Optimal Levels

[brighter84]

Could someone please point me in the direction of where the optimal levels of TSH/T4/T3 should be?

My results based on 50mg T4 and 20mg T3 are:

TSH: <0.01 (0.3 - 5.0)

Free T4: 11.5 (7.9 - 16.0)

Free T3: 6.3 (3.8 - 6.0)

The endo has just reduced my T4 dose to 25mg/50mg alternating days to try pull my TSH back up and I have symptoms returning - breathing difficulty, IBS, mood swings, depression.

I'm just at a loss, it seems I just can't find my sweet spot. I've tried NDT, T4 only and T4/T3 combo and things just seem to be getting worse. I need to get my vitamin levels retested I think as well.

[SeasideSusie Remembering]

Your endo should know that taking T3 means that TSH will be low, even suppressed. Lowering your dose of levo may not raise your TSH but will very likely lower your FT4 and possibly your FT3 depending on how much natural conversion you have.

TSH is irrelevant when on replacement thyroid hormone. It's a signal from the pituitary for the thyroid to produce hormone if it detects that there is not enough. FT4 and FT3 are the thyroid hormones and FT3 the most important result when on T3.

[brighter84 in reply to SeasideSusie]

I'm yet to find an endo who knows about TSH suppression. It's frustrating! Is there some official paper I can throw at her to prove a point?!

[SilverAvocado]

I'd say optimal blood levels are quite close to what you had in the test you showed. The most important level is freeT3, and you want it close to the top of the range.

Did you feel completely well on that dose, or was there still a lot of room for improvement? Symptoms are more important than test results. Its just a shame your doctor doesn't understand the importance of the freeT3 result. Most doctors don't

If you haven't tested vitamins, you definitely should look into them as you may get big inprovements. Start with ferritin, folate, vit B12, vit D. You may be able to get your doctor to do some of them (especially if you go straight back and say that your health has declined). But there are also mail order, finger prick blood tests from Medichecks or Blue Horizon.

[brighter84 in reply to SilverAvocado]

I don't know what "completely well" feels like anymore at this point to be honest. I'll ask for some blood tests to investigate the supporting factors. Thank you.

[silverfox7]

I would look for a different Endo if you need to see one in the future. My last Endo on my first visit told me that results are read ifferently when taking any form of T3. TSH will be suppressed, FT4 can fall in the range but FT3 should be high in the range but not over. I could have kissed him for that, a breath of fresh air. Sadly he only stayed a year!

[brighter84 in reply to silverfox7]

Goodness, if only we could all be so lucky! I've already ditched one endo because he took me off T3 and said it was only for people who had thyroid cancer or who were in a coma.

[jgelliss]

What an outrageous unprofessional comment to make . It's so obvious this Dr does Not understand Thyroid Issues and Dosing .

[brighter84 in reply to jgelliss]

Do you mean the comment about T3 being for those in a coma etc? Yeah... That was the head of the endocrinology dept at my hospital... Such an idiot, couldn't stand the man.

[vocalEK]

This is an interesting article regarding optimal levels of thyroid hormones and how those are interpreted by conventional versus integrative doctors. verywellhealth.com/interpre...