I had these bloods taken around 30 mins after taking my morning thyroid meds.
I’ve since found out that means they could be inaccurate or ‘false’. As I am only on 50mcg T4 and 10mcg T3, what would be best to up T3 or T4 to see if I feel any better as I am feeling exhausted and wiped out lately.
It would be best to get another test done, taken first thing in the morning before meds and food. These results are meaningless I think. If you adjust either dose now and feel unwell you won’t know what to do again. So best to get a test.
Thanks for your reply. Would they really have hit my system so quickly?
It’s annoying having to redo the test as I hate finger pricking.
Which test is best to order for a full picture I will be using Medichecks again. Thank you 🙏🏻
T3 leaves your system quickly but a dose of levo could take about six weeks to gradually reduce.
Your dose is very small indeed I'm not surprised you do not feel well. Are you self-medicating? You ae taking the equivalent (doses combined) of about 80 mcg of levo).
Hi Shaws
Thanks for your reply.
Yes I’ve been feeling very exhausted. I see an endo who has prescribed me t3 due to see her end of September.
Do I retest the test via Medichecks or just trial an upped dose? Would you suggest upping the t3 or the t4?
I have put weight also.
Thanks
Would they really have hit my system so quickly?
I think your answer to that is : look at the results. Would 10 mcg T3 really give you such a high FT3 if you'd left 12 hours?
As shaws says, you're only taking a tiny dose. If you don't feel well on it, I think in your place, I would increase the T3 by 5 mcg, then retest in six weeks - don't bother now. I doubt if 5 mcg would take you over the top, even if that were a true results. 
Hi
Yes your very right!
I doubt it’s even doing a lot! Such a small dose.
When would be best to add the extra 5mcg? I take 5mcg in morning 5mcg in afternoon. Also, I take it the t3 is better to up than the t4? As I had originally thought to try upping the T4?
No, increasing T3 won't increase T4. T4 converts to T3, not the other way round. But, T3 is the active hormone, so best to increase that. Get that to a good level, and then you can experiment with T4, to see what's the best level for you. It's all trial and error.
As is knowing when to take the T3. Myself, I take all mine in one go in the morning. I would suggest trying adding the extra 5 mcg to your morning dose, with your levo. See how that goes. You can always change if that doesn't suit you.
Thank you very much. I will try that then, I have nothing to loose!!
Will try it from tomorrow.
☺️
You're welcome.
I just read the last Endo letter and it does indeed mention she wanted me once stable on the 10mcg dose of T3 to go up to 15mcg, 3 times a day so 5mcg morning 5mcg afternoon.
How could i introduce the other 5mcg at lunch?
Would I need to leave so many hours between the first morning dose and can I eat before/after - how long?
thanks
I think she's being a bit unreasonable, saying three times a day. That makes life very complicated, and I'm not convinced it's necessary. You need to take T3 the same way as levo, on an empty stomach waiting at least an hour before eating or drinking anything other than water. Or, two hours after eating.
It's easy for these doctors to hypothesise, they don't have to live with the regimes they impose!
I know it’s very difficult as it is fitting them all in and then fitting vitamins in also!!
I think she was worried if I had a spike then felt lethargic when it wears off (t3) as that’s whats happening. I’m feeling dead when I wake up then meds in morning wake me up and bring me to life... then after 12/1 pm slowly I fall back to earth with a bang until my next dose of t3 at around 3/4pm which is only 5mcg! 🤔
Really? That's never been my experience. I take my 68.75 mcg T3 and 25 mcg levo all at once in the morning, and don't feel any lift at all. But, then, I don't feel it dropping off through the day, either. We're all different.
I do wonder if that might be because I flood the receptors by taking it all at once, and the cells can then take up all they need. Once inside the cells, the T3 is there for about three days. But, 5 mcg is maybe not reaching all the cells. What is in the cells will still be there at 12/1 pm, but perhaps not all the cells got all they needed. Have you ever tried taking it all at once?
You're right, it would be very complicated, with vitamins and everything, to take it three times a day.
The procedure we must follow if hypothyroid regarding blood tests is to have the very earliest appointment (sometimes that means booking it about six weeks ahead), fasting (you can drink water) and allow a gap of 24 hours between last dose and test and take afterwards.
You can get a private pin-prick one if your GP wont do another and I'll give a link - just in case. Youdraw blood yourself at home and make sure you are well-hydrated a couple of days before, if you decide to get a private test. Also make sure you are well-hydrated a couple of days before.
Hi shaws
What thyroid results will I need I will ask the Gp today as I am due in with the nurse for a thyroid review but not until a few weeks time.
Also, isn’t one 5mcg T3 pill equivalent to 25mcg t4?
I take one 5mcg pill in morning with my 50mcg T4 and then one 5mcg t3 pill around 3/4pm
I don't think you need to split T3 as it means you have to be concious of avoiding food before and after your second dose. It is much easier once daily dosing with combination or not with one full glass of water. There is a lot of misconceptions about T3, first it is the only Active Thyroid Hormone, T4 being inactive, therefore it has convert to T3 before it enters our T3 receptor cells which should be saturated and then it sends out 'waves' which last between one to three days.
25mcg of T3 is approx 100mcg of levo and I have read on the forum that 20mcg of T3 (I think UK only does 20mcg) is approx 60mcg of levo. Don't ask me how that is worked out.
How much is a 5mcg t3 pill?
I could always try 10mcg t3 in morning and 5mcg later afternoon as I have a crash of energy after 12pm lunchtime.
Just tried to get my thyroid bloods appointment changed at the nurse they only have 14th September at 10 am so do I not eat or take meds before this blood draw? I think I’d collapse if I can’t eat before 10 haha
I've no idea how much 5mcg costs but it is probably like everything else, more expesnive than a bigger pill which could be split into the dose you want.
I take my dose of T3 when I get up - not too high a dose and it lasts for more than 24 hours and I don't have any crashes or any symptoms at all except feeling well. I think only UK has 20mcg of T3 others seem to be 25mcg.
Sorry I meant the dose equivalent to t4 how much is a t3 pill 5mcg equivalent to t4 dose
This is all I could find:-
1mcg of T3 (Leiothyronine) is equivalent to 5mcg of T4 (Levothyroxine)
xydasclinic.com/resources/e...
Thanks Shaws, that may mean that 5mcg t3 is equivalent to 25mcg T4
That's a very optimistic view. I find that 1mcg T3 is about 3mcg T4 equivalent. Some people say 4, but only doctors who want a trial of T3 to fail by undermedicating say 5.
That’s interesting, also interesting how doctors want it to fail the trial. I am also sceptical that my doctor wants it to fail as it’s costing them more £ to prescribe me it, also I use the lactose free pills again so more cost for them.
So what would you say 5mcg pill of t3 is in T4 values?
5mcg t3 is about 15mcg t4 equivalent. If T3 doesn't make you better they won't have to prescribe it at all. A whole 25mcg pill is about 75mcg levo equivalent.
Oh it definitely does make me better, I feel better as soon as I take it but it wears off when the t3 wears off..
All thyroid tests should ideally be done as early as possible in morning and fasting. When on Levothyroxine, don't take in the 24 hours prior to test, delay and take straight after test. This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, GP will be unaware)
If also on T3, make sure to take last dose 12 hours prior to test
(So adjust last dose of T3 day before. Eg if blood test is 8am, take last dose T3 8pm day before)
I would suggest you increase either T3 by 5mcg or Levothyroxine by 25mcg and retest in 6-8 weeks and also include testing vitamin D, folate, ferritin and B12
Have you tried taking Levothyroxine at bedtime?
Many take early morning, on waking, but it may be more convenient and possibly more effective taken at bedtime.
verywell.com/should-i-take-...
Always take Levo on empty stomach and then nothing apart from water for at least an hour after.
Other medication at least 2 hours away, some like HRT, iron, vitamin D or magnesium at least four hours away from Levothyroxine
Many people find Levothyroxine brands are not interchangeable. Once you find a brand that suits you, best to make sure to only get that one at each prescription. Watch out for brand change when dose is increased or at repeat prescription. Many patients do NOT get on well with Teva brand of Levothyroxine. Though it is the only one for lactose intolerant patients
Thank you for your reply.
The earliest blood draw I could book was 10am on a Friday morning is this no good? I can keep trying for cancellations, so frustrating.
When would be best to add the extra T3? I take 5 in morning and 5 around 3/4pm.
Is it better to up the t3 rather than upping the t4? Should I also wait until my next blood results before alternating doses or is it ok to trial an increase of either t3 or t4 now?
If you are going to retest immediately then don't change dose yet
If changing dose wait minimum of 6 weeks before retesting
So if test is 10am, last dose T3 at 10pm
Lots of us find T3 at bedtime Improves sleep, so you might find it helpful experiment
Can I eat before the blood test just no thyroid meds? Then when can I take the thyroid meds
Personally I always fast before test so I can take Levothyroxine and T3 immediately after.
Drink plenty of water
I think I’d collapse waiting until 10 am to eat!! Because I’m feeling quite drained alot of the time at the moment, sure just to trial an increase or wait until bloods then trial it after that just means I’d be waiting another few weeks putting it off
You could eat small breakfast 8am latest
Thanks, what kind of thing?
Is the Gp standard bloods for thyroid enough? As you know they don’t test the full panel
Breakfast. Muesli and toast or similar. Avoid tea or coffee if you can, until after test
Absolutely essential to test FT3. Few GP's will do that....even if on T3 (madness!)
FT3 test costs NHS around 92pence......deemed too expensive
Is it better to trial upping the t3 or t4 and would an extra dose of T3 work added at lunch time? Not sure what to do wether wait until results or trial an increase
How long since vitamin D last tested ?
What supplements do you take?
Vitamin d a few months ago but was 90 and was high enough I think, it said beyond average in the results.
I take iron as irons can be low, b complex, vitamin c, vitamin d spray and b12 methyl on my tongue
Sounds like vitamin levels are good
I’d need to retest them all to make sure I am just not a fan of this finger pricking 😨
I pay the extra and get blood draw at local private hospital
Since the finger prick device changed, I found it impossible to get enough blood out.
Is the Gp blood tests sufficient to see how I am doing and if I can increase my meds or will I need to order the Medichecks service with the more full panel for thyroid?
Will your GP test FT3?
You presumably know to stop any supplements with biotin 3-5 days before (eg vitamin B complex) as biotin can sometimes mess up Thyroid and B12 test results
endo.confex.com/endo/2016en...
endocrinenews.endocrine.org...
If retesting iron levels stop iron supplements a week before
I don’t know if they will but I can ask if they will test it, so frustrating. It’s either trial an increase but book private tests for Monday costing me ££ or wait until the test on 14th and hold off on increases
If you are definitely having a GP/endo blood test on 12th, you probably need to hang on and not increase before that
But make sure you don't take T3 or Levo before test. And stop vitamin B complex and iron few days beforehand
Try to have your blood drawn as early in the day as possible eg 8am if possible.
Could you have your blood drawn at your local NHS hospital? I go there for 7am and have usually had it done by 7.30/7.45am. No appointment necessary.
Hi mistygrey, I’ve also experienced the peak and trough after taking T3. It does even out once you get on the right dose, but in my experience it does have to be distributed through the day for me to feel well. I agree with comments made above by others that; taking a small dose immediately before falling asleep can help by improving sleep and helping you to feel better first thing; taking a slightly larger dose in the morning improves how well it works. However it isn’t necessary to take T3 away from food, it’s absorption is unaffected by food so no worries there - it is Levo (T4) that should be taken away from food. As you feel well so soon after taking your T3 this suggests both that; your overall dose of T3 is too low; and it is absorbed very quickly. So it is likely to have affected your last test result. The key is to develop a routine that you’re happy with, both for tests and dose timings. I’ve found that the benefits of splitting dose far outweigh inconvenience. If you always have your tests at the same time the same distance from your last dose this enables you to compare results of tests if you need to - though if you change the size of the last dose before the test, this could affect test result. The advantage of being quite sensitive to T3 is that it supports you to adjust to just the right dose. Good luck
Thank you yes that’s true.
What times do you split your t3 dose at? I might start upping the t3 as I think that’s what my Endo wanted me to try.
I’ve put weight on also so my body probably needs it. So maybe an extra 5mcg at Morning times then the other 5mcg around 3pm I just don’t want a bigger crash from morning to afternoon if the dose goes higher in the morning.
I take first dose when I get up at about 6 /6.30 am and second in afternooon about 3.30. But until dose was established I took afternoon dose about an hour earlier as I couldn’t get through the working day without (!). Be careful using weight as a guide to dosage as I find that I gain weight if on too high a dose as well as if on too low (as I eat more!). However on too low a dose I gain more tummy flab. We’re all different so may not be same for you. Good luck
Blood Results T4/T3
is the T4:T3 ratio in NDT wrong?
Which to reduce, T4 or T3? 
