T4 verses T3: Hi I was recently diagnosed with... - Thyroid UK

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T4 verses T3

Leyla123 profile image

Hi I was recently diagnosed with Hashimotos and stated on levo and got upto 75mg. I told my consultant that I was getting really bad pains in my arms. So he changed it for NDT. 1 grain an and 1 grain in the afternoon. Result was I was in bed for two weeks could not do a thing. He advised to give it about 6 weeks. Stated to feel a bit better but still fatigued in the at noon about 4pm and have to go to bed. I've been off work for over 6 months as I have no energy and lots of pain in my body. He now has me on 1 grain at 7am half at 11.30am and half ar 3.30pm. To see if this helps in the afternoon. My latest results are.

TSH 0.06 (0.3-3.94)

Free T4 27.8 (12.3-20.2)

Free T3 4.0 (3.70-6.70)

Could anyone advise me what I can do for more energy and if I can get rid of body pain.

Many thanks.

8 Replies
SeasideSusie profile image

It would be a very good idea to get vitamins and minerals tested

Vit D




And for someone on NDT your FT4 is extremely high and your FT3 very low. Normally when taking NDT you expect to see FT3 nearer the top of the range. It could be that the balance of T4 to T3 in NDT isn't right for you (ie too much T4 and not enough T3), and you may be better on Levo plus synthetic T3 and adjust the dose of each to your own individual needs.

Hi where could I get T3 from? As I've heard it's so expensive!


SeasideSusie profile image
SeasideSusieAdministrator in reply to Leyla123

You can ask your endo. If he wont prescribe it on the NHS (which is probably what he'll say), then if he can give you a private prescription for T3 20mcg dose, you can get Thybon Henning from Germany with that prescription for about 30 euros for 100 tablets.

Ok I see. Thank you so much for the info.

Hi my other blood test results are

B12 678ng/L (197.0-771.0)

Ferritin 123ug/L (13.9 - 150.0)

Folate 6.5ug/L range 3.8ugl

Vitamin D 108 nmol/L

Do you think I need to get these any higher?

Thanks you

SeasideSusie profile image
SeasideSusieAdministrator in reply to Leyla123

These are actually rather good, are you supplementing?

Ferritin is excellent, it needs to be a minimum of 70 for thyroid hormone to work and I've seen it said that for females 100-130 is best, so spot on there!

Vit D is recommended to be 100-150nmol/L according to the Vit D Council, so you're within their range, you wouldn't really want to go any lower though.

B12 is fine but if you are an older lady, you might be interested in this quote from the book "Could it be B12?" by Sally M. Pacholok which says:

"For brain and nervous system health and prevention of disease in older adults, serum B12 levels should be maintained near or above 1000 pg/ml."

I have to admit to not liking the new way of saying that folate is OK if it's >3.8 because a result of 3.9 has to be vastly different from a result of, say, 19.9 . I think a proper range makes it much clearer. However, you are over that number so you must be OK.

Hi Leyla, your symptoms and you blood tests don't make sense to me, fatigued and pain would suggest not enough NDT, but your free T3 and TSH look ok. Did you take NDT an hour or two prior to blood test ?

I find a hot lunch will put me to sleep, keep my meals small and regular - basically graze on nuts and healthy stuff all day and then have smallish cooked (often cold) meals.

Daily exercise is important too. I swim, cycle or jog most days from work over lunch.


Your FT3 is right at the bottom of the range and your FT4 is very high. I wonder whether you are one of the people who have a faulty gene so they can't convert FT4 to FT3 properly? Either that or your nutrients are so low your body can't convert (see SeasideSusie's comment). It's good that you have a consultant who will try different approaches (e.g. NDT). You will probably feel better taking T3.

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