Total thyroidectomy T3 help (bad T4 conversion)

[Katta]

Guys, please help... new to the group, need advice...

3 months in, TT, it seems I can't convert T4 to T3... On 88mg of T4 results: FT4 in the middle, FT3 below range, TSH very high.

Before that, 125 mg of T4: FT4 over the range, FT3 bottom of the range, TSH below range.

Added 0.025 mg of T3 and my doctor said to keep it there for 6 weeks, till our next appointment.

Shouldn't I be raising T3 after 7 days, if I feel fine, then stop if I start to get worse (hyper)? This dose seems very low in my case?

Thanks to anyone that will reply!

[shaws Administrator]

I am sorry you are so desperate but I don't blame you. Those who've had TT will respond as soon as they read your post.

The very least they could give you is a combination of T4/T3 but if you cannot convert T4 at all they have to prescribe T3 which has been deemed too expensive.

[Clutter]

Welcome to the forum, Katta.

If your TSH is high on 88mcg you are undermedicated and that is why FT3 is below range not poor conversion.

On 125mcg it did appear that conversion was poor as TSH was low, FT4 high and T3 below range. It's not surprising as you've lost the thyroidal conversion and are now dependent on peripheral conversion.

If you were self medicating you would have been advised to add a quarter of a tablet (6,25mcg) to see how you tolerate it and it would then be okay to add another 6.25mcg a week or two later.

0.025mg (25mcg) is not a small dose, it is equivalent to 75mcg Levothyroxine, so you should wait 6 weeks and have a thyroid function test including FT3 before increasing further. T3 is quicker acting than Levothyroxine so your symptoms will hopefully start improving soon.

[Katta in reply to Clutter]

I read in STTM that as long as FT4 is in the middle, or above, I am not undermedicated with T4. My doc agrees. I am adding T3 with my doctor, I just googled how much people cca take (I know everybody is different) and my dose seemed low to me so wanted to hear different experiences.

Today I took as my doc said: 3x6 mcg and felt nothing. He said to take 25 mcg in 3 doses if I feel fine, so I'll try that tomorrow and keep it there for a while (I know T3 is not to be played with )

And thank you all for your quick replies, they are very much appreciated!

[Clutter in reply to Katta]

Katta,

You are undermedicated if your TSH is high unless your FT4 is also high.

You're not supposed to feel some sort of hit when you take T3. It will take a few weeks to build your FT3 up and any improvement in symptoms is likely to be gradual.

25mcg is not a small dose. Many American doctors prescribe 5mcg T3 and UK doctors 10mcg and are reluctant to increase even when FT3 remains low.

[Katta in reply to Clutter]

Shouldnt adding t3 supress tsh?

And ok, you convinced me, I will keep it as it is, and wait for the results in 6 weeks time.

Patience was never my strong side, that's why I ask, so the others keep me grounded. I tend to look for quick solution...

Thx once again, I hope I dont come off as an smartass, I really am here to listen and learn.

[Clutter in reply to Katta]

Katta,

Depends how much you take. 25mcg T3 + 88mcg Levothyroxine is certainly a suppressive dose for most people.

It is so hard to be patient when you're feeling unwell but there's really no rushing things with thyroid meds or you'll just end up overmedicated and, in my opinion, that's worse than being undermedicated.

You've not come across as a smartass

[silverfox7]

Yes always better to take your time in adding T3. Being overmedicated with it isn't nice at all! Some of us take longer than others as well to feel comfortable so your word for the moment is patience!

[Katta in reply to silverfox7]

Yes, I was hyper before TT, so I know how bad it can get.

I just read people feeling better after few hours after taking T3 for the first time and thought maybe there is a reason I am not feeling it at all. It's reasuring to know some take some time.

It's hard to be patient when you feel bad... But, we're all fighters! 😉