I posted last week and Seaside Suzy was very helpful in responding. I have been thinking about what Suzy said and not sure what to do now.
My question is - do I try and source T3 to take in conjunction with the T4 Levo prescribed? Or not??
Here are my latest results:
MOST RECENT RESULTS: 19 May 2018
T3 free 2.92 pg/ml (2.70 to 5.30)
T4 free 1.21 ng/dl (.80 to 2.20)
Reverse T3 0.15 ng/ml (0.09 to 0.35)
TSH 0.64 mUI/L (0.47 to 4.68)
D3 44 ng/ml (sufficient 31-100)
Following a recent consultation the doctor wishes me to reduce my dose of thyroxine to 75 mcg 3 days a week, and 50 mcg 4 days a week. I live in Portugal and she says she cannot prescribe T3 but if I can source it elsewhere is happy to monitor and advise me on the use of it. Do I need that? Should I reduce my dosage of T4?
Would appreciate some advice about this. Many thanks
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Fran6500
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I think because my TSH has lowered successfully over the past 5 months. I haven't reduced it yet. I feel a lot better than I have done for the last few years but still fatigued often, cannot find words for the end of sentences, remember names or similar and am often hoarse when I am tired. Also, weight hard to lose although I am only just overweight, not obese.
Personally I don’t think you can tell until you’ve taken the Levo dose higher. I wouldn’t advise taking T3 unless you have to as it’s a bit tricky to get adjusted right, worth it if you have to go that way though.
If you reduce your dose, you’ll go back to feeling really rubbish again. Levothyroxine isn’t a treatment - it replaces the hormone you can no longer make. It doesn’t cure you. So that comment about “because my TSH has lowered successfully” doesn’t make any sense! If anything, because your FT4 is also quite low in range, you’d benefit from a raise in levothyroxine, which might even result in you not needing T3. If your FT4 was higher in range, your body might be able to convert more of it to T3 naturally and you’d feel better.
I’d pursue getting more levothyroxine before trying to source T3.
Totally agree its not like taking paracetamol for a headache, this is a daily requirement for good health and natural function. My thyroid was removed and my dr thought if removed my body didnt need it (yes really) and friends who say, isnt that fixed, sorted, done etc etc no it is a daily thing. I am on t3 only and its no picnic when everything not balanced, i have cortisol crashes, which with low cortisol i cant handle, adrenaline rushes to compensate, im still easily fatigued so its no magic cure thats for sure.
I think your dr is bonkers reducing your dose but that seems the big experiment these days just how little can you survive on, not what actually makes us well....rant over x
Can it be guaranteed that it will convert to T3 and not rT3. And if so wouldn't a horse voice be a tell-tale sign that it was creating a testosterone increasing manly scenario fuelled by rT3 .
I think that because FT4 is low in range, it’s not very likely to turn to RT3. RT3, as I understand it, is a mechanism designed to get rid of any excess T4 knocking around. There doesn’t seem to be any excess here.
And re a horse voice being connected to raised testosterone, nay. I guess it’s a possibility but an unlikely one. Hoarse voices are usually inflamed larynxs or something pressing on the larynx, like a swollen gland or a goitre.
You more likely need a dose increase, not dose reduction. Both FT4 and FT3 are low in ranges
FT4 needs to be in top 1/3rd and FT3 at least half way in range
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
Do you have Hashimoto's? Diagnosed by High thyroid antibodies
What about vitamin B12, folate and ferritin levels?
I have had B12 injections and got well into range but not had any for more than 2 months though still have stock of medicine. Am thinking of continuing with that once a month.
Ferritin was low but in range.
I will increase my dosage of Levo gradually and see how I feel.
Taking a daily good vitamin B complex, one with folate in, not folic acid. (Eg Igennus Super B complex or Jarrow B right) Plus possibly a sublingual B12 can both help
If you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 3-5 days before any blood tests, as biotin can falsely affect test results
It was the doctor who advised me to go gluten free but she didnt suggest the coeliac blood test. I did have an operation in March 2017 and have had colonoscopies and nothing was noted about the lining of my intestines being damaged. I understand Coeliac disease damages the intestines if left untreated/gluten is not cut out?
With Hashimoto's we more commonly have gluten intolerance, not coeliac. It's similar, but doesn't necessarily have same visible gut damage
It's does need to be absolutely, strictly gluten free. Watching out for cross contamination, chopping boards, separate toaster, don't share butter, jam, marmalade etc
It does take a while to get use to, thinking ahead, if eating out etc.
Each time you eat gluten it can take weeks or months to recover levels. See Chris Kresser link
Did anyone watch that series that was on the television a while back called Victorian kitchen and bread crisis in times of war. Well they started to put cement and all kinds of stuff in with the bread to bulk it all so that it would go further. With all the cuts this country is having perhaps we are not gluten intolerant maybe we are polyfiller intolerant.
Good that your doctor suggested it. I went totally GF a few years ago. I didn’t test for coeliac first though but it won’t make any difference. My thyroid antibodies have plummeted since I started, I was intending giving it three months to see what happened but there was such a difference I never went back to gluten/ wheat foods.
I don’t find travelling all that difficult. Most restaurants are quite clued up about gluten these days. I found snacking the most difficult to begin with - no much of that sort of thing involves gluten -so I always carried a little tub of nuts and seeds with me or I would buy a pack of cooked chicken -GF of course! - from a supermarket.
Other than that it’s good old fashioned home cooking but I thicken with cornflour or GF gravy mix sort of stuff. I joined Coeliac UK when I startedand got their very usefulhandbook of GF products and general advice. It’s worth doing that when you start. Like Slow Dragon says - you’ve got to plan ahead. I look at online menus to check that the places we want to eat have good GF choices and I make sure to have nuts or something GF in case I need to grab a snack.
Thanks very much. Will ave a look at the website and also those travel cards.
I know I need to make more of an effort because mainly, my digestive system is very dodgy! And when I went gluten free and dairy free in the early part of this year, I had so much more energy.
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I guess it’s a possibility but an unlikely one. Hoarse voices are usually inflamed larynxs or something pressing on the larynx, like a swollen gland or a goitre. 
Update - Thyroid Test Results Requesting Dosage Increase
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