Should I lower T3 and raise T4

[Reneey2k]

I’ve been taking T3 for 2 years now after being referred to an endo. I tried ndt previously and told him and he said it wa apron the T3 I was responding too so he prescribed it to me. However my T4 has been really shocking. Never rising above 9 (8.0-22range) so last year he made me increase to 175mg from 150mg and said he wants to get it to mid range. I went for my appointment with him and my before blood test showed it at 13 but my t3 was 5.9 (2-5.7 range). So he repeated the test and my T4 has dropped back to 9.8 and T3 4.8 and he’s happy with that!!! My thought were that the T4 pushed the t3 above range but no idea why it’s dropped back down. I feel like I have no energy still so don’t know if I should just up my T4 so that goes up and cut back on the T3. I’m taking 20mg. Or is the T4 just not converting and the T3 is the more important med.

I’m also sweating like a pig and don’t know if this is related to it

Thanks in advance

[Angel_of_the_North]

You would expect low FT4 when taking T3 as the whole point of T4 is to be converted into T3. If you are taking T3 directly, you don't need as much T4 so you don't produce it. If you feel well and your free t3 is near the top of the range, no need to add T4. Really, adding T4 is more likely to make you feel bad if you are a poor converter, as it tends to be converted to Rt3 instead of T3 (and then to T2). You are aiming for FT3 around 75% of range (or a bit more) and we don't care too much about Ft4 or TSH. I always feel better on T3 only, so I'd raise T3 and drop T4, but that's just me. You don't want over range FT3, but you need to leave 6-12 hours between taking it and blood test or you'll get a false high.