Follow up to

[AKatieD]

Hi again helpful peeps

Have now reduced meds since last post 9 months ago when I was advised to reduce dose here:

healthunlocked.com/thyroidu...

Results now mostly in range - feel worse but not same way consistently - tired, can't sleep properly, panic attacks, throbbing legs and hands, aches and pains, short of breath, chest aches etc. Sometimes one thing, sometimes another, but no real consistency = very odd.

I am taking 150mcg levo + 3 grains NDT

Please can you have a look and see what you think I should do next?

TSH<0.005 range 0.27 - 4.20IU/L

T4 Total 102.5 range 59 - 154 nmol/L

Free T4 26.33 range 12 - 22pmol/L

Free T3 5.65 range 3.1 - 6.8pmol/L

[greygoose]

Oh, that's an awful lot of T4! And the FT4 is well over-range. You don't need all that unconverted T4. It could be converting to rT3, which could be why you don't feel so good. If it were me, I would reduce the levo a bit more - not the NDT, because the T3 isn't too high at all - but get rid of some of that T4.

[humanbean]

Compared to your previous results your Free T3 has dropped dramatically. I also noticed your Reverse T3 was sky high in your previous post.

I agree with greygoose that you have far too much T4, and you are taking too much. In your shoes I would want to make sure I reduced the reverse T3 and got rid of the high T4.

Have you considered taking T3-only for a while? It would get rid of the excess T4 and reduce your reverse T3 down to practically nothing (or actually nothing if you have no thyroid output of your own). You would almost certainly have to source your own T3 online though.

Another alternative would be to drop the Levo (in stages - not in one big lump) and increase the NDT.

Unfortunately, any such major change of thyroid hormone treatment is going to take a while and you would need to monitor what was going on.

If you were to switch to T3 only you could test your Free T3 alone for a while. Your Free T4 will drop below range under those circumstances so there is no point in testing it, and TSH is only of interest to a doctor. But if you were treating yourself on T3-only then the only thing that matters is your Free T3. You could test that with a finger prick test for £29 from Medichecks :

medichecks.com/thyroid-func...

Or if you really wanted to check all three - TSH, Free T4 and Free T3 you could do that for £39 :

medichecks.com/thyroid-func...

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I noticed in your previous set of results that your Folate was rather low in range. I think it would be better to be mid-range or upper half of the range.

And you don't give any iron-related results. If you've got any of those it would be good idea to post them.

[AKatieD in reply to humanbean]

Thank you. Some good ideas. How would i know how much t3 to start with and what sort of range of doses do people take?

Thyroid stuff is a pain! Now struggling to concentrate at work and it looks like another few months to fix. Should have added also put on 2 stone in last 9 months....

Guess i should have bitten bullet and paid for the whole range of tests inc rt3 and folate again this time. I just did a quick top up of gp's tests who only did tsh and ft4.

[humanbean in reply to AKatieD]

How much T3 to take is not easy to determine. You are obviously getting T3 from your NDT and that amount is fixed. For most kinds of NDT there is 9mcg T3 per grain of NDT, according to this link :

stopthethyroidmadness.com/a...

So the NDT is supplying 27mcg T3.

But obviously some of your T4 is converting to T3 as well, and there is no way I know of to tell how much that is contributing to your overall T3.

All I can say for certain is that you shouldn't start on less than 30mcg T3, if you went on T3-only. But I suspect you probably need far more than that.

[AKatieD]

Thanks again Human Bean. Sounds like it might be easier to go to ndt only first and then gradually over to t3 (as you suggested earlier) to avoid bombing completely at the start if the 30mcg of t3 might be far too low.