Please help me decide which dose of thyroid-s to stay on.

[JS33]

Hi , Newbie here asking for some help to decide what dose of thyroid -s to stay on. I have recently had labs done at 4 grains which were as follows : THYROID STIMULATING HORMONE * <0.01 mIU/L 0.27 - 4.2 FREE THYROXINE 18.0 pmol/l 12.0 - 22.0 FREE T3 * 6.9 pmol/L 3.1 - 6.8

I was previously on 3.75 grains : THYROID STIMULATING HORMONE * <0.01 mIU/L 0.27 - 4.2 FREE THYROXINE 16.6 pmol/l 12.0 - 22.0 FREE T3 6.2 pmol/L 3.1 - 6.8

I do feel a little better at 4 grains , but I was concerned the T3 Is very slightly over range and the thought also perhaps T4 was slightly high considering I am using natural thyroid. I was only on 3.75 grains for four weeks , maybe i would have felt a little better given more time. I am not having palps or anything really negative on 4 grains , and although it's only been a month , my mood is a little better.

I am just concerned about the numbers, as the 3.75 grain numbers look better on paper, even though i didn't feel it after 4 weeks.

[RedApple]

Welcome JS33,

It would be helpful if you added the following info...

Time of day for each blood draw. Number of hours between last dose of thyroid medication and each blood draw.

[JS33 in reply to RedApple]

Thanks redApple, the blood was drawn 7 am on both occasions , with no meds before drawing , but I usually take it in two doses , the larger at 7 am and the rest at 2 pm.

[RedApple in reply to JS33]

So that means 17 hours between last dose and blood draw. Going by bloods alone, I'd say you need to drop back, maybe even to 3.5 grains. But obviously, how you feel counts too. Do you have results for when you were on 3.5 grains?

[JS33 in reply to RedApple]

Not for 3.5 grains , but i am interested in what it is about the bloods makes you think a drop to 3.5 grains maybe required. I read on 'stop the thyroid madness', with regards to blood hormone levels, aim for T4 mid range and T3 upper third or maybe just over, but I see a lot of people say their T4 is low below range on NDT. That's why I thought the 3.75 grain results looked better on paper as both levels were in accordance with that recommendation, but at 4 grains the T4 was little over mid range.

Maybe I feel better on 4 because I'm a tad hypo LOL. If I was to try 3.5 , do you think I should go to 3.75 for a few weeks first, dropping a half grain in one go sounds like I would feel a bump ?

[RedApple in reply to JS33]

If it was me, I'd drop to the 3.5 grains as I see no good reason to drop back cautiously. I personally don't agree with the idea that FT4 should be that high when on a desiccated thyroid med. When you have sufficient T3, you don't need so much T4. Your body doesn't need to convert the T4 to T3 as the T3 is already there, and the excess T4 can bring about it's own set of symptoms. There are no hard and fast rules as we're all different, and each of us has to find our own 'sweet spot'. Often people get so wrapped up in increasing their dose and go sailing past the dose that they really need. I'm not medically qualified though, and can only go by what I've learned over the years

[JS33 in reply to RedApple]

yes , I can see the logic. I did have a test at 2 grains, my t4 was 9 (12-22) and T3 6.2 (3.1 -6.8) TSH 6 , but I could barely walk and talk I was that hypo. I went past 3.5 without a test , so really , dropping for a month is worth considering , after all , I would soon know, if I was meant to be on 4 I would soon feel wrong on the 3.5 and it would be interesting to see a blood count there as that would give a good picture ranging from 3.5 , 3.75 and 4 grains.

[silverfox7]

I would drop back to 3.75 and test again after 6 weeks. I've found when near where you want to be then a quarter grain can make a big difference. I would t feel comfortable being slightly over range but my endo told me on my first meeting when I said I was on NDT that TSH will be almost as low as 0.01 or even zero and that FT4 likely to drop to half way in range if your body is happy with your FT3 levels.

[JS33 in reply to silverfox7]

Thanks silverfox7 , according to STTM , too high a T4 on NDT increases the chance of reverse T3 , which is another concern. I thought I felt better on 4 grains , but today I noticed by bed feeling very comfortable when the alarm went off.- perhaps it's starting to catch up with me, I think I'll drop down again , and leave it a little longer.