Thyroid UK
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Thoughts on results.

Hi-I'm on 3 grain NDT and just had levels checked again and my tsh is -0.03, t3-3.1(2.0-4.4), t4-1.09(0.9-1.7) my levels vary but pretty much always the same. My ft3/ft4 seem low. Dr won't up the dosage because the tsh is too low according to him?

My dr doesn't think something is adding up. Well, I certainly don't know because I'm not the doctor. He said I may not have a thyroid issue rather a pituitary problem.

Thoughts? Suggestions?

14 Replies
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Do you have your results from the time you were diagnosed?

When you're taking NDT, your TSH is bound to be suppressed, because of the T3. It doesn't matter. It's suppressed because you don't need it.

Your Frees are a little on the low side, but half a grain would probably bring them up nicely - they're both around mid-range.

Your doctor doesn't understand NDT. He probably only learnt about levo, and what the results would look like on that. To me, your results look to be more or less what I would expect. Your conversion isn't brilliant, but as I said, an increase of half a grain, and things should look a lot better - except for the TSH, of course, which will always be suppressed. And, if your doctor is obsessed with the TSH, then you're always going to have a problem with him. :(

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I'm actually going to a functional medicine dr an he deals with NDT. Before I was out on meds 6 years ago my tsh was .76 t3/t4 both mid range. No antibodies. Was told I have a small thyroid.

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Well, then he shouldn't be perplexed by these results. How did you get diagnosed with a TSH of 0.76 and mid-range Frees? That's hardly hypo.

And, if those were your results when you were diagnosed, one would expect the Frees to be higher on three grains of NDT - which NDT are you taking? How do you take your hormone?

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I previous Dr said I most likely had hashimotos due to my symptoms. I went off of all thyroid meds for 6 weeks and tsh rose to 4.2 and ft3 stayed about the same and ft4 went up?

take my 3 grain first thing in the morning. I live in Germany so it's made at a compounding pharmacy. Levothyroxine 114, liothyronin 27=194.4 mg 3 grain.

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Yes, but do you take it on an empty stomach, and wait at least an hour before eating or drinking anything other than water? Are you taking any other supplements or medication?

If your doctor thinks you have Hashi's, why doesn't he test the antibodies, to either confirm it, or rule it out? But, I can't see anything in your results that would suggest Hashi's.

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I take it on an empty stomach and wait about 20 minutes before I have coffee. This current dr tested my tpo and it was negative. He doesn't think I have hashimotos. He's very perplexed by a lot of my labs which is why he suggested I go off of my meds but 6 weeks was a long time and to stop cold turkey wasn't a good idea. I had tinnitus and vertigo. It felt like my throat was pulsating.

I take lots of supplements but in the afternoon.

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OK, well, that explains a lot. The coffee is blocking your absorption of the thyroid hormone. Did no-one ever tell you that cafeine does that? You should wait at least an hour before drinking coffee.

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No!! Ugh. Maybe I could take it at night before bed instead?

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Yes, you could. Just make sure it's two to three hours after your last meal. :)

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Thanks so much. Can't believe no one has ever told me this!!

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Doctors do not know :)

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Well, it doesn't really surprise me, doctors know so little about thyroid.

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I believe that if we take NDT the doctor cannot use the regular blood tests which are for levothyroxine alone. This is how a compassionate doctor would treat us:-

web.archive.org/web/2010103...

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Doctors don't understand the the blood test he uses if for levothyroxine alone, i.e. T4.

If we take NDT it contains, T3, T4, T2, T1 and calciton so due to the T3 in NDT the TSH will be low or suppressed but there's no danger to what he believes, ie. that we will bet osteo or heart problems. In fact on NDT you'll probably avoid these.

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