Latest results. Please help!

[Apollo_Creed]

Hi folks,

Below are my latest results. At the time I was on 100mcg T4 and 10mcg T3. I asked for additional T3 on basis that I think it is having some benefits. However in order to do that endo dialled me back to 50mcg T4 and 20mcg T3 on the basis that my TSH was too low. However some of the old hypo symptoms have crept back in. Do you have any recommendations based on these results?

FT3 5.6 (3.1-6.8)

FT4 17 (12.00-22.00)

TSH 0.07 (0.27-4.20)

PS I feel things are on the right track but am still up and down.

Thanks!

[HLAB35]

How are your iron levels? Sometimes thyroid resistance occurs at a cellular level if Iron is low. Also, periods of stress can cause similar issues due to cortisol.

Stop The Thyroid Madness did an article about it, but it's not explained very well.

[silverfox7]

Sadly the Endo does not know much about taking T3! He won't be the only one in the dark either!

When taking any form of T3 results are read differently. TSH should be suppressed, FT4 can fall lower in its range but FT3 should be high in its range but never over! I can't give you any links as it was word of mouth from a previous Endo but my present one has never commented and my TSH is 0.01!

[SlowDragon Administrator]

Your Thyroid results look pretty good

Would suspect low vitamin levels are an issue

Your previous post a month ago shows very low B12 and folate

Did GP test for Pernicious Anaemia before starting B12 injections of daily sublingual supplements

Are you also now taking a good quality daily vitamin B complex?

Have you had vitamin D tested as recommended?

vitamindtest.org.uk

Did you get coeliac blood test before changing to strictly gluten free diet?

[ShootingStars]

Your endo should not have reduced your T4 by 50% when your T3 was only increased 5 mcg. Should have just decreased it by 12.5 mcg, depending on what your bloods were maybe 25 mcg, then retested in 6 weeks. No wonder your FT4 is now just at 50% range. Makes sense that you’d have increased hypo symptoms. Reducing your T4 by 50% is the cause of your increased symptoms. Based on your results and increased symptoms, T4 needs to be increased.

[HLAB35]

Definitely a deficiency problem - just seen your previous post. Slow Dragon is right about this. Also you may have good ferritin but low iron, so your GP should check both (mine does). A good methylatedB complex should help + cofactors such as Magnesium and Zinc.

[Apollo_Creed]

Thanks everybody for you comments. Much appreciated!

silverfox7 could you explain a little further why when taking any form of T3 that the results are read differently? How should they be read?

SlowDragon yes vitamins may be an issue. I've seen a nutritionist and am starting on a programme including diet and supplements, but very early days. Have not tested for Pernicious Anaemia yet, but will do so. Am definitely not coeliac though.

ShootingStars yes, I think I do need to increase my T4. The endo lowered the T4 by 50mcg (50%), which is significant, but increased T3 from 10mcg to 20mcg (100%), so ought to be equivalent dose but a different mix between T4/T3. However I think I'd be better with 75mcg T4 and 20mcg T3.

However, even though I have a progressive endo who sees the benefits of T3, he will prescribe according to TSH. He believes it is still the best measure available because it is my body telling me what it needs. And that makes some sense to me. My pituitary gland functions perfectly well, so it knows whether or not I have enough hormone. But if I wanted to self-medicate and top up my dose with additional T4, how much would you recommend? How do you actually get additional T4 without a prescription (I know T3 is avail privately)? And even if I did self-medicate, it would show on my blood tests, and that would lead to a difficult conversation with the endo!

But perhaps I am on the correct dose, and my pituitary functions fine, and I have the correct hormone level, but it is down to vitamins, absorption, and conversion.

Thanks all!

[SlowDragon Administrator in reply to Apollo_Creed]

You may not be coeliac, that doesn't mean you may not be severely gluten intolerant

Your endocrinologist has reduced your Levothyroxine far too much

Typically an endo reduces Levo by 25mcg to add 10mcg T3 . But often it doesn't need reducing at all. Certainly not reduced again to increase the T3

Such dramatic dose reduction in Levothyroxine will most likely be making vitamin levels much worse

TSH is nearly ALWAYS suppressed on T3

[silverfox7]

I can't really expand on what I have put above but the only accurate reading when taking T3 is the T3 one which if you are taking the right amount should be high ( but never over) . So if we have enough T3 then our body does not hold onto all the T4 but it doesn't drop by an exact amount. The TSH should be suppressed asagain your body has enough T3 and the TSH reading is actually a message from the pituitary asking your body to increase the thyroxine as your body needs more. So the higher the TSH reading the more medication we need but taking enough T3 means we aren't short of it so no need for the pituitary to send a message (TSH) to ask for more. I wastold by my then Endo that the TSH reading is suppressed or even zero but I've read somewhere that the machines in the U.K. wouldn't go as low as zero (my Endo came from Romania so possibly thinks are different there). Sadly many medics hear know very little about the thyroid and even if a patient take T3 some don't insist that T3 is necessary! If your were getting private testing then they wouldn't read them properly either but would say with a high FT3 and a suppressed TSH that you are over medicated but I understand they don't ask what medication people are actually taking so although the figures are correct their interpretation isn't.