Latest thyroid results. Reduce T4?

[ceedee81]

The notes from the lab say my T4 dose may still be too high. They also warned that a consistently low TSH can lead to osteoporosis.

Do I need to lower my T4 dose?

[greygoose]

The important thing is, how do you feel at that dose? Your FT4 and FT3 are both at the top of the range, but not over it. So, if you feel good, I wouldn't reduce it if I were you.

And, it's not true. Consistantly low TSH does not lead to osteoporosis. TSH has nothing to do with bones. It would be far more detrimental to your bones to be under-medicated for hypo.

[ceedee81 in reply to greygoose]

I feel ok. Not bursting with energy but not overly tired either. I just wondered if I could feel better by reducing T4. My FT4 has gone up slightly (by 3) since the last bloods. I'm trying to get optimal levels rather than just acceptable.

[greygoose in reply to ceedee81]

Well, of course you are! Aren't we all! But, ask yourself this: did you feel better when your FT4 was lower? If not, then why do you think you will feel better if you lower it now? It will come to the same thing.

[ceedee81 in reply to greygoose]

I didn't feel any different really. I guess I've just been worried by doctors about the low TSH. But if it's not really an issue and my levels stay in range, I'll leave my dose as it is.

[greygoose in reply to ceedee81]

Are you taking T3? If not, you're a super converter!

[ceedee81 in reply to greygoose]

Yes. I wish I could convert! Prior to taking T3 I was a zombie unable to work full time, sleeping for 13 hours a day etc. Since taking T3 I certainly feel more human

[greygoose in reply to ceedee81]

Ah ok, well that does change things a bit. So, maybe you don't need your FT4 quite so high, as your taking T3. However, I don't know if reducing it will make you feel better, and it certainly won't raise your TSH, so up to you to decide if you want to try it.

[ceedee81 in reply to greygoose]

Hmmm if it won't change my TSH I'm not sure there's any point. However it is my life goal to get off T4 completely if only to have as little dealings with doctors as possible.

[greygoose in reply to ceedee81]

Try reducing it, then. See how it goes.

[SlowDragon Administrator]

As you are taking T3 then TSH is almost always suppressed

FT4 and FT3 are within range

Essential to get vitamins optimal

Vitamin D was low and ferritin not brilliant

healthunlocked.com/thyroidu...

How much vitamin D are you supplementing

Are you on strictly gluten free diet?

[ceedee81 in reply to SlowDragon]

I've just had vit D and ferritin tested this week so waiting for results. I take about 4000 - 5000iu liquid vit D but don't remember every day.

Yes I'm on a strictly gluten free diet and have been for about 8 months.

[SlowDragon Administrator in reply to ceedee81]

So I would wait until you get these results back before thinking of changing anything

Do you supplement Vitamin B complex or B12?

[ceedee81 in reply to SlowDragon]

Yes I take a B complex

[SlowDragon Administrator in reply to ceedee81]

Did you remember to stop this 3-5 days before blood test?

endo.confex.com/endo/2016en...

endocrinenews.endocrine.org...

[ceedee81 in reply to SlowDragon]

Yes I usually stop on a Thursday and do the blood tests on a Monday.

[Hashihouseman]

why dont you?

[Hashihouseman]

people should take care with unequivocal advice. . . super supressed TSH often has a health warning and is usually only appropriate to manage thyroid cancer risk. Allowing T3 levels to fluctuate normally even under replacement therapy may be an important element of restoring a more normal thyroid balance. And, perhaps even more importantly, Excessive levels of free T4 are likely to supress intracellular conversion to T3, which is the major Supply compartment for T3. Consequently this T3 supply pathway needs to be optimised with a carefull approach to exogenous T4 dosing to avoid rapid feedback inhibition of intracellular DI02 enzyme activity. It is highly plausible that patients being flooded with free T4 from single large doses of Lerothyroxine turn to excessive exogenous T3 supplementation or suffer iatrogenic low T3, both of which are undesireable. People often say that higher level of free T4 are required in hypothyroidism but this is an attempt to bully the system into increased T3 production and or reduce TSH, often to unphysiologically low levels/both of which could be a vicious circle that many people are selling as a good thing - why? If T3 levels are not adequate despite healthy thyroid levels of free T4 then supplement with exogenous T3 but no more than a healthy thyroid would do! In my humble opinion the best first approach to replacement therapy would be to mimic normal natural healthy thyroid hormone characteristics (not Lab data aggregated from healthy and unhealthy individual blood tests) then make fine adjustments. As an example and Without going into detailed kinetics; for a 70-80Kg body weight this would likely be 100mcg Levothyroxine split into at least 2 or preferably 4 doses over 24 hrs with a 10% increase in overall dose if day time (ie non fasted doses are utilized) In addition, and given the healthy thyroid would maintain about nanomols of endogenous supplied T3, this could well be replaced with 5-8 mcg of exogenous t3 probably best taken 2hrs before rising to be consistent with circadian rythyms. Trial and error may be the way Exogenous T3 is fine tuning. And, finally.. it may be worth considering that The healthy thyroid does not dump 100-200 mcg of free T4 over a few hours hours like a typical dose of levothyroxine doesI The Sledgehammer and nut analogy comes to mind. . . .

[christa1 in reply to Hashihouseman]

very complex explanation , hashihousman, too complex for my sluggish brain to understand. but I will copy and paste it and read it again in a more alert state of mind. it is too early for me and without coffee to kickstart my body. thank you for the explanation.

christa.

[ceedee81]

I was diagnosed with Hashi earlier this year. In may 2018 my antibodies were over 4000 so they've almost halved already which is why I'm not worried about those right now.

[christa1 in reply to ceedee81]

I am glad you know about your hashies, and it is coming down. but not caring about your autoimmune illness is a bit wrong if I may say so! it is the up and down number in the blood test, that is messing with your result and your health. get a holt on your hashies and you might get stable bloodtest results.

and about your question, what you should do about the t4 medication....as you also take t3 meds, if I was you I would cut down on t4 .

I take eutrosic t4 50mcg and THYROID-s 1grain. I self medicate for my needs. in times of stress I take 2 grains insted of one to give my body an extra bust of t3. in times of bliss and happiness (so to speak) I leave out the t4 for a day or more. I just listnen to my body.

I have problems, converting t4 into t3 as a very high Rt3 has shown. it was 700 high and at that time and I felt like a zombi in a dead kinda way.

I still have not much energy and zilch libido but I feel more positive.

christa

[ceedee81 in reply to christa1]

Excuse me? When did I once say I don't care about my illness?? Halving my antibodies shows that I do care. Cutting a hell of a lot of things out of my diet to cure leaky gut and reduce my antibodies mean I care. I have already had discussions on here about my Hashi. This post was about my T4 dosage.

[christa1 in reply to ceedee81]

ok, wrong wording on my part, you said: not worried.

I answered your t4 with my oppinion.