closer to top of range, perhaps even over range. Increasing T4 would raise FT4 and FT3.

[Learner1 in reply to Clutter]

That's what I was thinking. So then wouldn't it be better to up the T4 which might keep my T3 in range?

[Clutter in reply to Learner1]

Learner1,

That would be my thought, especially as you were over medicated with over range FT3 a few months ago.

[Learner1 in reply to Clutter]

Thanks!

[Eddie83]

The question is, do you tolerate T4 well? You said you had FT4 at range top in the past, so I assume you do (unless you had high rT3 when your FT4 was at range top, or you had intolerance symptoms). Since you tolerate T4, it seems to me your best approach is to increase T4 so that your FT4 is about mid-range. Converting T4->T3 will give you a more even T3 level. If you decide to do more T4, you need to know what hyperthyroid feels like, and be prepared to reduce your T3 dose to deal with it. Are you taking your 50mcg T3 in one dose, or multiple doses over the day?

[Learner1]

Originally I had an rT3 of 450, so I was on T3 only for quite awhile, then had a hysterectomy and chemo for cancer. Finished all that, then chronic fatigue and crashed adrenals, all on T3, so 5 years on T3, taken in divided doses, 2/day.

rT3 went low, so only started T4 8 months ago. From what I've gathered, I convert some, but not all of the T4 I should. I've had hyper symptoms a couple times and easily recognize them.

Part of my issue is I have to get T4 compounded, which is a hassle, and comes in capsules, while the Perrigo T3 tablets break in half or quarters easily...

But from what I'm gathering, more T4 is the better way to go, right?

[Stourie in reply to Learner1]

More importantly is how you feel. You could try the t4 for 3 months say unless you have adverse reactions and if you do then stop it leave a gap and then try a little t3 say maybe start with 5 mcg and build it up. Hope that helps.

Jo xx

[Learner1]

Thanks! It's definitely about how I feel...I will give it a try.