T4 dragging the floor but feel fine

Hi all

Just had my test results back after 13 weeks on ndt , 2 grains - been feeling good, temps good . Was hoping to get my t4 into mid range but instead got these disappointing figures

TSH 0.01 (0.27-4.2) always suppressed so ok

T4 12 (12-22)

T3 4.5 (3.1-6.8)

T4 was slightly higher last time I tested although not quite where I wanted it (14.?) and t3 was definitely nicely up in the upper third ( same dose ) I was expecting to see an improvement in these labs.

I was supported with supplements when I last tested but had dropped back on those so maybe once they are fully reinstated over the next few weeks my figures might improve.

Just very wary of increasing above 2 grains as has the potential to cause me issues. 2.5 grains sends me hyper. Suppose could try 2.25 - and be brave - any thoughts most welcome ( I want to conceive so looks like I still do need some fine tuning)

Thanks .

17 Replies

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  • Katoir,

    FT4 is usually much lower on NDT than on Levothyroxine. It doesn't matter that FT4 is low when FT3 is good. You say you are feeling good so there's no need to increase dose. How you feel is much more important that blood results.

    In the UK it is recommended that women planning conception should have TSH in the low-normal range 0.4 - 2.5 with FT4 in the upper range. Of course, they are basing that on women taking Levothyroxine. You will almost certainly be pressured to revert to Levothyroxine when you are pregnant.

    british-thyroid-association...

  • Ok Clutter - thanks

    But why mess with it if it's all ok . Argh

    Really not liking the idea of converting when I'm feeling so well .

    Makes me think I need to convert now and I'm actually happy where I am (finally)

    potentially could feel rather rubbish on levo and struggle to find the correct range .

  • Katoir,

    You don't have to switch but you will be pressured to do so.

  • Yes- I think I would have a go at explaining that the t4 is lower with ndt and use Doctor P

    I actually thought I wouldn't be able to sustain a pregnancy unless the t4 was at least mid range , t3 upper third . As you say I feel good though .

  • Clutter - could I just clarify please .

    Question- If well and pregnant on ndt and my t4 persisted in staying at the lower end of the range and the t3 staying higher up in the range would that still be a safe level to sustain pregnancy or would I be better off increasing the dose and aiming for that mid range ? ( I know it's hypothetic- apols)

    I guess it wouldn't be the end of the world reverting (although technically not reverting as I've never been on Levo) as long as the gp knew what they were doing and it didn't rock me around too much which is my concern.

  • Katoir,

    I find it hard to believe that a pregnancy can't be safe on NDT when NDT was the only replacement prior to Levothyroxine but I don't know of any evidence to show that it is safe. Lack of evidence doesn't mean that NDT is unsafe during pregnancy but you're unlikely to find UK doctors happy that you are taking NDT during pregnancy without evidence it is safe.

    Perhaps there is evidence in the USA where NDT is more widely used. hypothyroidmom.com site and FaceBook page may be helpful.

  • Ok.

    There must be people on here who have some experiences to share regarding their t4 on ndt .

    I can't see much specific about the t4/t3 ranges in hypothyroid Mum .

    Thanks

  • Katoir,

    Why don't you write a question asking about members experiences taking NDT during pregnancy.

  • Just did that - you read my mind

    Have asked the t4 question

  • Hi

    As no one replied I've been thinking about this a lot

    I will ask doctor p.

    If I added in a little Levo how much do you think I'd need. My gp won't know as she doesn't seem to know much about thyroid at all. I'm thinking If it's a tiny amount it should raise the t4 a little and not affect me too much.

    Althoughhypothetical I want to have a plan as we are wanting to try again in a few minutes months .

  • Minutes !!! Meant to say months !!

  • Katoir,

    I suggest you contact some of the American sites like hypothyroid.mom, Mary Shoman, Gena Nolin and ask whether pregnant women continue taking NDT during pregnancy and, if so, what thyroid levels they aim for.

  • Katoir have you joined 'thyroid disease and pregnancy' page on Facebook? There are people on there who seem quite knowledgable about non-levo thyroid hormone replacement in pregnancy and relevant levels.

  • No - would be interested in that .

    Take it, I'd find it via google ? X

  • You would have to create a Facebook account via a google search yes. facebook.com

  • Katoir,

    My labs look pretty much like yours on NDT and I feel just fine. I tried to raise it slightly in order to increase my FT4 levels, and ended up with out-of-range FT3 levels. Like Clutter says, FT3 levels are what's important when on NDT.

  • Very similar Anna.

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