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Thyroid UK
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Can anyone help me with my t3 levels?

Hi everyone, I was just wondering about my latest blood results:

TSH 1.01

T4 17.3

T3 3.1

I went to the docs because I am putting on a little weight but mainly my left hand keeps getting pins and needles in it. Before my blood test, I upped my dosage from 100/125 mcg (my tsh went around 3 on this dose) alternate days to 125 every day for a week beforehand. Anyway, isn't my T3 a little low? Would others act upon this result?



31 Replies

Your T3 does look as if it could be low but you need to add in the ranges of your results as labs differ throughout the country in their ranges. Re pins/needles doctor should also check your Vitamin B12 and at the same time Vit D, iron, ferritin and folate if you've not had them recently.

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Auntbessy It's possibly low but without the reference ranges for your FT4 and FT3 it's not possible to say how well you are converting or whether your FT3 is very low in range. Can you please edit your post to include them.

The pins and needles could very well be low B12. Ask for vitamins and minerals to be tested or do them privately with Blue Horizon or Medichecks:

Vit D




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Thanks for replying so quickly! The ranges are

t3 3.1-6.8

tsh 0.27-4.2

t4 12-22

I often have low ferritin and B12 and take drops for the B12 and take spatone for the iron problem. My docs seem very awkward about retesting me for levels if I ask more than twice a year!



TSH 1.01 (0.27-4.2)

T4 17.3 (12-22)

T3 3.1 (3.1-6.8)

As Diogenes has said, your FT4:FT3 ratio is 5.6 : 1 .Good conversion takes place at 4:1 or less and adding some T3 would help. However, don't hold your breath that you will get it prescribed. A GP wont prescribe initially, you would need to see an endo and then your GP would have to agree to fund it. Due to the extortionate cost of T3 (currently around £250ish for 28 tablets I believe), very few health authorities are allowing new prescriptions for T3.


What? That's crazy. What do people do then?


We self source, self medicate and do private blood tests.

Some people tell their doctors, some of us don't.

In the first instance discuss with your doctor, he may or may not know anything about T3 and conversion, some don't. Some endos are recognising poor conversion and adding T3 to Levo.

You can always tell your GP that you have taken advice from NHS Choices recommended source of information for thyroid disorders (which is ThyroidUK) and you understand that your conversion is poor and that you might benefit from adding T3. If he's dismissive then suggest a referral to an endo.

If you go down the endo route, email louise.roberts@thyroiduk.org.uk for the list of thyroid friendly endos then ask on the forum for feedback (replies must be by private message) so that you don't waste time seeing one who won't contemplate the addition of T3.

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So would you say I have a good case for bad t3 conversion? Do the nhs docs tend to wait till you go under their lab ranges? Thanks for your help. Everything you have told me has been so helpful and informative : )


Yes, you have a good case for poor conversion.

At 17.3 your FT4 is 53% through it's range of 12-22.

At 3.1 your FT3 is 0% through it's range of 3.1-6.8.

Unfortunately, the NHS rarely tests for FT3 and don't seem to attach any importance to it. The reality is that T4 is a pro hormone, it is inactive and some of it converts to T3 which is the active hormone that every cell in our body needs. Without a decent level of T3 we cant function well and remain hypothyroid.

From ThyroidUK's main website > Hypothyroidism > 'Treatment Options':

' According to the BMA's booklet, "Understanding Thyroid Disorders", many people do not feel well unless their levels are at the bottom of the TSH range or below and at the top of the FT4 range or a little above.

Dr Toft states in Pulse Magazine, "The appropriate dose of levothyroxine is that which restores euthyroidism and serum TSH to the lower part of the reference range - 0.2-0.5mU/l.

In this case, free thyroxine is likely to be in the upper part of its reference range or even slightly elevated – 18-22pmol/l. Most patients will feel well in that circumstance.

But some need a higher dose of levothyroxine to suppress serum TSH and then the serum-free T4 concentration will be elevated at around 24-28pmol/l.

This 'exogenous subclinical hyperthyroidism' is not dangerous as long as serum T3 is unequivocally normal – that is, serum total around T3 1.7nmol/l (reference range 1.0-2.2nmol/l)." '

Dr Toft is past president of The British Thyroid Association and leading endocrinologist. You can email Louise (as above) for a copy of the article to discuss with your GP.

Note that the article is talking about being medicated with Levo. When you add T3 then TSH and FT4 can lower, but again it is the FT3 result that is important.

It's also worth being aware that all nutrients should be at optimal levels for thyroid hormone to work properly, these are:

Vit D - 100-150nmol/L

B12 - very top of range, even 900-1000

Folate - at least half way through it's range

Ferritin - a minimum of 70, recommended is half way through it's range

If your GP won't test them then you can get them done privately with a fingerprick test as mentioned above.

Supplementing to achieve optimal levels then stopping supplements is a waste of time, once optimal then a maintenance dose is needed to stay there.

It's also worth testing for Thyroid antibodies to rule out (or in) autoimmune thyroid disease. There are two types - Thyroid Peroxidase (TPO) and Thyroglobulin (TG). The NHS rarely does TPO and almost never TG. Again these can be done privately.

There are a few general supplements​ that it's worth taking when hypo:

Vit C - 2000mg daily in divided doses, more if you want to bowel tolerance. This supports adrenals, thyroid and adrenals work together.

Selenium L-selenomethionine 200mcg daily - this aids conversion of T4 to T3

Mineral Complex that doesn't contain iron, calcium and iodine


SeasideSusie is BRILLIANT ... Gives VERY solid advice ...


Good luck with getting T3 prescribed .. My endo completely lied about its 'Dangers' ... You would be better off telling your Dr and Endo to go **** themselves, as all they care about is keeping their jobs and not getting in trouble for prescribing a drug that MP have risen the price obscenely so that they can make money from the NHS out of T4 for which they hold the patent! Your better off buying your own T3 and ask the brilliant members here for advice rather than in my opinion unethical lieing so called Dr's and Specialists.


Your FT4/FT3 ratio is 5.6/1. Plus low normal FT3 at best, if you are on T4 only this looks like underconversion of T4 to T3. TSH at 1 could be lowered to around 0.1, probably by adding T3 to your T4, to get your FT3 higher.


Thanks, I will speak with my doc. I just don't what to over-medicate or be worrying when I don't need to be!


When you say your TSH went to around 3 on 100/125, did you mean it lowered to 3 or increased to 3? Our TSH should be around 1 or below.


It was around three for the last couple of blood tests and so recently I upped my dosage but haven't discussed this with my doc.


I think it's right to increase your dose. Your GP may think 3 is 'in normal range' but once diagnosed we need a TSH of 1 or lower and some need it suppressed. :)

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increased to 3 slowly after my second pregnancy when I was on a higher dose. I am now taking my original pregnancy dose of 125 per day.


The main question is 'Are you free of all symptoms and feel well?'


you can up your levo dose till cows come home but unless your able to convert levo t4 into t3 its poibntless and simply makes you toxic

get tests for




vit d3

go gluten free

do you take any other meds


Yes I take vit d, b12 drops, spatone for iron, selenium and a high strength multitvitamin I am also gluten free (99 percent of the time)


spatone is a very low dose can you not eat liver somehow even if its inced into soups or shepherds pie apparently its far more complete and raises ferritin better in some people


unfortunately I am vegetarian so struggle to sort the iron thing. The stuff they prescribe also really upsets my stomach : (


Have you tried taking vit C with your iron, to protect your stomach?

I'm sorry, but you're not going to get much benefit out of a multi-vit, they're really a waste of money.


A little trick a midwife once told me, was if you have to take any form of iron tablet, do so with a glass of orange juice. It's gentler on your stomach and absorbs into your system faster. It's also stops the iron causing constipation

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Yes, because of the vitamin C. :)

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sorry but vegetarianism and hypothyroid do not go together

its not possible to get adequate amino acids, nutrients etc on a vegetarian diet you need meat and fish etc too


Interesting to note that human digestive systems haven't fully evolved to eat meat, there hasn't been enough time since farming has begun and we've actually had a constant source of meat. For the previous 150,000 years humans were mostly vegetarian with the very occasional meat meal. Our guts haven't evolved beyond this, and many health problems are caused by meat consumption.

Here's a great article from Scientific American: blogs.scientificamerican.co...

I do agree it's probably best to eat meat every now and then, I try to have fish a couple times a week. But most people eat waaaaay too much meat for their health.

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i also know vegetarians who nearly lost their lives because their stomach started eating itself ..theres a balance of eating a small amount of meat or fish with lots of veg and fruit


I agreed with you that for most people a balance of vegetables with some meat is healthiest. However genetics and other factors play a role too. Some people can digest meat a lot easier than others. Some can't handle fibres in vegetables. Diet really is a personally tailored thing, no one way works for everyone in terms of health.


Have you any evidence whatsoever of this? It is an extremely strong claim, with potentially huge consequences for many, many people. Just throwing it in as an unreferenced comment really isn't at all satisfactory.

Even without references, a more complete explanation would be in order.

Did someone you know not eat meat for a week and lose their stomach? Or did someone you have heard of have some stomach problems after sixty years of not touching meat, fish, dairy, eggs, etc.?

It is rather surprising that we do not hear of this being a major cause of demise in India.


its a long time ago but i worked in a hospital and i worked with one person who had been vegetarian for years who became very ill and eventually they fathomed it was because her stomach was eating itself another doctor confirmed the situation can and does occur

I am sure if people are totally healthy vegetarianism is fine but with hypothyroid everything from amino acids to vitamins are so critical ...hence being totally vegetarian is not helpful because ferritin ,folate,b12 are all so critical and you cannot get adequate levels of iron or b12 from non meat sources


Spatone is unlikely to improve iron levels. Just for comparison :

A single sachet of spatone contains 5mg of pure iron.

A single pill of ferrous fumarate 210mg (an iron supplement often prescribed by doctors) contains 69mg of pure iron. People can take up to three per day.

Before going on to high dose iron supplements you really need to know what your serum iron and ferritin levels actually are though, because having high levels of iron is dangerous. (Ferritin is a measure of your iron stores.) An optimal level of serum iron and ferritin is mid-range or a little bit higher. Going as high as near the top of the range must be avoided.

Some people who eat meat can get impressive results improving their iron levels (when necessary) by eating liver twice a week.

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