Thyroid UK
90,465 members104,840 posts

Still feeling cold on Levothyroxine. Low Ft3, add T3?


I got diagnosed with subclinical hypothyroidism half a year ago. TSH slightly elevated and low normal FT4 and FT3. Been taking 75mcg T4 and increased that to 100mcg few weeks ago because of still 3+ TSH. Will get latest blood results soon but it won't show any new things. FT3 has always been low for me also after starting to take T4, so maybe a conversion problem. Ferritin was at 50 (30-500 range). Ft4 now at 12 (9-17 range) and FT3 at 2.0 ,sometimes 2.1-2.3, highest was 2.4 (2.0-4.2 range). Still feeling cold extremely fast which is annoying. Thinking about ordering some T3 online if my doc won't prescribe it to me.

How much should I start with ? Any good source for T3 online ?


8 Replies

Well you are not on enough Levothyroxine yet to tell. You might find once FT4 is high in range that FT3 improves.

Have you had vitamin D, folate and B12 tested too? If any of these is too low it can cause a problem

Do you have Hashimoto's also called autoimmune thyroid disease diagnosed by high thyroid antibodies?

Get full testing 6-8 weeks after dose increase

Private tests are available if GP unhelpful

Medichecks Thyroid plus ultra vitamin or Blue Horizon Thyroid plus eleven are the most popular choice. DIY finger prick test or option to pay extra for private blood draw. Both companies often have money off offers.

All thyroid tests should ideally 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. (Patient to patient tip, GP will be unaware)

Nice guidelines saying how to initiate and increase. Note most patients eventually need between 100mcg and 200mcg Levothyroxine


Thanks for your input. Since I'm from Germany these private lab testing companies mentioned won't work for me. Also Docs here just go after lab ranges rather than well being, so since I'm in range a dose increase will be difficult.


They should still test thyroid antibodies and FT3

Increase in T4 will improve levels, it has to step up slowly.

Getting or keeping vitamins optimal helps too

Germany also has its own T3 (Thybon Henning) many in UK get German T3 on private prescription

There must be recommended thyroid specialists in Germany

Why not put a post up asking

There are quite a few from Germany on here

If you have high antibodies then looking at strictly gluten free diet likely to help

Can help regardless, even if no antibodies


Didn’t have antibodies. VitB12 and VitD were absolutely fine, B12 even slightly elevated.

You think FT3 will get better if FT4 is already mid range ?


I can tell you how it worked for me - although my symptom has been fatigue rather than feeling cold. Eliminating wheat was key, as were taking some helpful supplements, but I also began taking 5 mcg of liothyronine. That didn't do much for me so after six months my doctor agreed to increase it to 10 mcg. I felt much better on that dose. Latest blood work showed elevated levels, so she asked me to try alternating between 10 and 5 for a while. Waiting to see how this is working out. I notice a tiny bit more fatigue on that dosage, but since my bone loss accelerated on a higher dose (she also increased my dose of levothyroxine to 100 mcg and we've cut that back a fraction as well) I am willing to tolerate some fatigue if is means I maintain bone density better. I'm American and my doctor is sympathetic to my symptoms, not just my blood work. I think responses are highly individual so this is no more than my experience. But keep trying different things because your solution is out there too.


Hi, you may have success increasing T4 in the hope there is more conversion to T3, however this is not always the case and can often makes matters worse as reverse T3 increases. For me, I had to add T3 in addition to the T4 so this may be a path you want to consider.


I'll second that.


Oh let me tell you something about Levothyroxine but stuff made my hair fall out it also made me have heart palpitations my old endo put me on that 88mg then back to 75 I tried telling her that it was doing something to my heart she wouldn't listen to me and told me go to a heart specialist went to a heart specialist they did an echocardiogram and heart monitor both were normal so finally I didn't want to go back to her anymore so I got off my medication for 6 months hair stop falling out heart palpitations went away but I did o to a new endo doc well my TSH from my regular doctor was 3-point something went to get it checked a month later by my endo 4.26 tsh she said my T3 and T4 were normal first she told me I can wait until I get to 10 but now a month later she told me to start taking my medication i am in a very low dose 25mg of triosint its a t4 medication basically it's like levothyroxine with no fillers in better absorbed so I've been on that 28 days and my heart is starting to act up again and my hair is starting to fall out call my endo and she said I need to go get a blood test that I can't be hyper but we will see maybe I just don't need medication at all I don't feel any different either way only heart palpitations and hair falling out actually feel better off medication


You may also like...