Added T3 ... but FT3 gone down!

[Judithdalston]

Last winter I spent 24/7 on a sofa almost unable to walk with a diagnosis of fibromyalgia, which I put down to 12 years of poorly treated hypothyroidism. My Gp had tested my TSH only yearly. Research brought me to Dr. Lowe's treatment.... I upped my levothyroxin to 133 mcg to take FT4 over range (12-22) at 22.60, and still my FT3 was 4.72. I was not converting T4 to T3 adequately ( in 2006 my conversion ratio, which was ignored by doctors, was 5.39:1, now it was 4.79:1). I had also checked my VitD, B12, folate and ferritin, and started supplementing to get them to optimum.

I reduced my levothyroxin to 125mcg, started to keep records of basal body temperature ( with glass thermometer by mouth), and Bp and heart rate. I noted that members suggested decreasing T4 by 25 mcg for every 10 mcg of T3 added. I was hoping to add, gradually, a whole 25 mcg T3, Tiromel pill, so knew that this might mean an 'exchange' of 62.5 mcg levothyroxin, but realised as a bad converter this might not hold true. Anyway I introduced T3 initially at 1/8 th of a pill in May increasing the dose slowly...I got some high Bp and pulse results, no temperature differences...and reduced my levothyroxin down to 100 then 75 mcg, and kept on this dose for 6 weeks. About a month on this dose the Bp went down nearly overnight from as high as 169/90 to 117/56, and stayed as this 'normal' level. I feel much better- I can walk 10,000 steps daily, but a still get very tired, have aches, hair falling out, still no weight loss, and despite the hot weather can feel the cold.

My recent blood tests from Medichecks showed:

TSH 0.015 ( 0.27-4.2). From 0. 175 on 133 T4

FT4 12.70 (12-22). from 22.6 on 133 T4

FT3 4.57 ( 3.10-6.8) From 4.72 on 133 T4

Antibodies, though Hashi, been normal both May and July tests.

So what happened to my FT3, going down though adding 25 mcg of T3? I have read that suppressed TSH can lead to poorer conversion of T4 to T3, the more you reduce the TSH the less you are able to convert. So I presume I am no longer converting any , or next to nothing, of the levothyroxin to T3, and the 4.57 is largely the T3. I still need to raise my FT3 so presumably I cannot do this by tinkering with an increase of levothyroxin but will have to add more T3. Any suggestions re levothyroxin dose etc. Any comments in general about what has happened to my FT3?

Many thanks

[SeasideSusie Remembering]

Judith

I also take a combination of Levo and T3 for the same reason as you, although my FT4 was nearer 30 with poor conversion with FT3 about 5.

I reduced my Levo and added T3, all done very gradually.

When I got Levo down to 100 (from 175mcg) and T3 up to 25mcg, my FT4 was 19.5 (12-22) and T3 near the top of the range.

Assuming, because it's mentioned a lot on here, that FT4 should be lower when on a combination, I reduced my Levo to 75mcg. Big mistake. My FT4 plummeted to 12.8 and my FT3 reduced. I was very unwell and realised that I need FT4 to be higher to function. It also showed that I was still showing some conversion although not enough to do without T3.

So I increased Levo back to 100mcg and eventually found that I need both FT4 and FT3 around 75% through range .

Maybe you could try increasing your Levo and see what happens.

[Judithdalston in reply to SeasideSusie]

Thanks SeasideSusie. Does sound like you were similar to me as you dropped down to 75 mcg levo. everything else plummeted too. I'll go back up to 100 to try it.... bit weird though!

[SeasideSusie Remembering in reply to Judithdalston]

Judith

I think we're all different so we need to try all sorts to find what's best for us individually. I know there are many members who are fine with a very low in range FT4, but for some reason that doesn't suit me. It's taken me a very long time and lots of dose tweaking (plus a brand change of T3 which didn't suit) before I found where I feel best thyroid-wise.

[shaws Administrator in reply to Judithdalston]

Keep in mind that the ranges and results were introduced along with levothyroxine alone. So if we add in other hormones such as in NDT the results wont correlate as we are not taking levothyroxine only. It should be how 'we feel' which is the best judge of whether dose of hormones suits us.

[SlowDragon Administrator]

Personally I think your FT4 is too low, suggest you increase it back up, perhaps 12.5mcg or even 25mcg and retest in 6-8 weeks

you are much more physically active now. And ready for dose increase. Initially I would try adding more Levo, not T3

I found exactly same. Initially dropped my Levo from 125mcg to 100mcg on Endo advice. Added in T3. After several months able to be much more active my FT4 was too low. Now back on 125mcg and 2 x 10mcg T3. More on my profile

[adin]

I not reduced levo when I added t3, now I take 125 tirosint and 25 t3(all first in the morning). After many teaking my levels are good, ft4 is 15,6 and fT3 - 5,6.