Thyroid UK
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less T4 more T3?

Yesterday, as a result of my annual thyroid review, I received a phone call from my doctor about my suppressed TSH. She said this wasn't good for my bones and I said it was because I was taking T3 and the pituitary was not producing TSH. My levels were TSH 0.01mu/L (0.55-4.78 mu/L), T4 16.6pmol/L (10-18.7pmol/L), T3 5.2pmol/L (3.5-6.5pmol/L). The doctor suggested that I take less levothyroxine.

I was thinking that if I take less T4 maybe I can increase T3 a bit. I take 75mcg T4 and 15mcg T3 now. it would be much better from the point of view of not having to split T3 tablets if I could take 20mcg T3 and, say, 50mcg T4. What are others views? Thanks

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Bossgirl,

If the point is to raise TSH then there's no point in reducing Levothyroxine and increasing T3. TSH is suppressed because the pituitary has detected sufficient T4 and T3 from the combined dose and switched off TSH.

You are not overmedicated because FT3 is within range but suppressed TSH may increase the risks of developing osteoporosis and atrial fibrillation. You have to decide how risk averse you are ie continue with your current dose to feel well today and accept there may be future adverse health outcomes or reduce the risk by reducing dose and raising TSH.

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The risk of a suppressed TSH is so small, that it's hardly worth mentioning - in fact, I don't believe there's any risk at all. I would refuse to reduce anything, if it were me, because your Frees are well in range. So, if you feel well on that dose, my advice is to stay on it.

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