A year ago, despite TSH of 3.8 and FT4 of 14.7, my FT3 was 3.3 (range 4.00 -6.80).
Doctor advised increasing Levo by .50 mg per week from 1.25mg x 5 days, 100mg x 2 days per week to 125mg each day. I am highly dose-sensitive.
Latest test shows, as expected, FT4 raised to 18.2, FT3 raised slightly to 4.5 but TSH now even lower at 0.71 - much lower then I would want it to me for optimum health.
I am experiencing symptoms of low T3 - chronic pain, restless legs, cramping hands ands feet, weight gain despite exercise, hair breakage, brittle nails, dry skin, bulging tender neck.
Is this a reverse T3 process? How can I increase free T3 uptake and avoid reverse T3?
Written by
Tanwood
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Dr Toft, past president of the British Thyroid Association and leading endocrinologist, states in Pulse Magazine,
"The appropriate dose of levothyroxine is that which restores euthyroidism and serum TSH to the lower part of the reference range - 0.2-0.5mU/l.
In this case, free thyroxine is likely to be in the upper part of its reference range or even slightly elevated – 18-22pmol/l.
Most patients will feel well in that circumstance. But some need a higher dose of levothyroxine to suppress serum TSH and then the serum-free T4 concentration will be elevated at around 24-28pmol/l.
This 'exogenous subclinical hyperthyroidism' is not dangerous as long as serum T3 is unequivocally normal – that is, serum total around T3 1.7nmol/l (reference range 1.0-2.2nmol/l)."
You can obtain a copy of the articles from Thyroid UK email print it and highlight question 6 to show your doctor please email Dionne at
tukadmin@thyroiduk.org
Also request list of recommended thyroid specialists, some are T3 friendly
Professor Toft recent article saying, T3 may be necessary for many otherwise we need high FT4 and suppressed TSH in order to have high enough FT3. Note especially his comments on current inadequate treatment following thyroidectomy or RAI
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.
If on Levothyroxine, don't take in the 24 hours prior to test, and if on T3 don't take in 12 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)
You are quite likely to have low vitamin levels
Some people on here have found it beneficial to go strictly gluten free diet after RAI too
Obviously very very many Hashimoto's and Graves patients find it very beneficial
Difficult to say without the range for the FT4, but it looks like your problem is a conversion problem, rather than an rT3 problem. If your FT4 is up the top of the range then your rT3 will be high. But, present thinking says that rT3 does not impede the uptake of T3 by the cells. It's simply that you do not have enough T3 to take up. What you would appear to need is a reduction in levo, and a little T3 added to it.
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