T4/T3 not optimal

[HYPOUSER]

My recent Thyroid tests shows below values

TSH 2.1 ( 0.450-4.5) uIU/mL

FreeT4 1.1 (0.82-1.77)ng/dL

FreeT3 2.3 (2.0-4.2) pg/mL

They are not in optimal range and I continue to have severe hair loss, dry scalp.I am only on Levothyroxine 50 mcg/75 mcg alternate days.Can i switch to Tirosint. I dont have antibodies.Please suggest if I need to add zinc/selenium, aswagandha to improve.With great difficluty though I bring my tsh to normal, when i keep taking same dose it goes out of range to <.5 and if dosage is reduced to 25 mcg, it shoots upto 10.5 .So not sure whats causing these.Puzzled.Need inputs/suggestions.Thanks in advance

[shaws]

Do you have the ranges for your above results? It makes it easier to comment.

[HYPOUSER in reply to shaws]

Sure, Added the ranges

[SeasideSusie Remembering]

If you add the reference ranges for your results then we can interpret them, without them we can't know where in the range they lie.

As Tyrosint is T4, same as Levo, I assume your GP would be the one to decide if you can change to it.

Zinc you might be better testing before supplementing.

Selenium can be tested if you want, it's good for helping conversion of T4 to T3.

Be aware that Ashwagandha can lower cortisol.

Vitamins and minerals and hair loss healdove.com/disease-illnes...

[HYPOUSER in reply to SeasideSusie]

Yes, added the ranges now.I will test them zinc/selenium.

[ARoy]

I just asked the same question to a doc yesterday. She didn't get back to me on that one :/

Have you had your vit d, b12, ferratin etc checked? And have you went gluten free yet? Optimising vitamins and minerals as well as eliminating gluten could help. I take flaxseed and Krill oil...that should help your dry scalp problem. Use a sulphite free shampoo too, Boots should have a children's one, otherwise try Salon Services (I bought mine there).

[HYPOUSER in reply to ARoy]

Yes, B12 is 500, Vit d is 45, ferritin is 75.I will check for the oils and the shampoo

[greygoose]

If you want to bring your TSH down, you increase the dose, you don't decrease it. The lower your dose, the higher your TSH. And, right now, your TSH is too high. You need and increase to bring it down to 1 or under.

[HYPOUSER in reply to greygoose]

Yes, thats why my doc told to add 75 and i was able to bring down to 2 from 10 and still continuing the same, but once it reaches 1 or less, if i still keep taking same dose, it was going less than optimal range and <0.006 few months back.So not sure why its not staying in same tsh levels, so doc tried reducing dose to keep stable, but it shooted up again.Thats why concerned abt t4 t3 too if anything is hampering and not making these optimal.

[greygoose in reply to HYPOUSER]

Silly doc! He hasn't yet learned that that's what happens when you dose by the TSH. You can't do it. Once the TSH reaches 1, you just have to let it go it's own way. Having a low TSH does not mean that your FT4 and FT3 are automatically going to be too high. You need to test them, and see where they are, and then dose by the FT3.

The TSH is a very bad indicator of thyroid status, and a very unreliable test because it changes throughout the day. And a doctor that doesn't know that, shouldn't be treating thyroid patients.

[HYPOUSER in reply to greygoose]

Yeah, am frustrated with the conventional medicine docs and want to check with functional doc.So once tsh is stable, and if t3 is low, do we need to add low dose of T3 supplement too along with T4 dose?

[greygoose in reply to HYPOUSER]

Functional docs tend to know even less about thyroid than conventional docs! And go in for some really weird treatments. I wouldn't advise it. And, your TSH is never going to be stable if your doctor continues to dose by it. It's just going to keep going up and down.

If your FT3 is low, you have to look at the FT4 and compare them, to see how well you're converting. If your FT4 is also low, then you need and increase in levo. But, if your FT4 is up the top of the range, and your FT3 low then, yes, you do need to add T3 to your levo.

[HYPOUSER in reply to greygoose]

Hmm, so I need both increase in Levo plus the T3 then and no doc is even looking at my T3 or conversion levels and giving the prescription to add too after asking them and saying its impacting my hair and have severe hair loss and not feeling overall better with optimal tsh:((((

[greygoose in reply to HYPOUSER]

Not necessarily. You cannot really tell how well you convert until your TSH is around one. Yours is too high, at the moment. You need an increase in levo. The first thing you have to do is either stop your doctor dosing by the TSH, or find a doctor that knows how to dose. That is the number one mistake, here : dosing by the TSH. And it's a times like this that I think, why the hell do we bother with these idiot doctors, anyway, when we can just self-treat!

[HYPOUSER in reply to greygoose]

Yes, I stopped going to my endo and cancelled the follow up and will look for new endo or naturopath.

[greygoose in reply to HYPOUSER]

Sounds like a good idea.

But, whatever you do, do not let a naturopath give you iodine! They are rather inclined to do that, because they don't understand thyroid very well.

[shaws]

The aim for us who are hypothyroid is to have a TSH of 1 or lower. Some doctors believe that a low TSH will give heart problems but we might be more likely to develop this if our hormones aren't optimum.

Your FT3 is too low so you need a rise in levo in order to bring it nearer the upper part or the range.

Before levothyroxine and blood tests were introduced we were diagnosed upon our clinical symptoms and given NDT (natural dessicated thyroid hormones) until symptoms were relieved.

Did you have your blood test at the earliest possible time, fasting (you can drink water) and allow a gap of 24 hours between test and dose? If not results will be skewed. TSH is higher early a.m. and drops throughout the day. This is a past post:-

healthunlocked.com/thyroidu...

I am not medically qualified - not one professional medical person could diagnose me at all despite clear symptoms and no-one took a blood test.

One of our Advisers (deceased) only took a blood test for the initital diagnosis and thereafter it was all about how clinical symptoms were relieved and patient began to feel well.

web.archive.org/web/2010103...

Our dose of levothyroxine (T4) is an inactive hormone, it has to convert to T3 (liothyronine) and it is T3 which is the active hormone needed in our millions of T3 receptor cells.

[HYPOUSER in reply to shaws]

Yes, I took the test in the morning and had 24 hours gap.Since I have almost reached TSH 2, will a rise in Levo further to increase T3 not screw the tsh again, because in Nov after rising the dose it was TSH was .5 but T3 was 2.1 and stayed same no matter increase or decrease the entire year.So I had the doubt that my T4/T3 conversion not happening the right way.

[shaws in reply to HYPOUSER]

For accuracy you need a Free T3 and Free T4 blood test. You might have to get these privately. I shall give you a link and read why these two are important:-

thyroiduk.org.uk/tuk/testin...