Results surprise: Hello My results have come... - Thyroid UK

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Results surprise

Frances0008 profile image
28 Replies

Hello

My results have come back from my latest thyroid check showing I’m probably taking too much t3 now. I’m currently on 150 t4 and 37.5 t3.

I was a bit surprised as I’m not feeling like I’ve gone over - I did do a blood glucose check recently and that was really high. Could that be because of high t3?

My resting heart rate is in the 70s and my morning temp is around 97.

I had been very ill and under range on t3 with slow heart rate etc not that long ago really and I’m still having muscle aches, weakness and joint pains so I assumed I hadn’t reached optimal dose yet. Perhaps I just need more time to recover ?

Thoughts?

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Frances0008
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28 Replies
SeasideSusie profile image
SeasideSusieRemembering

Frances0008

When did you take your last dose of Levo and T3 before the blood draw?

Levo should be 24 hours before blood draw, T3 should be 12 hours before blood draw.

If you left those gaps then you are overmedicated on both Levo and T3.

Frances0008 profile image
Frances0008 in reply to SeasideSusie

Is it possible that taking t3 has increased my levels of t4 because I’m just not using my t4 now and it’s pooling? Otherwise it doesn’t make sense why my t4 is now over.

SeasideSusie profile image
SeasideSusieRemembering in reply to Frances0008

Frances

T3 wont increase levels of FT4, taking T3 usually lowers FT4. In my opinion your FT4 is over range because you don't need to take that much (but I'm not medically qualified).

Looking back at your previous posts, this post from 23 days ago

healthunlocked.com/thyroidu...

you say you've been taking T3 for "nearly 3 weeks now", so in six weeks you've gone from zero T3 to 37.5mcg. That is rushing it. In that post, SlowDragon advised

You need to stay on EXACTLY same dose of T3 for 6-8 weeks and retest thyroid and vitamin levels

Usually the advice is to start on 5mcg and increase to 10mcg (2 x 5mcg as split dose) after week or so. Hold at that and retest 6-8 weeks later

As you have already jumped to 20mcg you definitely don't want to go higher without testing

and I think it would have been a good idea to heed her advice.

Another of your posts show that you were taking 125mcg Levo on 4/9/18. What dose of Levo were you on when you added T3? You say you're on 150mcg Levo currently, it's normal to reduce Levo slightly when adding T3 (depending on FT4 result at the time).

SlowDragon profile image
SlowDragonAdministrator in reply to SeasideSusie

I agree absolutely with SeasideSusie

Only ever increase T3 or T4, not both

Only max of 10mcg T3 added initially, usually with 25mcg reduction in Levo. Retesting after 6-8 weeks minimum

Your result strongly suggests you're now over medicated

Frances0008 profile image
Frances0008 in reply to SlowDragon

When I started taking t3 I was very undermedicated and extremely unwell after my doctor had reduced my t4 from 200 to 125. My t4 was bottom of range and t3 below range. That’s why I’m confused that t4 has increased so much as well as t3. I’ve been on higher doses of t4 before without going over range so there must be some sort of feedback loop going on with t3 meaning t4 isn’t getting used. I’m not feeling any negative side effects so I’m not hugely worried but I think I will reduce t3 by a quarter pill and retest.

Breena profile image
Breena in reply to Frances0008

Suggest you get rt3 tested a same time.

MissGrace profile image
MissGrace

Hello Frances0008. This does seem to suggest over medication. But I would honestly go on how you feel. The normal ranges are just and average and standard deviation from the mean. There are bound to be out-liers and if you have no signs of over medication (heart racing, sweating etc) you probably aren’t.

Maybe before you got hypo you always did have high levels and that’s the norm for you. We are all individuals and react differently and there really is no such thing as normal. It always seems ironic to me that they try to get someone who is hypo into the ‘normal range’ when we clearly aren’t normal because our thyroids are screwed! That’s why being in the ‘normal range’ is often not enough - we need to be at the top for T3 and T4 and maybe even higher. Your doctor might panic about the low TSH, but if you’re not over medicated I don’t know how that can have a negative effect. Maybe I’m wrong but others on here will respond who are much more knowledgeable than me.

I’m not a doctor, I can’t give medical advice so it would be worth getting yourself checked out, particularly your heart (I had scary heart racing when I was over medicated), but maybe your optimum is higher than the normal range. And before these blood tests were developed in the 50s, they treated people by upping the dose until they felt well. I wish they still did! Maybe there wouldn’t be so many under-medicated people on this forum then asking for help.

Just my opinion. 😄

Frances0008 profile image
Frances0008 in reply to MissGrace

Yeah I don’t actually feel bad. But I will reduce t3 a bit to try get that lower. The thing I really really want right now is to be able to build up the strength in my muscles and joints again so I can do normal things like pick up my daughter or carry shopping and just not be in pain all the time! I just want to recover from all the damage that last drop did! I really hope it’s possible 🙁

SmallBlueThing profile image
SmallBlueThing

You say you had been very ill and under range on t3. Was that an unconnected illness or feeling ill due to undertreatment?

Frances0008 profile image
Frances0008 in reply to SmallBlueThing

It was due to being undermedicated. I was very hypo with all the symptoms in my muscles and joints. Suffered a lot of muscle wastage this time and damage to my joints.

SmallBlueThing profile image
SmallBlueThing in reply to Frances0008

Illnesses are often accompanied by a more hypo state. I had a skin infection and discontinued the regular dose increases I was having at the time, and then had a series of tests with under range TSH and high but in range FT4. I was then allowed an FT3 test as I was feeling more hypo than usual (near constant shivering). The FT4:FT3 ratio was over 4.6:1 so explained my rationale (including cost!) to my GP for adding NDT and reducing Levo.

I had several flares before treatment but the worst for muscle symptoms was when taking Levo. It didn't affect bowels or temperature -- the symptoms can be different each time.

Since combining Levo and NDT, I made the mistake (for me) of concentrating on NDT for its T3, thinking I needed more. I went from 50 mcg Levo + 2 grains of Thiroyd (instead of 175 mcg Levo) to 50 mcg + 2.5 grains, which was enough for me to feel weak in shoulders and hips when cutting the hedge. That was solved by dropping to 50 mcg + 2.25 grains, and I certainly wouldn't want to hold the previous dose for six to eight weeks, under the circumstances. I was needing to sleep for two to four hours in the afternoon, while turning into more of a night-owl, and that seems to have been solved by increasing Levo to 75 mcg.

Best wishes for tailoring your treatment to your requirements.

Judithdalston profile image
Judithdalston

6 months ago I too added T3 to Levi ( DIYing) after 12 plus years of hypothyroidism with poor conversion, and more recent fibromyalgia diagnosis.... took my T4 down to 75 ( from 125 mcg) and up to 25mcg T3 to find all results even FT3 went down. Been back on 125/25 combo, now 100/37.5...should have blood test soon. Unlike you when hypo my bp/ heart rate goes high...so T3 has improved this, but basal body temp. hardly raised has been 36.3 but gone back down yesterday under 36C. Still tired, aching.... this T3 use is not easy, everyone seems so different! Recommend patience...stick to one dose for 6/8 weeks, then only adjust one med. like Levo downward.

Frances0008 profile image
Frances0008 in reply to Judithdalston

I didn’t start t3 by lowering t4 as I was already very undermedicated at that point. My doc had reduced me from 200t4 where I felt fine , to 125 t4 and I became very ill and unable to do many things and in a lot of pain. I had a lot of upping to do to get back to normal. I actually think I just need to lower my t3 a little. Maybe a quarter or half a pill and I might be in the right place. It’s hard to tell because my muscles and joints are still very painful but I think I’ve just lost a lot of muscle very quickly when my t3 was so low and I’m going to have to do some sort of rehab to get better again as well as getting my dose right.

greygoose profile image
greygoose

Do you have Hashi's? High TPO antibodies?

SlowDragon profile image
SlowDragonAdministrator

In this old post it shows you originally had high antibodies, so you have Hashimoto's and you had very high TSH

healthunlocked.com/thyroidu...

So high results in this test "could" be hashi flare, but you have increased dose significantly in just 6 weeks

T3 is equivalent to 3-5 times the strength of T4

So 37.5mcg of T3 is minimum increase of 112mcg Levo or maximum of 187mcg......plus 25mcg Levothyroxine if also increased Levothyroxine from 125mcg to 150mcg

As you have Hashimoto's are you on strictly gluten free diet?

If not, ask GP for coeliac blood test before trying it

amymyersmd.com/2017/02/3-im...

chriskresser.com/the-gluten...

thyroidpharmacist.com/artic...

scdlifestyle.com/2014/08/th...

drknews.com/changing-your-d...

thyroidpharmacist.com/artic...

Your vitamins looked good a month ago

All thyroid tests should ideally be done as early as possible in morning and fasting. When on Levothyroxine, take last dose 24 hours prior to test, and take next dose 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 exactly 12 hours prior to test

Is this how you did the test?

If so, suggest you reduce T3 by 6.25mcg initially. Perhaps another 6.25mcg after few weeks ......but don't try to reduce too much too quickly

Frances0008 profile image
Frances0008 in reply to SlowDragon

Yes that’s how I did it. I am going to lower t3 by quarter pill, retest and see where I am.

When I started taking t3 I was under range, and t4 bottom range. So I couldn’t have lowered t4 - I was already extremely hypo and very ill.

I’ve taken 200 t4 before and felt well. 175 t4 made me about 3/4 through range before and 150 t4 had made me a third through range - so I assumed it would be the same going back up. Obviously a bit more complex than that.

I’m not going to reduce t4 tho - I’ll reduce t3 and see if that effects t4 storage levels too.

SlowDragon profile image
SlowDragonAdministrator in reply to Frances0008

Good plan on slight T3 reduction

Are you on strictly gluten free diet?

Frances0008 profile image
Frances0008 in reply to SlowDragon

Not exactly, but I’ve cut down carbs a lot!

SlowDragon profile image
SlowDragonAdministrator in reply to Frances0008

If trying gluten free it does need to be absolutely strictly gluten free.

Could be cause of joint pain.

G2G2 profile image
G2G2

High T3 does not cause high blood glucose. Typically, it causes hypoglycemia. Was your doctor concerned by your glucose results? Was it fasting? Please look into blood glucose.

Frances0008 profile image
Frances0008 in reply to G2G2

This article I read suggested it does? I also had low blood sugar episodes when I was undermedicated for thyroid.

thyromate.com/blog/thyroid-...

SilverAvocado profile image
SilverAvocado

Frances0008, if you were on zero T3 6 weeks ago, then you haven't taken the blood test under best practice conditions. Ideally you should wait 6 weeks on exactly the same dose, and then do a blood test. If you don't do that, the test results may not be accurate.

I think there's another option available to you, besides reducing the dose. You could try staying stable on your current dose for 6 weeks and retest. If you haven't felt any symptoms of overmedication at all, it may be that these high tests are just a blip in your body getting used to the new dose.

Apollo_Creed profile image
Apollo_Creed

the consensus here seems to be that you're over medicated, however this forum usually advocates to treat the symptoms, not the blood tests. That being the case, if you're still presenting hypo symptoms in the absence of signs of over medication, then I don't understand why you would reduce your medication. Maybe the blend of medication needs to be changed. Perhaps greygoose, or SlowDragon, or SeasideSusie could clarify their views?

Frances0008 profile image
Frances0008 in reply to Apollo_Creed

My exhaustion seems a

Lot better but I’ve still got really bad muscle weakness, pain and joint pain and stiffness. It’s really hard to know. It came on when my doc reduced my medication, but it hasn’t gone yet after I’ve increased it with t3. Could there be another cause? Not sure! Could it be that my muscles and joints were damaged during the hypo episode and I need physio?? Or maybe I’m just not on the right thyroid dose yet.

HughH profile image
HughH

There are many people on this forum who take large amounts of thyroid medication (T3, T4 or NDT) so that their Free T3 is above range and their TSH suppressed. Most of them seem to be self medicating as they cannot get doctors to help.

Most do not have a diagnosis but could have thyroid hormone resistance, also known as impaired sensitivity to thyroid hormone. With this condition the Free T3 needs to be high to overcome the resistance.

Frances0008 profile image
Frances0008 in reply to HughH

It’s so hard to know! Those people that do that, like that famous doctor who took hundreds of t3 every night, did they have high t3 in blood tests?? I’ve never heard it said if that’s the case. I am not exhausted anymore but I still have muscle and joint pain which started when I was very hypo.

HughH profile image
HughH in reply to Frances0008

Yes people taking high doses of T3 have high Free T3 in their blood tests. Most have given up on doctors and blood tests and rely on symptoms to determine their ideal dose.

I know of one person who had a good endo who wanted to find out what was happening when he took 200 mcg of T3 as a single daily dose. He took the T3 at 8:00 am and the endo planned to do blood tests hourly. After the first sample at 9:00 am the hospital labs phoned the endo to ask what was going on. The Free T3 was so high that their equipment could not read it. They had never seen such high Free T3 and were concerned that it would impact on the calibration of their equipment. That was the end of the test!

Frances0008 profile image
Frances0008 in reply to HughH

Shame! Would have been really interesting to see the results!!

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