Tsh under one but T4 in the low end of range an... - Thyroid UK

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Tsh under one but T4 in the low end of range and t3 over the range

Joanneconnor profile image
41 Replies

What can I do to lower t3 and raise t4 ?

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Joanneconnor profile image
Joanneconnor
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41 Replies
cjrsquared profile image
cjrsquared

Are you hypothyroid? Are you on medication? Not enough info to give any advice.

Joanneconnor profile image
Joanneconnor in reply tocjrsquared

Yes I have been hypo Hashimotos (never tested for hashi's ) for 14 years, I was on Levo increasing doses over the years till 18 months ago now on thyroid s 120mg and 50mg of Levo per day but never had antibodies done until recently and they were negative I have been on auto immune Palio diet for a year, my gp said my thyroid was dead that's why had no antibodies showing ???

Angel_of_the_North profile image
Angel_of_the_North in reply toJoanneconnor

So if T3 too high reduce thyroid-s by 1/4 grain and see how you feel. Free T4 doesn't need to be high is you taking something containing T3. Around mid range or even lower when on NDT is fine.

Joanneconnor profile image
Joanneconnor in reply toAngel_of_the_North

If I reduce it I'm cold to the bone, I can't function like that

Angel_of_the_North profile image
Angel_of_the_North in reply toJoanneconnor

So what are your actual results?

Joanneconnor profile image
Joanneconnor in reply toAngel_of_the_North

I haven't had bloods done for over 4 months, endo told me to come back in 6 months, can't remember what they were as endo won't do me a print out, have to speak to his secretary which is like trying to contact God!!! Really annoying

Joanneconnor profile image
Joanneconnor

Was in 250mg Levo before I changed

Jazzw profile image
Jazzw

Million dollar question, how do you feel? Do you feel ok?

When you take NDT, it’s common for T4 to be low in range or under range. The body just gets shot of any excess T4 because it’s got T3 to use - so it does!

If you’re feeling a bit overmedicated, then a very small dose adjustment downwards might be indicated - maybe lose some of the levothyroxine, or keep that the same and drop by a quarter of NDT.

But if you’re feeling ok and FT3 is only just over the top of its range, personally I’d leave well alone.

Joanneconnor profile image
Joanneconnor

If anything I feel under medicated, I still feel the cold a lot, I do remember feeling a bit better with higher t4 my muscles ache and hurt when I use them even walking

shaws profile image
shawsAdministrator in reply toJoanneconnor

Blood tests were only introduced along with levothyroxine.

If we take NDT our blood tests cannot correlate and we only go upon how we 'feel as Jazzw has commented.

If we have symptoms we increase by 1/4 tablet every two weeks until symptom free. Take pulse/temp and if either goes too high you go back to the previous dose.

Levo is T4 only and is inactive. It has to convert to T3. T3 is the only hormone required in our millions of T3 receptor cells

NDT contains T4, T3, T2, T1 and calcitonin.

Jazzw profile image
Jazzw in reply toJoanneconnor

Aha, well, 250mcg is actually a larger dose of thyroid hormone than 2 grains of NDT (in terms of a rough equivalent, I’d say 2.5 grains would be closer to the mark).

Oh, and just a thought - you aren’t taking your NDT on the day of the test are you? Best to leave 12hrs between taking it and having a test, otherwise your FT3 might look higher than it actually is.

Joanneconnor profile image
Joanneconnor in reply toJazzw

My thyroid s doesn't come in grains it comes in 60g tablets I was taking 3 but was hyper so dropped to 2 not high enough so now I take 2 and a 50 Levo, need to get more recent bloods done yes I usually don't take them the day before and go early next morning

Jazzw profile image
Jazzw in reply toJoanneconnor

Ah, ok - makes sense. Could you cut the tablets in half maybe? A whole tablet probably would be too much of an upwards hike, but a half tablet rise (dropping the levo altogether) might make all the difference.

Joanneconnor profile image
Joanneconnor in reply toJazzw

Not sure I started taking the Levo in the hope it would higher my t4?

Angel_of_the_North profile image
Angel_of_the_North in reply toJoanneconnor

No point in raising T4, it doesn't do anything unless converted to T3, and if you have to much it is just converted to rT3 instead.

Joanneconnor profile image
Joanneconnor in reply toAngel_of_the_North

Ohh ok

Kell-E profile image
Kell-E in reply toJoanneconnor

You might even benefit from reducing NDT and adding a little T3 if you are already at the point where you get hypo symptoms if you reduce NDT.

Joanneconnor profile image
Joanneconnor in reply toKell-E

Right ok I though adding more t3 would make my free t3 even higher?

Kell-E profile image
Kell-E in reply toJoanneconnor

True, that's why you might consider reducing something else. I just reread this whole thread. I would ditch the levo. Don't worry about the free t4 level, just focus on the free T3 level. Adding levo probably just increases RT3 and pushes you toward hypo symptoms.

Angel_of_the_North profile image
Angel_of_the_North in reply toJoanneconnor

One of your tablets is one grain. You might do better on no levo and slightly more NDT.

Joanneconnor profile image
Joanneconnor in reply toAngel_of_the_North

I was on 3 but I was always clammy and endo said I was over medicated and they told me to take levo

Angel_of_the_North profile image
Angel_of_the_North in reply toJoanneconnor

And what were your results when they said you were overmedicated? And endos are trained to understand levo blood results and nothing else so they tell you to take levo for their benefit, not yours. If you felt better on 250 mcg levo, then I'd go back to it, but not otherwise.

Joanneconnor profile image
Joanneconnor in reply toAngel_of_the_North

No I hated Levo, I was TSH 0.01 but low end t4 and over t3

Joanneconnor profile image
Joanneconnor in reply toJoanneconnor

On thyroid s about 7 months ago

in reply toJoanneconnor

One tablet is called ( one grain) OK

Joanneconnor profile image
Joanneconnor

Ok might try the pulse thing and temps again, I was doing temps for my high cortisol originally but it's not high any more, I feel much better on NDT than levo

What meds are you taking?

Joanneconnor profile image
Joanneconnor

At the moment thyroid s, vit c, biotin, and roaccutain for skin issues

Angel_of_the_North profile image
Angel_of_the_North in reply toJoanneconnor

Biotin messes up your blood results, so remember to stop it for a week or so before going for tests. Any you had done while taking it are not guaranteed to be correct, so you might not have over range free T3.

Joanneconnor profile image
Joanneconnor in reply toAngel_of_the_North

Ohhhh I didn't know that, I will go next week for bloods and stop taking today thanks

Angel_of_the_North profile image
Angel_of_the_North in reply toJoanneconnor

It depends on what test mechanism exactly the lab uses but see article from last year: endocrinenews.endocrine.org...

I wasn't quite right on 3 grains of NDT or 2 or 2.5 I still felt tired. I now take NDT and T3 together and feel well. I was on thyroid s and still felt tired but that's all. My FT3 was 1/3rd over the top range when on 3 grains. What is your FT3 and range?

Joanneconnor profile image
Joanneconnor

Ive not had it done for a while think it was about 14 about 5 months ago I'm hoping it's gone a bit lower, I don't feel tired just cold all the time and muscles ache really quickly

Joanneconnor profile image
Joanneconnor in reply toJoanneconnor

I'm a lot over my top of range which should be 6.5

Joanneconnor profile image
Joanneconnor

Oh ok so if I take 3 I have clammy symptoms but feel ok, if I take 2 or 2.5 I am freezing and achey muscles but only a bit tired

Kell-E profile image
Kell-E in reply toJoanneconnor

How long are you trying out these doses for? Because NDT contains T4 it takes 5 or 6 weeks for a different dosage to settle out. If you've thoroughly tried 2 and 2.5, you could always try 2.75 or add a little T3 to your 2 grain dose.

Joanneconnor profile image
Joanneconnor in reply toKell-E

Yes been on this one for atleast 3 months just haven't had time to chase my doc for more bloods they don't keep track very well and endo fobbing me off too only see him every 6 months because all they want to see is blood results not listen to any of my problems, will get bloods done next week then go for a change,

What should I ask to be checked in addition to the normal thyroid bloods

Angel_of_the_North profile image
Angel_of_the_North in reply toJoanneconnor

Get your own bloods done and don't rely on endo, who seems not to care.

Also need B12 (if not supplementing), folate, ferritin and D3.

silverfox7 profile image
silverfox7

I changed over to Thyroid S over two years ago now. Before that I was in 125/100 Levo. I got up to 3 grains but couldn't get any high even though I had spent 5 months correcting my conversion problem before I changed over. Endo saw me and told me to drop down to 1.75 grains and he was right! I found out the hard way that being slightly over medicated is very similar to being under medicated. I was also told I mustn't go above my FT3 range.

Joanneconnor profile image
Joanneconnor in reply tosilverfox7

Ohhh why do I feel so cold when I drop?

silverfox7 profile image
silverfox7

It. An take a bit of time juggling dosestill you know what suits you best plus we sometimes need a higher dose in the winter months so think about that as well.

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