low FTx levels but severely suppressed TSH

[Caesard]

Hey there, maybe someone from this lovely bunch can help me understand what's going on here with my tests

I am on 137.5 T4 and 27.5 T3 (treatment after TT) in two daily sessions and I usually get a low TSH and upper limit FT3 when tested.

Now, blood drawn as usual at 08 am, fasting and without hormone administered in the last 15 hours I see:

TSH 0,009 [0.27 - 4.2]

FT4 14,5 [12 - 22]

FT3 4.9 [3.1 - 6.8]

While FT3 is a bit lower than usual I could live with it, but the FT4 as low as that has previously brought symptoms. However, I've never had the TSH so suppressed and though I am in control of my dosing, my doctors will make a fass about it and this time I am a bit worried as well. I've seen also a general decline of well being in the last weeks but it might be correlated also with stress.

Now, what to make of it? I am overmedicated? FTx doesn't point to this but I used to have reasonable levels with a relatively normal TSH (0.2/03)

How to increase the FT4? Put some more T4 and reduce the T3 ? I really don't know how to act on this...

The only thing that changed is that I have been a bit chaotic the last weeks in taking the meds, both in terms of hours and intervals between food/coffee and though I know first hand the absorption effects it still doesn't explain those results, I think.

[SlowDragon Administrator]

Suggest you get your vitamin D, folate, ferritin and B12 tested

And be more careful on dosing intervals.

Both FT4 and FT3 are on low side. That can happen if vitamins are low.

Have you had change in brand of Levothyroxine?

[Caesard in reply to SlowDragon]

Thank you SlowDragon,

I am on D3, reasonable doses and consistent. Last tested folate and B12 6 months ago and, though not ideal, even b12 was good. I mind the food intake (lots of liver, spinach and Brazilian nuts) and also take supplements in an on/off approach.

I wasn't the best converter even before adding T3 (some 2 years ago) but not the worst.

No change in brands as well, I take Novothyral 100 and 75, in a mix.

[Caesard in reply to SlowDragon]

I was actually thinking again get rT3 tested, a high result may be an explanation and it could be the case as my medication was a bit on the high side for quite a while. Actually this is my only route to explore that I can think about right now.

[SlowDragon Administrator in reply to Caesard]

Well if you use Blue Horizon or Medichecks they can test vitamin levels too

[Caesard in reply to SlowDragon]

Will have it tested as well in the clinic. I am privately testing it, in this part of the world it's still affordable. Barely

[greygoose in reply to Caesard]

I can't see anything to worry about in those results. Your TSH is suppressed, but that is of no importance. And your FT4 is low because you're taking T3 - that's what normally happens. So, your rT3 is hardly going to be high unless you're ill or have low iron, or something. And, even if your rT3 were high, it would have nothing to do with your low T4.

If you have hypo symptoms, I would increase my T3 dose, if I were you. But I wouldn't worry about those results. And I wouldn't waste money on an rT3 test, either!

[Caesard in reply to greygoose]

You are such a ray of sunshine in a cloudy winter day

One more important thing that I've forgot to mention: during last testing I've lost approx 10% of total body weight, through a mix of sports and diet (no hipocaloric though, that crashed me once and will not do it again)

In terms of hypo symptoms i am still hood but ive felt a decrease of general well being, mostly energy and mental clarity. Otherwise I'm quite good thoigh i had a strange episode one night ago suffocating during sleep. Might have been a panic attack (I don't suffer from them though) a sleep apnea episode or simply lung mucus as I suffer for a strange cold since almost one month ago.

Other thing that I have and need to investigate is a heavy tongue, I have it for almost one year now, tried regular acidity treatment under medic advice with poor results and will go to a specialist for further investigations.

[greygoose in reply to Caesard]

If you've been excessively exercising, that would explain the drop in your FT3 - you've been using more of it!

I have no idea what a 'heavy tongue' is, I'm afraid.

[Caesard in reply to greygoose]

I've been exercising intensely for the last few months but one week before test not at all.

About the tongue issue it's a whitish coating of the entire surface, I have been tested twice for yeast infection and it's not the case. Also tried already the acidity reduction meds, as required by the medic, with little effect. I wonder if this is not an indication of some other stomach disease or hormonal imbalance...

[greygoose in reply to Caesard]

Even if you didn't exercise for a week before the test, the intensive exercising could still be the reason for your lowered T3. But, the solution, if you intend to carry on with your exercising, is to increase your dose of T3.

I would think you're more likely to be suffering from low stomach acid, rather than high. But doctors don't even know that's a possibility. For them, all stomach problems are caused by high stomach acid. However, acidity reduction meds will just make things worse. You probably need to increase your stomach acid, not reduce it.

[Caesard in reply to greygoose]

I was thinking to introduce some more T3 on training days.

It's not usually a very nasty training, 45' boxing training, 15' sparring, min 5k treadmill and sometimes weights.

The low acidity route sounds interesting.... Possibly that's a reason for which I crave lemon juice :))

[greygoose in reply to Caesard]

Possibly. Have a look at this article, and try the home test at the end :

scdlifestyle.com/2012/03/3-...

You may not think that your training routine is anything 'nasty', but it's too much for someone with low T3. Introducing more T3 on training days, is not a good idea. Your body needs a steady, regular daily dose of T3.