I am wondering if I can get your advice. I take NDT and a fair amount of it. 180 mg. I believe that is 3 grains. It has suppressed my tsh and my doc wants me to lower my dose. However my reverse T3 is 11 on a scale of 8-25.
I still am tired and have some symptoms of low thyroid.
What do you suggest? Thank you.
Daisylain
There's nothing wrong with your rT3, it's nice and low which is what we want.
NDT will lower or suppress TSH because it contains T3. Does your doctor not know that?
What are your TSH, FT4 and FT3 results? When taking NDT (or T3) it's the FT3 result that is important.
I have tested them all. Ft3 and Ft4 are very low normal. I don't have the numbers with me at the moment. I have 3 different doctors. The one that wants me to get my TSH up is actually the specialist ( functional doctor). Is it your opinion that my tsh is okay to leave it surpressed? It is 0.01 with a range of 0.10-5.0. I really don't want to drop my meds and tank my T4 and T3 again. Mt TSH has been suppressed for 2 years now. But this doctor tells me my low TSH gives me higher risk of bone issues and cancer.
Daisylain
Is the functional doctor a thyroid specialist?
All I can say is that I have been hypo and taking Levo for 43 years and I have kept a record of my results since 1994. In all that time my TSH has been suppressed with results showing as <0.005, <0.01 and <0.02 depending on which lab does the test. I haven't developed cancer (that's a new one, haven't heard that before) and as far as I know I don't have bone issues.
It might be an idea to ask this doctor does every thyroid cancer patient, who has to keep TSH suppressed, go on to develop bone issues and cancer.
Thank you!!! This is really helpful for me! I feel like she is wrong based on everything I have read. She apparently specializes in thyroid and hormones. And though she had helped me alot, if I had stuck with her advise I would be very undermedicated. I really appreciate your information!! 
Have you tested ft3?
You must check levels of vitamin D, folate , B12 and ferritin too
Do you have Hashimoto's? Also called autoimmune thyroid disease diagnosed by high thyroid antibodies
No. I have secondary hypo-thtroid and it's my t4 that is always very low. I have been working on this for a few years. I had iron ivs and I take b12 injections. Also I take d3 etc. All my bloodwork is great these days. Except the non existent tsh. I just am not sure if I need to actually lower my meds to bring it up. Thanks
If you have secondary hypo, then your functional doctor shouldn't even be looking at the TSH - especially if she calls herself a thyroid specialist. It's the FT3 that is the most important number.
And your FT4 is going to be low when taking NDT, because of the T3.
But, as you're taking three grains, I'm surprised your FT3 is low. How do you take your hormone? On an empty stomach, waiting at least an hour to eat, and two hours before taking other supplements or medication? Do you have stomach/gut problems?
There is not direct link between TSH and rT3. rT3 will be high if your unconverted FT4 is high in range. But that is highly unlikely on NDT.
Thank you for this amazing info! Yes I have had gut issues. I am celiac but fully controlled. I tested positive for sibo but took antibiotics. I do take the hormone first thing on an empty stomach. But I do drink a black coffee sometimes in about half an hour. This is probably an issue. Right? That darn caffeine is my weakness.
The only way to find out if the coffee is an issue, is to wait an hour before drinking it. No-one says you have to give it up completely, but at least wait until the levo is out of the stomach. If it is causing the problem, you'll see a difference in your next tests.
Vegovy 
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