Hi everyone.
I recently started self medicating T4 and T3 to correct my underactive thyroid.
I have been taking 100mcg T4 and 25mcg T3. Feeling slightly anxious, and irritable, but otherwise better than before starting medication, with body temps staying around 37°c, apposed to the 36°c prior to starting.
Here's my blood results I just had back. Thinking of reducing T3 to 12.5mcg, and upping T4 to 150mcg.
TSH - 0.231 ( 0.27-4.2)
FT4 - 15.6 ( 12-22)
FT3 - 6.38 (3.1-6.8)
Any advise welcome.
TIA
I see you first posted about DIYing thyroid hormones, did you start then? If you did you appear to be doing it too quickly as should stay on same dose for 6-8 weeks then test bloods... eg 50 mcg levo as starter, 6.5 weeks ( allowing for result back) later raise to 75 mcg etc...if necessary raise till FT4 just above range to see whether your FT3 raises to say above 1/2 to 3/4 way thru range. If It doesn’t then consider adding T3. But meanwhile make sure your folate, ferritin, b12 and vit D are optimal ( in upper end of range ). I personally would not recommend using T3 if T4 levo.gets the thyroid results good. Once you use it TSH, FT4 goes down anyway, and you rely on FT3 result only...your’s is good, and ‘how we feel’. Basal temp., bp, pulse can be helpful to record ...perhaps in your case you don’t go over 37 C. Your anxiety could be over stimulation.... did you record what dose you were on when you were not anxious?
It has been 4 weeks since on the T4 T3. I started with low T4 dose, and gradually increased to 100mcg. I felt good on 75mcg T4. Perhaps I should drop the T3, and stay on T4 only, although the vast majority of people say adding T3 made a huge difference, so I'd like to keep taking a small dose of T3.
Would you think dropping T3 to 12.5mcg, and increasing T4 to 150mcg would be a good start judging by my blood results?
But as you have said ‘you felt good on 75 mcg Levo’. People add T3 who don’t feel good on any dose of levo, perhaps due to poor conversion, and can’t get their FT3 to even half way thru range. Again if you drop T3 by 12.5 mcg and raise levo. by 50 mcg in one go that is too much: due to different half life’s and ‘strength’ of the two different ‘meds’ ideally they should be treated differently : T3 leaves the blood system in about 3 days, tho some may remain in cells up to a week, but T4 has a week half-life so if you stopped 50 mcg of that 25 mcg would still be in blood 7 days later, 12.5 two weeks later. So go slowly if you are changing your dose, either 25 mcg levo only and wait 6 weeks, or 1/4 T3 pill and wait 2 weeks, but not both at same time. You have to be very patient.
I was taking 25mcg T3 with the T4.
T4 needs to be higher in range, whilst T3 appears to be slightly too high. I'd guess that halfing the T3 dose, and slightly increasing T4 would make sense?
No FT4 does not need to be higher in range, T4 is not in itself an active hormone, it only converts to active T3. Once you use T3 you can give up on the advice you see on the forum re ‘ TSH at 1 or under, FT4 at top of range’ etc this only applies to those on levothyroxin only. It is only the FT3 result that might be relevant. However some on T3 need highish FT4 to feel good, others just go down the T3 only route , like I am now. Some even need FT3 result above the range... so it is all about how you feel ( bp, pulse and basal temp. might help guide you re. under or over medication). Don’t think halving the dose of T3 and slightly increasing T4 as these are big changes all at once: perhaps take 1/4 T3 off and wait 2 weeks, to see how you feel before you consider anything else.
Ok. Thanks for the advise, much appreciated.
I would keep the T4 the same and reduce T3 by 6.25mcg, If you still feel bad after 10 days or so, reduce T3 by a further 6.25mcg.
Would that raise T4 at all? Im aiming to have both T4 and T3 in the upper quarter.
Impossible to say, but when I lower T3, my free T4 rises slightly. Everyone is individual in what they need so don't just go by numbers, consider how you feel. It might be that if your free T3 is high enough your freeT4 never reaches the top of the range.
Your equivalent dose of T4/T3 might be a little too high, i.e. T4 = 100mcg and T3 = 100mcg. 25mcg T3 is equal 'in its effect' to 100mcg of T4. Some people do need higher doses. Do you 'feel' your dose is a bit too much? It isn't sufficient just to look at the blood results.
Excerpt:
One thing that is probably not generally appreciated is that the TSH blood test is unique among blood tests as having a very high inter- and intra-individual variation. In other words, it varies a lot both between individuals at the same time and in the same individual over time. This will not be reflected in the reference range because it is statistically derived from the sample population group and statistical methods are intended to highlight overall trends only, so masking individual variations.
Some researchers are now calling for a much more individualised approach to the interpretation of the blood test results, using new reference criteria based on a combination of TSH, FT3 and FT4 results.
In reality therefore, there is no absolute, definitive 'normal' that can be applied to everybody. Each of us might be 'normal' in some ways and yet be abnormal in lots of other ways because in the final analysis we are all individuals, after all.
So, when the doctor says your blood tests are normal, he means that they fall within the 'normal' or 'reference' range, as it should be called. The problem is that he doesn’t know what is 'normal' for you as your truly normal measurements in health are not available.
thyroiduk.org.uk/tuk/thyroi...
Read 'Safely Getting Well on Thyroid Hormones:-
naturalthyroidsolutions.com...
If adjusting dose, it is recommended a 1/4 tablet each time (either up or down) always taking note of your symptoms. Blood tests don't tell us how 'we feel' and it i 'how we feel' which should tell us if we're on sufficient dose.
Yes i feel slightly agitated and restless, although more energy than before starting.
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