Too much T4 and ?too little T3: Hi there I’ve... - Thyroid UK

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Too much T4 and ?too little T3

Unhole profile image
5 Replies

Hi there

I’ve just got my latest results in and as I suspected my T3 is on the low side but I am also concerned that my T4 is slightly over the upper limit. I have still got problems with weight and tiredness and pains in joints as well as not having much vavavoom!

I’m on 100mcg of levothyroxine.

Could anyone explain my so called ‘normal’ results please? I would very much appreciate your thoughts...

TSH 0.25 miu/L (0.2-4.00)

FT4 22.7 pmol/L (10.0-20.0)

T3 1.6 nmol/L (0.9-2.5)

Vit D 82 nmol/L (75-250)

Previous iron folate Vit B etc within normal range

Many thanks folks

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SeasideSusie profile image
SeasideSusieRemembering

Unhole

T3 1.6 nmol/L (0.9-2.5)

Is that a Free T3 test (FT3) or a Total T3 test? There is a big difference and you need to know FT3 level. If your FT3 is low in range then you're not converting T4 to T3 well enough and low FT3 gives us symptoms. T3 is the most important hormone, the active hormone which every cell in our bodies need, and FT3 the most important test. Total T3 isn't much use.

Previous iron folate Vit B etc within normal range

It's where in range that matters, not just being within range. Do you have the results?

Vit D 82 nmol/L (75-250)

This is slightly low. The Vit D Council, the Vit D Society and Grassroots Health all recommend a level of 100-150nmol/L. You could do with supplementing with D3 and it's important cofactors - magnesium and Vit K2-MK7 - to bring it up into the recommended range. 3000iu D3 daily for 3 months may be enough, retest then and if you've reached the recommended range you could go onto a maintenance dose of maybe 1000-2000iu daily, maybe more in winter than summer, it's trial and error to find our maintenance dose.

Unhole profile image
Unhole in reply toSeasideSusie

Thank you Seaside Sue👍...your message was spot on and much appreciated.

As a result I’ve just written to the GPs and suggested FT3, Vit K and Magnesium be tested and that I stay on VitD therapy (I just finished the high dose therapy 6 weeks ago)

Many thanks once again!😊

Unhole profile image
Unhole in reply toSeasideSusie

Hi again!

GP now say they can’t do FT3 and even an endocrinologist may not be able to order the test either!...so the plan now is to exclude other causes for symptoms and if nothing discovered as an alternative cause then possibly refer to endo🤔all seems such a waste but I’ll see what happens....

if I was not converting adequately what would I notice as a result do you think?

Many thanks and best wishes

SeasideSusie profile image
SeasideSusieRemembering in reply toUnhole

Unhole

I'm not psychic but I am going to make a prediction here.

You will get certain tests done - not sure what they will be but they will most likely come back with no problems. Then you will be told that your symptoms are not thyroid related. You may then be told it's a mental health problem. This is all so familiar, all because they wont do the one simple test that tells them exactly what they need to know.

Let's look at what we've got

Total T3 1.6 nmol/L (0.9-2.5)

Total T3 is the total amount of T3 that you had at the time the test was done. That measures both bound and unbound to proteins. The unbound (Free T3) is what is available to be used by your cells. Every cell in our bodies need T3, they can't function without it.

Your Total T3 is 43% through the range, so when you consider that is both bound and unbound, there isn't an awful lot of Free T3 available. The logical conclusion is that your FT3 is low.

It's low T3 that causes symptoms.

I have still got problems with weight and tiredness and pains in joints as well as not having much vavavoom

and there we have symptoms that can be attributed to low T3.

Why don't doctors understand this? Well, that would be because the amount of education on thyroid disease in med school is appallingly low. I think one member's son, training to be a doctor, mentioned one afternoon on the thyroid. So they have a total information bypass when it comes to T3, and are taught that it's only TSH that matters and that must be "somewhere" in range and then the patient is fine and any symptoms are not thyroid related.

[You can see I'm going off on a bit of a rant here!]

So in your shoes I wouldn't waste time and I would get a private test, a full picture that includes a full thyroid panel and all the important vitamins and minerals. You haven't said what your iron, folate and B12 are, so let's include them. Your Vit D has been covered in my previous reply, but it wont hurt to include it again.

I would suggest this test

medichecks.com/thyroid-func...

or this one (same test, different company)

bluehorizonmedicals.co.uk/t...

Either one will be fine, although the Medichecks does Active B12 and Blue Horizon does serum B12. Both companies offer fingerprick test, or you can arrange venous blood draw if you prefer.

Do the test early morning, no later than 9am. Delay breakfast until after the test and drink nothing but water. Also leave off Levo for 24 hours (no longer).

Come back with the results and we can go from there.

Leave it to your GP and an endo (who will undoubtedly be a diabetes specialist as most of them are, thyroid specialists are a bit like hen's teeth) and you would very likely end up with a diagnosis of somatoform disorder.

You are in the same position as hundreds of members here, if not thousands, and we see it every day, and all we can do is help ourselves.

Unhole profile image
Unhole in reply toSeasideSusie

Thank you once again Seaside Sue...sadly I’m also predicting your psychic conclusions will manifest in reality!...I’m a retired mental health nurse and convinced thyroid problems were misdiagnosed as mental health problems...I will see what the Gp says tomorrow but ultimately if the NHS which I want to believe in and I’ve worked in for over 35 years cannot help I will take your advice and go private😕

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