Extreme confusion as FT4/FT3 levels have dropped?

[queenmabroo]

Hi,

Earlier this year (February) I started a regime of adding liothyronine to my levothyroxine and I just retested with bluehorizons. I'm incredible confused by the fact that all of my levels have dropped - though I have changed my vitamin regimen which could be influencing the less than optimal ranges.

I'm on 100mcg levothryoxine and 6.25mcg liothyronine (1/4 tablet).

Here are my two recent tests for comparison:

16th January

TSH: 0.19 (0.27 - 4.20)

FT4: 19.35 (12 - 22)

FT3: 5.87 (3.1 - 6.8)

22nd June

TSH: 0.17 (0.27 - 4.20)

FT4: 16.70 (12 - 22)

FT3: 4.34 (3.1 - 6.8)

I had hoped that this test would show whether I could increase my T3 to half a pill instead of a quarter, but with everything dropped I'm now worried!

I feel that adding the T3 has improved a lot of symptoms, though currently my fatigue and bounce back is reduced. Obviously having a strict vitamin regime (which was Vit D, B12 & B Complex, Vit C, Iron and Vit E daily) really helped me with my general thyroid levels.

So my questions are:

1) Do i resume vitamin regime only, then retest?

2) Do I resume vitamin regime and increase t3 to half a pill, then retest?

3) Should I investigate anything else?

I'm due to see my doctor for the yearly thyroid tests in August and as my TSH is surpressed I want to be fully armed for that!

[shaws Administrator]

Did you have both tests at the earliest, fasting and did you allow 24 hours gap between last dose and test? TSH is meaningless if T3 is in the mix as the blood tests were invented for the use of levothyroxine alone. I shall give you a link of Research re T4/T3 and go to page 80 and the top para gives a series of combinations tested.

tpauk.com/images/docs/reduc...

It is not so much the dose(s) we take but how we 'feel' which is the best test.

[queenmabroo in reply to shaws]

Hi,

Thanks for your reply

Yes, both tests were fasting, at about 8:30am and 24 hours after my last dose of T3 and 36 after last dose of T4.

So from your research link, the best combination is 3 T4 to 1 T3, so I'm probably aiming for a T3 dose of around 33mcg?

Do you think it would be safe to increase to half a T3 pill and bring back my full vitamin regime at both times? I feel that I have space for some more symptom reduction, and I've been monitoring heart rate which remains quite low (as does my temperature).

[shaws Administrator in reply to queenmabroo]

I suppose some things aren't set in stone.

If someone takes T4 only and adds in T3 they drop levo by the equivalent amount of T3, i.e. if on 100 levo they drop 25 mcg = 75mcg levo and add 1/4 tablet of T3 (which is around 25mcg levo in it's effect. Total effect of combined hormone is (125mcg) . After a week if not improving add a 1/4 T3 then if still not benefiting add T4 by 25mcg and so on until you feel an improvement. As you already feel better an increase in T3 might be all that you need.

We cannot always get an accurate dose combination.

It would be hard to get a T3 dose of 33 so I'd adjust your levo as well Being mindful I'm not medically qualified.

I've never split daily doses, always once daily whether on levo, or T4/T3 or NDT. I am lucky to be on the optimum dose for me and have no symptoms so my life isn't only about hormones/vitamins/minerals.

I always take vitamins etc at lunch as most have to be taken with food and away from thyroid hormones.

web.archive.org/web/2010112...

[bonnyaus in reply to shaws]

I think this is so true. Besides the medicine doses it has to be able how well you feel. That is the aim og medication and dietary changes.

I split my NDT 1 dose in the morning and 1 last thing at night. My other medication I take the appropriate time span from NDT then take most of my vitamins at lunch time. Except for magnesium which I take 2 hours after lunch. Not sure why but it all works for me as last blood results were good and I feel very well.

[queenmabroo]

My mum has just made a rather interesting observation that I had done Aerial Hoop the night before. After that type of activity I'm normally a little depleted and struggling to get up the next day, so I wonder if that was the issue. Also just remembered that I had a flu type bug a few weeks ago, so i wonder if that has also brought my levels down.