Thyroid UK

My results. Would t3 help?

Hi . Thank you all for support so far. These are my recent results. TSH 0.01 , T4 27.7, T3 5.2. Endocrine has just reduced my Levothyroxine from 200mcg to 175 mcg after these results. I am 10 years post thyroid cancer and ablative I 131. Still feel rubbish. I went to GP and asked for further bloods . Awaiting results of B12/ folate/fsh levels.

Would T3 possible help? Which test shows if I convert to T3?

Many thanks

2 Replies
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Jsimp,

TSH 0.01 is suppressed and FT4 27 is usually over range. FT3 5.2 is usually just shy of the upper third of range but it will drop as your endo has reduced dose to 175mcg.

Poor conversion is indicated by low/suppressed TSH, high FT4 and low FT3. FT3 5.2 usually indicates good conversion but that doesn't mean you wouldn't feel better with it higher. I suspect your endo reduced dose because TSH is suppressed and FT4 over range but I would need to see the ranges which are the figures in brackets after results) to confirm.

If your endo won't prescribe T3 write a post asking members to send you a private message recommending sources where you can obtain it without prescription.

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Check your levels of vitamin D, folate, ferritin and B12 first. Supplementing to improve if necessary

You will need thyroid tests repeated after 6-8 weeks on reduced dose

All thyroid tests should be done as early as possible in morning and fasting and don't take Levo in the 24 hours prior to test, delay and take straight after. This gives highest TSH, lowest FT4 and most consistent results

Always take Levo on empty stomach and then nothing apart from water for at least an hour after. Many take on waking, but it may be more convenient and possibly more effective taken at bedtime

verywell.com/should-i-take-...

Many people find Levothyroxine brands are not interchangeable. Once you find a brand that suits you, best to make sure to only get that one at each prescription.

Dr Toft, past president of the British Thyroid Association and leading endocrinologist, states in Pulse Magazine,

"The appropriate dose of levothyroxine is that which restores euthyroidism and serum TSH to the lower part of the reference range - 0.2-0.5mU/l.

In this case, free thyroxine is likely to be in the upper part of its reference range or even slightly elevated – 18-22pmol/l.

Most patients will feel well in that circumstance. But some need a higher dose of levothyroxine to suppress serum TSH and then the serum-free T4 concentration will be elevated at around 24-28pmol/l.

This 'exogenous subclinical hyperthyroidism' is not dangerous as long as serum T3 is unequivocally normal – that is, serum total around T3 1.7nmol/l (reference range 1.0-2.2nmol/l)."

You can obtain a copy of the articles from Thyroid UK email print it and highlight question 6 to show your doctor

please email Dionne:
tukadmin@thyroiduk.org

Prof Toft - article just published now saying T3 is likely essential for many. Note his comment regarding current inadequate treatment after Thyroidectomy or RAI

rcpe.ac.uk/sites/default/fi...

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