To T3 or not to T3? That is the Question.....

[maymay28]

My Free T3 is 1.9(2.3-5.5). My PCP does not prescribe T3 but my Functional Medicine Doctor does along with NDT. I am presently taking 100mg of Synthroid and intend to eventually go on the NDT. My TSH is 6.1(.4-4.5) and my Free T4 is .8(.8-1.7). Should I supplement the Synthroid with the T3 now? I am due for blood work in about 3 weeks.

[Judithdalston]

Bit surprising a doctor has never increased your T4 dose to top of FT4 range to both get FT3 up and TSH down, as you have a long way to go before you needed to be considering T3 or NDT. Once you add T3 you , and your doctor can give up blood test ranges, and just rely on how do you feel. You will see on this forum very few doctors treat hypothyroidism like this, and get bogged down in blood tests, especially TSH( when it goes into 0.00something range they panic). I've added T3 recently to my T4, because I was not converting T4 properly, and it's not as easy a medication as T4 to use/ administer, in your situation I'd raise T4 25 mcg every 6 weeks to try to get optimum levels first.

[maymay28 in reply to Judithdalston]

Thank you Judithalston for your response. I will wait until my levels are optimal. Hopefully it will rid me of this insomnia.

[shaws Administrator]

Don't supplement now. You have to take sufficient synthroid to get TSH to 1 or lower with a FT4 and FT3 in the upper part of the range. Blood tests have always to be the very earliest, fasting (you can drink water) and allow a gap of 24 hours between dose and test and take afterwards.

This gives the best results for us an may prevent an unnecessary adjustment.

Regarding daily doses, do you allow an hour at least to elapse after taking it as food interferes with the uptake.

[maymay28 in reply to shaws]

Thank you Shaws for your info and I take Synthroid one hour before eating and any other medication and four hours before taking magnesium supplements. My major complaint now is insomnia...I can't seem to fall asleep at night. I'm hoping that once my levels and vit D are optimal, that this will dissipates. I take my Synthroid in the morning, but am thinking about changing to bedtime to see if will help with insomnia. What do you think?

[silverfox7]

When you are only taking T4 then you can see if you are converting or not. At the moment you are not taking enough medication as your TSH needs to be nearer one. That way you can see better if you are converting properly but if you are both FT4 and FT3 will both be in the top third, may be more, in their respective ranges so that is really what you need to know and do for the present.

However if you take T3 in any form by either adding it to T4 or taking NDT or even T3 on its own then the results are read differently and look very different as well. TSH will be suppressed, FT4 can drop in the range and FT3 should be high in the range. Sadly in doing this you cannot tell if you have a conversion problem. This is because the FT4 can fall, not by s set amount but it will just be lower so you can't compare it with FT3 to see if you are converting. You need to check the conversion first and make sure it is working properly.

So get an increased dose and get it optimal. It may involve one increase but could involve more. When that is stable then do your comparison but if FT4 very high and by comparison FT3 very low then you are having problems converting one to the other and this will need to be addressed first.

4 things help our thyroid to work better but results must be optimal. Vit D, B12, folate and ferritin are very important and changes won't solve this overnight. Its depending how low you are on each we could be talking several months. Lots of us need to supplement to get levels high and need to keep supplementing to get it and keep it there.

Many think that the answer is going over to NDT or adding in T3 but often in reality it's not that easy. If the basics aren't in place then sometimes nothing will make a difference so patience is needed. So one step at a time, we can't cut corners, but things should improve giving time to let it happen.

[maymay28 in reply to silverfox7]

Thank you Silverfox 7 for your informative response. Will be doing as you suggest.

[maymay28]

Thank you Reallyfedup 123. When I get my levels to optimal, I will look into the NDT. Right now, I'm trying to get my levels to optimal so hopefully the insomnia will dissipate .