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Thyroid UK
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Should I stop T4 and take T3 only medication?

Hi All

I am currently using 25mcg of T4 and 12.5mcg of T3 together in the morning. I am still encountering hypo symptoms. My recent lab results show that my ferritin levels have dropped considerably low, and I'm still Vitamin D deficient which require optimising. However my Reverse T3 levels are fairly high, which makes me feel this could be impairing my healing progress. Would it be sensible to just dose on T3 only and start with one 25mcg dose in the morning daily? Any input would be really appreciated. My latest and previous results can be seen below:

03/05/18 Results - Levo 25mcg/Lio 12.5mcg

TSH 1.53 mIU/L 0.27 -4.20

FREE THYROXINE 13.3 pmol/L 12.00 -22.00

TOTAL THYROXINE(T4) 79.2 nmol/L 59.00 -154.00

FREE T3 5.08 pmol/L 3.10 -6.80

REVERSE T3 15 ng/dL 10.00 -24.00

REVERSE T3 RATIO 22.05 15.01 -75.00



ACTIVE B12 129.000 pmol/L 25.10 -165.00

FOLATE (SERUM) 19.98 ug/L 2.91 -50.00

25 OH VITAMIN D 83.5 nmol/L 50.00 -200.00

CRP -HIGH SENSITIVITY 0.16 mg/l 0.00 -5.00

FERRITIN 45.9 ug/L 30.00 -400.0

Levo 25mcg ONLY results are as follows:

January 2017 - TSH 1.9 mIU/L, Thyrglob antibodies 244 IU/mL, Thy Perox antibodies 80 IU/mL.

31/07/17 - TSH 1.16 mIU/L, Free T4 21.7 pmol/L, Free T3 3.8 pmol/L.

15/02/18 - TSH 2.38 mIU/L, Free T4 19.9 pmol/L, Free T3 3.88 pmol/L, Thyrglob antibodies <10 IU/mL, Thy Perox antibodies 21.4 IU/mL

Reference Range, Optimal Reference Range

TSH - 0.4-5.5 IU/L, 0.5-2 IU/L,

Free T4 - 9-23 pmol/L, 15-23 pmol/L

Free T3 - 3-7 pmol/L, 5-7 pmol/L

TPO Antibodies - <35 IU/m, <2 IU/m

TG Antibodies - <35 IU/m, <2 IU/m

17 Replies


Your reverse T3 is not fairly high, it's just 1/3rd through the range so it's nice and low. And your FT4 isn't high enough to be making rT3 instead of FT3.

You really need to optimise your Ferritin and Vit D. Ferritin needs to be a minimum of 70 for thyroid hormone to work and conversion to take place, preferably 100-130 for females, 150 for males.


Hi SeasideSusie. Thanks for your reply... really appreciate the input. I thought Reverse T3 should be less than 10? I am focusing on Vitamin D with the Better You supplement spray 9000iu daily so to speak. Yeah Ferritin is getting lower and lower. I have low stomach acid which of course impairs the absorption of the Iron in my diet. Im now taking Betaine HCL to resolve this, and I have also ordered Digestive Enzymes to help. Is there anything else worth taking to raise ferritin levels??



What makes you think rT3 should be less than 10 when the range is 10-24?

With your Vit D, are you taking magnesium which helps your body use it, and Vit K2-mk7?

Do you take Vit D four hours away from your thyroid meds?

Do you take your thyroid meds on an empty stomach, 1 hour before or 2 hours after food, with water only 1 hour each side?

Do you take other medication and supplements at least 2 hours away from thyroid meds?

To help raise Ferritin, eating liver regularly, maximum 200g per week, and including other iron rich foods will help. I raised mine from 39 to 109 by eating 120-140g lamb's liver a week.

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I overlooked the RT3 reference range Dr Izabella Wentz posted and just noticed your right...sorry my mistake.

I am taking a Magnesium supplement NOW Foods 400mcg daily.. but not a Bit K2-mk. I take the Vit D along with many other supplements 4+ hours after thyroid meds...and yeah thyroid meds on an empty stomach several hours before my first meal.

My Iron is optimal, its just the ferritin that is dropping low and im guessing its due to poor absorption caused by low stomach acid....thanks for your support really appreciate it....



So you got the

"Reference Range, Optimal Reference Range"

from Isabella Wentz's website. Forget them. You can only use the reference ranges from the lab that did your test, no other ranges are applicable.

Try liver. It raised my Ferritin but not my serum iron.

D3 aids absorption of calcium from food and K2-mk7 directs the calcium to bones and teeth where it is needed and away from arteries and soft tissue where it can be deposited and cause problems, so you should start using K2-mk7 now. It is fat solute, as is D3, so needs to be taken with dietary fat. If you get a softgel version, it will contain some olive oil which helps it to be absorbed, look at Healthy Origins.

1 like

You possibly need to increase your Levothyroxine up a bit. Your FT4 is right at bottom of range.

Perhaps try 25mcg/50mcg alternate days. Assuming you have enough Levo to do that . Make sure it's same brand

You have high thyroid antibodies previously so you have Hashimoto's so are you on strictly gluten free diet?


Hello SlowDragon thanks for the input. Yes indeed on a gluten free diet, No Gluten, Dairy, or Soya so to speak. yeah T4 levels have become low, not sure why that is...previous results showed it was optimal...


Was that before you added the T3? Taking T3 reduces the FT4 level. You're only on a tiny dose of levo, anyway. Was it really 'optimal' on 25 mcg?


Hey greeygoose..Thanks for coming through....Yeah before I added T3..my T4 was optimal on 25mcg on levo...i never knew T3 reduces the Ft4 level....based on responses thus far i guess i need to focus on optimising Vitamin D and Ferritin levels.


Well, let's just say that when you're taking T3, the body doesn't need as much T4 as before, so it doesn't hang on to as much. Therefore the FT4 will be lower.

Good idea to raise your vit D and ferritin, but you could perhaps have a small increase in T3. :)


Hey greygoose...u suggesting go from half a tablet 12.5mcg to a full 25mcg tablet?


No, increases should be by 6.25 mcg at a time. So, from 12.5 to 18.75. :)

1 like

Thanks for the input will certainly take this into account


You're welcome. :)


Hey greygoose...have you got a link for a good pill cutter that can easily break T3 pills into quaters??


SeasideSusie recommends one here :




Thank you


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