At wits end with Thyroid

[Eshep]

I am currently taking 62.5mcg of Synthroid. I have been for 6 weeks.

TSH 1.66 (.5- 4.5)

Ft4 1.6 (.8 - 1.8)

Ft3 2.7 (2.3- 4.2)

It is possibly my own fault for originally going up way too quickly on my Synthroid and causing a reverse t3 problem (rt3 18). Before I was on 100mcg Synthroid with the reverse t3 of 18 and ft3 of 2.7. So I reduced my Synthroid to 62.5mcg and my free t3 is still low at 2.7!!! Waiting on most recent reverse t3 results but I know they will still be high.

I just want to feel good. Should I go off the Synthroid all together and start on 5mcg (x2) a day of Cytomel? I can actually convert t4 to t3 pretty well, if I don’t overload my system with way too much t4, like I did. So my thinking is stop the t4, start the t3, which will lower the ft4 and rt3. Then after a few weeks I will check my levels and see where I am and eventually stop the t3, and start over with the t4, if I ever really needed it in the first place? Any suggestions?

[ShootingStars]

Hi Eshep, what's your Hashi's status and both of your antibody levels? If one, the other, or both are high, that is probably why you aren't converting T4 into T3.

You say that you actually convert well. You definitely aren't if your FT3 is 2.7 and your FT4 is too high in range. When were you converting well, on what dose, and what were your numbers? It's possible your antibodies have increased since then, so that's why you're not converting T4 into T3.

Your FT4 is still quite high in the range, which usually causes symptoms, plus your very low FT3, definitely causes symptoms. Most people do best with FT4 over 50% but below 75% and FT3 over 50% and near 75%. If both are so unbalanced with one so high and one so low like yours are, that can be torturous. Too high and too low in the range is where the most symptoms hang out. Over 50% but under 75% is where there are the least.

That roller coaster of med doses will make you even sicker. The idea is to keep levels stable. No big drops and no big spikes. You still need to take T4. You'd crash without it and your FT3 would also drop even lower, even if you're taking T3. You need T3 to increase your FT3 levels, and T4 to maintain your T4 levels. If you're going to take T3 and 4, lower your T4 to 50 and add T3. Start with 5 for a few days. If you don't feel much change, add a second 5. When I started my meds, it was 50 T4, 5 T3 for two days, then new I needed to add another 5 T3. I did, and immediately felt much better. I eventually increased to 5 more T3 p.m., and eventually increased my T4. It's been years and my T3 is still 15 mcg a day, plus my T4.

[Marz]

Do you have good levels of B12 - Folate - Ferritin - VitD ? - so your thyroid hormones work well and for you to feel well ...

[greygoose]

rT3 only stays in the body for a couple of hours, before it is converted into T2. So, the rT3 caused by you increasing your synthroid too quickly (which doesn't cause rT3, anyway) will be long gone. It's having high levels of T4 that causes rT3, because it stops you becoming 'hyper'. It's a safety measure. When your FT4 gets to a certain level, it starts converting to more rT3 than T3. It looks like you have poor conversion, anyway.

So, yes, your rT3 results will probably still be high, because your FT4 is high in range. But, you don't have to stop the Synthroid altogether. Just lower slightly and add in the T3. But, I don't think much of the idea of then stopping the T3 and going back to Synthroid only. That will really confuse your poor body! Stay on T4+T3, why not?

[Eshep in reply to greygoose]

Thanks Greygoose! You always have the best answers. I was hoping you’d chime in. I am on 62.5mcg Synthroid. What should I lower my Synthroid to?

And I was thinking of adding 5mcg t3 in the am and another 5mcg in the afternoon, in hopes of lowering my free t4. Does that sound like a good place to start?

[greygoose]

Take it down to 50 mcg. But, only start on 5 mcg T3 a day. You can increase it by 5 mcg in two weeks time. You need to give your body plenty of time to get used to it.

[Eshep in reply to greygoose]

Then in two weeks when I increase by 5mcg, should I lower my Synthroid dose?

[greygoose in reply to Eshep]

I think once it's at 50 mcg, you should leave it at that until you get your next test.

The body will automatically reduce your FT4 to the level it feels comfortable with, because when you're taking T3, the body only hangs on to the T4 it needs, and it doesn't need as much. So, your FT4 level will go down, and thus the rT3.

[Eshep in reply to greygoose]

Wow! I learn so much from you. Literally, what no doctor has been able to tell me in a year, you told me in one posting.

When I was on T3 before, my ft3 would of course increase immediately after taking it, but 24 hours later at baseline it would be 2.6. Does the t4 not know to convert when taking t3?

[greygoose in reply to Eshep]

It will convert, but less of it. Obviously, before, you weren't taking enough T3. But, it will be out of your blood within 24 hours, yes. Which is why we say to leave 12 hours between your last dose and the blood draw.