Where in range does T3 need to be?: GP ordered T... - Thyroid UK

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Where in range does T3 need to be?

mcdermott
mcdermott

GP ordered T3 and T4 but lab only did repeat TSH and T4.

TSH 0.66 (0.5-4.4)

T4 20.0 (10.9-20.0)

Previous 3 T3 results done by endo since October-

4.7 (3.5-6.5)

4.7 (“ “)

4.8 (“ “)

I think with TSH dropping from 3.8 and T4 going up to top of range (started 25mcg Thyroxine, then increased yo 50mcg) this may mean T3 could have gone too high.

TPO ab have been consistently 1300 (0.0-6.0) up to Jan.

My GP has reduced to 25mcg.

28 Replies
oldestnewest

It's rather doubtful that your FT3 is over-range. With an FT4 that high, most of it will be converting to rT3 rather than T3. But you cannot possibly know without having it tested. Dropping your dose to 25 mcg - which is only half a starter dose - your FT3 is likely to be much too low for good health. There was no reason for your doctor to do that.

mcdermott
mcdermott in reply to greygoose

Thanks. Even the last one at 4.8?

greygoose
greygoose in reply to mcdermott

It's not even mid-range. Mid-range here is 5.

mcdermott
mcdermott in reply to greygoose

My T3 range is (3.5-6.5), so 5 would be mid range wouldn’t it? 4.8 was when I was on 25mcg, so it must still be at least that or maybe even 4.9.

Thanks

greygoose
greygoose in reply to mcdermott

Yes, that's what I said, mid-range is 5. I should imagine it must still be at least that, yes. But, that's a long way off over-range! I'm not really sure what you're trying to prove, here.

mcdermott
mcdermott in reply to greygoose

Not trying to prove anything, just that I have been told on here that T3 needs to be at least 5, so as I have been close to that with no meds, then surely now TSH has dropped drastically and T4 is now the very top of range, then T 3 can’t be lower than 5 and could be bit more, which hopefully means I am not at a dangerously low level. Need to be sure I’m OK for my major surgery on Tuesday, no time left to do more than I have done to achieve the best for that. It’s been a very stressful and worrying 6 months.

Thank you.

greygoose
greygoose in reply to mcdermott

Ah well, that depends on the range. The range you've got there isn't the normal one we see. Normally, mid-range is below 5 on the ranges we see here.

But, in your question, you were saying you thought FT3 might have gone too high. I was replying to that - no, I don't think it will have gone too high. I didn't know you were worried it would be too low! But, no, I don't think it will be dangerously low, either. It will probably be just slightly over 5, mid-range, but it's very difficult to guess like that. But, your doctor should have got back to the lab as soon as he knew they hadn't done the FT3, and explained why it was needed. This really is his fault you haven't got a result!

Good luck with your surgery! :)

mcdermott
mcdermott in reply to greygoose

GP thinks could be too high because of other results, usual thing! I wasn’t sure what to think as been told too low when 4.8 now GP saying could be too high. So confused with it all. GP says her hands are tied, as most are!

Thank you.

greygoose
greygoose in reply to mcdermott

I think the phrase 'my hands are tied' very often means 'I can't a***d'! And, she obviously doesn't know very much about thyroid. Just because your FT4 is at the top of the ranges doesn't mean your FT3 will be. With that FT4, at most your FT3 would be 6, I should think. But, I very much doubt it will be that high. What was your FT4 when your FT3 was 4.8?

mcdermott
mcdermott in reply to greygoose

FT 4 was 13.6 (10-20)

greygoose
greygoose in reply to mcdermott

OK! I see your point, now. It did shoot up alarmingly, didn't it. You did leave a 24 hour gap between your last dose of levo and the blood draw on that last test, didn't you? Because it's an unbelievable increase.

mcdermott
mcdermott in reply to greygoose

Yes I did. Funny thing is had same thing 8 years ago, and ended up back down to 25mcg from I think 50mcg (may have tried 75 for short time) TSH under 1 and T4 over range and FT3 right at top.......

TSH 0.11 (0.3-5.5)

T4 22.5+ (10-19.8) above high ref limit.

T3 6.7 (3.5-6.7)

This is why my GP (and me) are cautious. I seem to be very sensitive and different to most people who come on here. It’s really hard. My TPO were 1300 (0.0-60.0) then and were the same recently. Without medication my TSH has been between 3.8 and 5.3. My cholesterol has been as high as 8.4 or lowest 6.3.

Thank you

greygoose
greygoose in reply to mcdermott

Yes, very unusual. Well, if it reassures you, you could lower your dose back down to 25. But, looking at your results on 75, I doubt that 50 would take you over-range. Could be, it's just right. :)

mcdermott
mcdermott in reply to greygoose

I am unsure whether I got to 75mcg 8 years ago, I can’t remember and didn’t take note of dosage. I’ve only been on 50mcg about 3 weeks. GP did TFT’s, but lab only did TSH which was 1.1 (3.5-4.4), I pushed for T3 and T4 in view of operation and she agreed, but lab didn’t do T3. TSH was done instead and dropped to 0.66 (0.5-4.4).

Yes I think 50 could have been right dose.

I do get Adrenalin rushes at night, so not sure if something else going on. Synacthen test came back normal from endo, no range.

Thank you

greygoose
greygoose in reply to mcdermott

OK, well, look at it this way, if your op is next Tuesday, that will be under six weeks since you started the 50 mcg, so it's very doubtful that your FT3 would be over-range, because the levo hasn't had time to fully convert. But, as I said, if it makes you feel more reassured, you can always drop down the dose to 25 until after the op.

mcdermott
mcdermott in reply to greygoose

Yes, that’s what I thought, so would get tests when recovered. Many thanks.

greygoose
greygoose in reply to mcdermott

You're welcome. :) Hope all goes well. x

GP's say their hands are tied when they mean they can't be bothered with the hassle. They also know very little about thyroid. Just get private tests done through Blue Horizon or Medichecks.

Will do but too late now before op on Tuesday. Thought the T3 and T4 ones by GP would be quicker, which they were, just didn’t do T3!!!!

Often, to get lab to do T3, GP has to say that you are taking T3 or it sometimes works to say suspected central hypothyroidism (I don't why as that would just mean TSH is no use)

Looking more likely that you aren't converting well. This is a huge problem if they don't test FT3! But having said that then 4 things that can help reverse bad conversion is to be optimal in it D, B12, folate and ferritin. They also help your thyroid to work better and can help some of your symptoms do get your GP to test them and post any results in a new thread.

mcdermott
mcdermott in reply to silverfox7

My vitamin results are:

Vit D now 112 (24.0-167) on supplement spray with K2 since November ‘17. D was only 50 then.

B12 704 (190-800) taken Oct ‘17 taking B12 spray since then, so should be even more.

Folate 8.6 (3.0-17.0) Oct’17, taking sup since.

Ferritin 75 (12.0-300) Oct’17...was 117 Sept’17, taking iron in multi since.

I haven’t posted on new thread as have put them on many times before, and I would have to re-write a lot of info again as I can’t copy paste on my phone. Never have enough time either, I’m always researching, posting etc. Need to chill before op really.

Thank you 😀

silverfox7
silverfox7 in reply to mcdermott

That's fine to follow on. I put the new thread as often folks have to get an appointment etc which takes time and by that time it would get lost if you added it on. Your ferritin has dropped between September and October. I would keep an eye on it. I don't know how much iron is in a multi but it may not be enough.

mcdermott
mcdermott in reply to silverfox7

Hopefully ferritin will be higher now as have to stop before surgery apparently. Think I’ll stop them all until after as it’s difficult in hospital, same with thyroxine, so take mine between 5-6 am and have breakfast and hot drink an hour later, but they bring tea at 6.30 meds at 7.30- 8.30 and breakfast at 8.30, so that’s a nightmare!! Might be best at night but will have one on morning of op so not sure.

Thank you

SlowDragon
SlowDragonAdministrator

Personally I would stick on 50mcg and get private testing of FT3. Only decide if staying on 50mcg or reducing once you get result

Are you strictly gluten free as you have Hashimoto's?

It's extremely common to be poor converter with Hashimoto's

With high FT4, you may have high reverse T3. But that's an expensive test to do.

mcdermott
mcdermott in reply to SlowDragon

I’m worried about staying on 50mcg with operation. GP has stuck her neck out to re instate thyroxine and she stressed that if anything happened, she would be in trouble especially since increasing to 50mcg, she has advised me to reduce and I feel so confused again. I have been gluten free since November, but don’t think it’s made much if any difference. I have no more time to get T 3 tested, but will when I am recovered which could be 8 weeks or longer. I don’t understand the reverse T3, still trying to educate, but so confusing and poor memory. I have tried to get all tests and treatment sorted before operation but I have been let down by lab changing T3 to TSH, or it may be senior GP who has changed it, I never see him. I cannot do any more at the moment, it’s been so stressful.

Thank you

SlowDragon
SlowDragonAdministrator in reply to mcdermott

NHS lab often refuse to test FT3 even if requested by GP

Make sure B12 retested after operation if having anaesthetic

mcdermott
mcdermott in reply to SlowDragon

Will do, thanks xx

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