RESULTS: LOW T4, NORMAL T3?: TSH is 0.04 O.4... - Thyroid UK

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RESULTS: LOW T4, NORMAL T3?

GKeith profile image

TSH is 0.04 O.40-4.50 mIU/L range

My T4 Free is 0.6 0.8-1.8 range 0.8-1.8 ng/dL

My Free T3 is 3.7 3.7 2.3-4.2 pg/mL range

My Total Iron is 205 50-180 mcg/dL (calc) my TIBC is 351 with a 250-425 mcg/dL range

% saturation is 58% , range is 15-60% (calc)

Ferritin level is 41 from a 20-380 ng/mL range

I know my T4 Free shows hypo my FT3 is good, so, whereas if, conversely, the FT3 was low and FT4 was normal it would be a conversion problem but this way around, it appears that the T4, being low, is converting, I would think? So. I need more T4 or … ?

The only other concern would be that I have been fasting a lot because of the blood testsI I take to check my glucose and cholesterol levels and wonder if that would affect my T4 levels? Anybody ever have any similar problems?

17 Replies

Do you take any thyroid hormones, or diagnosed with thyroid problems or Hashimoto’s autoimmune disease? The biggest concern I can see from your blood results, is the low ferritin, should be halfway thru the range. Also important are folate, vit D and B12 for good thyroid health...been tested?

GKeith profile image
GKeith in reply to Judithdalston

I take 30 mcg of T3 & 50 mcg of T4, after taking 88 mcg of T4, Levothyroid, for 25 years. I was diagnosed with hypothyroidism 26 years ago and, after over a year of arguing & fighting with GP's got an endo to prescribe me some T3, which immediately made me feel much better. I've had my bloods tested before and everything has been "within range," although the Ferritin has been around 40 several times. I feel good but am wondering if my T4 being low is converting or not? That is the purpose of this post, mainly, if anyone knows or not if, with a T4 low and a T3 where it belongs is the T4 converting or not?

Judithdalston profile image
Judithdalston in reply to GKeith

I have been thru the adding T3 to levo., getting from max. 150 mcg dose to combo of 50 mcg T3 and 100 mcg T4, though now on nearly 70 mcg T3 only. Once you take T3 then the FT4 result goes down automatically, as does the TSH, and only the FT3 result is important. I presume you weren’t converting well in the first place, tho 88 mcg of levo you took for 25 years was a low dose anyway...did you ever raise this dose to put the FT4 out of range, if so what was the FT3 result? Raising your ferritin will improve your thyroid health. The idea of equivalent to of T4 to T3 becomes rather irrelevant for unhealthy hypothyroids as you ‘swopped’ 88 mcg T4 for 140-170 mcg of T4...don’t worry about the levo. producing low FT4, if you feel all right you might not need it at all, some do like to keep it at 75% in range, others, find it’s not needed. You may find when ferritin up you need adjustment in doses downward. Do you keep a diary or bp, pulse, how you feel, basal temp., to use alongside results, so that you can adjust dosing in future?

GKeith profile image
GKeith in reply to Judithdalston

I do check my basal temps first thing in the morning and sometimes afternoon. Once I went off T4 I did a lot of research and saw the large lens you need to look at this hypo and hyper syndromes, I had both at the same time many times, and I realize you need seleneuim, zinc, and other vitamins just to convert T4 to the active T3. I don't do well on T4 alone and the low dose of T4 with 30mcg of T3, which is equal to about 105 mcg of T4, makes me feel much better. Whether I'd do better still on NDT or T3 only remains to be seen. I'm just afraid to try NDT because my endo will start me on so low of a dose, as opposed to starting me on an equivalent of what I'm on, or very close to it, today and I'm not sure about NDT?

Judithdalston profile image
Judithdalston in reply to GKeith

bit alarmed you say you had both hypo and hyper at the same time...do you mean you have alternated from being under to over medicated? Ie having Hashimoto’s disease’flare’.

GKeith profile image
GKeith in reply to Judithdalston

No, I don't have Hashi's; only Hypo. But, it is a known fact that you can show signs of both and be only hypo.

Hello GKieth, Are you taking T3? If you are on T3 you'll get this kind of pattern if you are T3 only or if you are on T3 and only lowish dose of Levo? T3 will signal your pituitary gland to reduce TSH which in turn will signal your thyroid to stop producing any T4 it is still capable of. There are other more experienced T3 users here who can advise on getting a balance. I take 20mcg T3 and of I take less than 100mcg Levo my T4 falls below range and I get major fatigue and muscle pain. Talk with some of the other posters here or your endo if sympathetic?

Michael

GKeith profile image
GKeith in reply to

I'm wondering because I have to see the endo today and wonder if taking 50 mcg of T4 & 30 mcg of T3 is keeping the T4 low or what? Because it feels as if the 50 mcg of T4 I take with the 30 mcg's of T3 is negligent. I was on Levo only for 26 years and did good until a year ago when it wasn't converting and I was trying to eat much less sugar. I'd much rather take just one pill (T4) again but if it's not agreeing with me, I don't want to take it (at all) esp. if it is so low and feels and appears negligent. I was on 88 mcg of T4 for the full 26 years never diagnosed up or down and, wonder if the Levo should have been raised years ago? Of course my endo lowered the T4 every time he gave me more T3 so consequently I'm on 30 mcg T3 & 50 mcg T4. The T4 should probably be 100 mcg or more but the endo would then take all my T3 away, making no sense to me as I realize I was probably on too little T4 when I crashed, with terrible headaches and brain fog a year ago and never want to repeat that. So, I am in a catch-22: supplement myself with more T4 with 30 mcg of T3 to see what would happen or keep taking the 30 mcg T3 & 50 mcg of T3.

in reply to GKeith

seasidesusie and slow dragon were a big help to me getting used to a T4 and T3 combo. Why not ask them for advice. It's always very helpful.

GKeith profile image
GKeith in reply to

O.K. but do you think a T4 & T3 combo is superior to NDT, which, after all, has T1-T5 + calcitinon? Of, until I try it I'd can't know how NDT would make me feel.

in reply to GKeith

You will have to try for yourself GKeith, but hopefully with some help from this site. Everyone responds differently, you may also need nutritional advice regarding your b12, D, ferritin and folate levels as these can affect your symptoms too. Personally I don't feel well on less than 112.5 T4 if taken on its own. I was on 75 T4 plus 20 t3 and this fixed my brain fog but left me very B tired and achy. I've just increased to 100 T4 plus 20 t3 but am now getting mentally high so probably too much of one or other, never tried NDT. So you can see it takes a bit of trial and error and I really relied on expert advice from this site.

Michael

GKeith profile image
GKeith in reply to

I know & you need certain amounts of selenium, iron and others to convert T4 to T3. But, (why) would that also be true for taking T3 alone?

in reply to GKeith

Not sure about that, maybe post a question someone is bound to know

This might be of interest, posted on another thread: Calculating Your Levothyroxine / NDT / T3 Dosage

tiredthyroid.com/blog/2014/...

helvella profile image
helvellaAdministrator in reply to cc120

I do agree with her that it is an estimation of minimum requirement.

My spreadsheet does the arithmetic and uses several different formulas. Which also rather emphasisies the fact that those who invent formulas disgree with each other. :-)

Read the words (disclaimers, etc.) carefully:

dropbox.com/s/779n1uycxtujx...

GKeith profile image
GKeith in reply to helvella

These are for people who've undergone thyroidectomies. I still have my thyroid. Besides, I always feel that doses of (anything) hormones are personal to that person and his/her lifestyle(s)

GKeith profile image
GKeith in reply to cc120

Very interesting and informed post. Thanks for that. I always find that everyone responds a little differently to hormone meds but exchanging dose levels, etc. is very helpful and uplifting.

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