How can this be possible? Ft3 ok but TSH is high. How can it be?

[Marie0606]

I have been on 1 grain of NDT (Thiroyd from Thailand) since october 2017. My symptoms got better, so my dr run a blood test and my TSH is 6.12 uUl/mL -normal ranges: 0.27-4.2- and my Free t3 is 0.24 ng/dL -normal ranges: 0.22-0.44-. Dr said my TSH i way too high but my Ft3 is ok, he wants me to take more NDT, but I am confused, because if my ft3 is ok, does it matter my TSH? I Always thought that if my ft3 is ok my tsh should be low so I don't know how to interpret my results, dr. Said my pitituary is trying to make my thyroid to react but without success. So now do I need more t4 or more NDT or less t3? Thanks!!

Ps. I can not run reverse t3 test as in my country that does not exist.

[humanbean]

Some general comments :

1) Both T4 and T3 levels have an effect on TSH. Your Free T3 is practically at the bottom of the reference range. You haven't given a Free T4 level.

See this post from diogenes :

healthunlocked.com/thyroidu...

2) Do you take any supplements containing biotin? Biotin can affect some machines doing the testing, and they produce spurious results. Note, it is not the person whose blood it is that is affected, it it the test machine itself.

3) In your shoes I would suggest trying more NDT. But I would much, much prefer to know Free T4 as well as Free T3 before making a decision.

[Marie0606 in reply to humanbean]

Hi! Thanks for answering, no, I do take collagen but no biotin. You are right about ft4 test, but I see much sense now as my ft3 is low too. Can I ask what should I expect from my ft4 and t4 total results given my results os tsh and ft3? I mean should t4 and ft4 be as low as ft3? If so would you advise to increase NDT or if turns out normal should I take only more t3? Thanks!

[humanbean in reply to Marie0606]

should t4 and ft4 be as low as ft3?

I can't really answer that with any certainty. Total T4 is something people on this forum don't use much, if at all, for deciding on dosage.

Someone on NDT would tend to have lower Free T4 and higher Free T3 than someone on levo only. Beyond that I can't really comment.

You ask if you should take more T3. Are you trying to use NDT to duplicate the results that you might get with NDT? Because I doubt very much that it will work.

Another point is that depending on how well people absorb thyroid meds, or convert T4, or lots of other issues, people might find that they feel best with NDT alone, NDT + T4 or NDT + T3, or T3 alone Nobody can tell you what will work best for you, I'm afraid.

You might find this post from another forum of interest :

forums.phoenixrising.me/ind...

[SlowDragon Administrator]

Your FT3 is low in range, so plenty of room for an increase in dose

Looking for FT3 to be above halfway in range and ideally probably in to 1/4 of range so perhaps between 0.35 - 0.40

[Marie0606 in reply to SlowDragon]

Hi! Thanks! Good to know that I could increase the dose as I am not optimal in my ft3.

[Angel_of_the_North]

Your free T3 is way too low - that's probably why your TSH is so high.

[silverfox7]

Yes agree, increase your NDT in quarters and see what happens. My Endo when I went back to NDT said your TSH eill be suppressed, FT4 can fall but FT3 should be high in the range.

Two other points, have you seen the actual printout just in case something has been mis-transcribed and biotin is in Vit B complex which you may not have known plus lots of hair products as well. Anything with biotin in should be stopped 5 days before testing.

[SilverAvocado]

The answer to your a that freeT3 is not okay. Just being inside the range is not enough, it needs to be at the top of the range. Yours is on the floor.

This is why the TSH is high - your body is calling for more hormone.

[Hidden]

More NDT is required for your TSH to drop to the correct level and therefore your FT3 with increase. Easy!