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Thyroid UK
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Can anyone help? On combination t4 - t3 treatment. Latest labs low.

Can anyone tell me where to go from here? latest labs came back low (results below).

My GP says they are adequate and my endo appt is not until may.

Joint pain, lethargy, internal shakey feeling, some nausea and lack of appetite. mood is good and no brain fog.

I am taking 100mcg t4 and 25 t3.

There are some signs of inflammation with no obvious cause.... this has happened before. I feel as if I am banging my head against a wall. Any advice welcome. My feeling is to try to address the inflammation, ensure the iron b12 and folate are in top range and swap to ndt. any help or clarification VERY gratefully recieved. Cait x

TSH 0.18 (0.27 - 4.2)

free t4 11.1 (12 - 22)

free t3 3.8 (3.1 - 6.8)

folate 3.2 (>3.9)

b12 498 (197 - 771)

D 25OH 91 (50-120)

7 Replies


Are you self medicating T3?


No prescription from GP on recommendation from nhs endo.



I think you could do with either Levothyroxine or T3 dose being increased to raise FT3 which is low in range. FT4 is low because you are taking proportionately a high T3 to Levothyroxine dose. Raising either dose will suppress TSH which your GP and endo might find problematic.

Folate is deficient. My GP prescribed 5mg folic acid for a couple of months to correct my folate deficiency.

B12 498 is unlikely to be deficient. Don't supplement B12 until you have corrected your folate deficiency as B12 and folate work together.

VitD 91 is in the replete range >75.

1 like

Is your thyroid problem autoimmune, i.e. Hashimotos/Graves?

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originally graves. partial thyroidectomy over 35 yrs ago and thyroxine 25 years before getting t3 treatment.


Hi - how is your ferritin, the other one in the "thyroid quad"?

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Ferratin not tested as far as I can see. But will check it out. Thank you Cx


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