DO I NEED MORE T4: TSH is 0.04 O.40-4.50 mIU/L... - Thyroid UK

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DO I NEED MORE T4

GKeith profile image
16 Replies

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 posted these results 3 days ago. As you can see the only thing low is my FT4. So, funny thing happened last night I got heart palps at 5:30 am when I take my usual 10 mcg of T3: I take 50 mcg of T4 and 10 mcg of T3 at around 1:00 AM & then 10 mcg of T3 anytime around 6:00 AM, give or take. So I took the dose but added 25mcg of T4 and the palps went away. I guess I need to add more T4. I believe, now, after 26 years of never having 88 mcg's of T4 raised or lowered (because they only checked the TSH) that I have been severely under-dosed for many years. If the T4 is converting than I need more T4, as the blood tests reveal, I would think. Anyone disagree?

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GKeith
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shaws profile image
shawsAdministrator

Do you not find it inconvenient to split your doses throughout the day. Meaning that your stomach has to be completely empty each time you dose and I note you take a very early dose but you aren't "free" and it must be difficult to find a window when stomach is empty.

The following may be helpful and the doctor who wrote it was also an adviser to TUK before his accidental death. He took one blood test for the initial diagnosis and thereafter patients took one daily dose of either NDT or T3 (he'd never prescribe levo) and the concentration was all about symptoms being relieved.

naturalthyroidsolutions.com...

SlowDragon profile image
SlowDragonAdministrator in reply to shaws

Many of us find it essential to split dose through the day

Even though it is a slight pain

shaws profile image
shawsAdministrator in reply to SlowDragon

I'm glad I don't and it is such a bind to have to do this for the rest of our lives to split doses. Especially as stomach has to be empty. If it enables people to feel better that's fine although Dr L states that - a once daily dose is preferential.

SlowDragon profile image
SlowDragonAdministrator in reply to shaws

Many with Hashimoto's find this simply isn't possible

GKeith profile image
GKeith in reply to shaws

Well, one reason I was "thinking" of T4 was because of that, specifically, the fact that it's one pill and "done." however, being a former pro boxer, I had to "make weight" for years in my "amateur" and pro fight years and it is a small price to pay for feeling better.

SlowDragon profile image
SlowDragonAdministrator

Yes it's not uncommon to need to increase Levothyroxine dose after T3 is added.

Partly because we might be physically more active perhaps when T3 is added

Or the body realises what it's been missing!

Perhaps increase the Levothyroxine by 25mcg and retest in 6-8 weeks

Personally I split my T3 into 3 doses 8 hours apart. 10mcg at 7am, 5mcg at 3pm and 5mcg at 11pm

100mcg of Levothyroxine at 11pm and 25mcg of Levothyroxine at 7am (recent experiment to see if splitting dose of Levothyroxine makes a difference too)

Important to regularly retest vitamin D, folate, B12 and ferritin

GKeith profile image
GKeith in reply to SlowDragon

Doesn't Levo stay in your "system" much longer than T3? And, I did, (do) feel good taking T3 every 6-8 hours. Of course, it is much simpler and easier to just take one dose but, if (big if) changing my lifestyle, as I had to do to box, make weight, work out daily, etc, then I would, (will) try my best to live such a lifestyle. Dr. Lowe seems a very caring, concerned medical professional, so he must have known, also, that everybody is different: even though we are all human beings, our bodies and minds are typically shaped by forces we have no control over.

shaws profile image
shawsAdministrator in reply to GKeith

T4 does stay in our system long and it is an inactive hormone and has to convert to T3. T3 is the Active thyroid hormone and we have millions of T3 receptor cells which need T3 in them. T3 saturates the receptor cells and then it sends out 'waves' that last between one to three days.

I shall give you a link which was by an Adviser to TUK: he died through an accident.

naturalthyroidsolutions.com...

GKeith profile image
GKeith in reply to shaws

Dr. Lowe seems to be a quite an independent thinker who is hard to disagree with; as his intentions to treat thyroid-related disease(s) appear to be with nothing but good intentions for those with hypothyroidism or any of the many related thyroid problems. He does, however, appear to be totally against the T4 Levothyroxine drug, even as it has been known to "cure" many thyroid patients, myself included, for 26 years, until it failed me by not converting, for whatever reason.

I do not believe it should have been treated, by almost all the GP's and numerous endos, however, as a be-all, do-all, miracle drug. That said, however, it must have some use as it is an enzyme that we all need to function in our thyroid gland, as long as we have one, or a replacement of same, do we not?

There must be a reason for it to be sent out inactive, just to be activated into T3? If T4 circulates as T4 what happens when it is low? as mine was (is) on my recent blood test. My T3 was normal to high range, and, being as the T4 was low, it would seem logical that it is being converted to T3 and I need a little more added from the current (low) dose of 50mcg of T4. Last night, I took a 75mcg T4 pill (from previous self-dosing) and it made me feel a little better because my basal temperature, 97.1 the previous morning was 97.7 that morning. It appears to be simple: my T4 was low (FT4 O.6 from 0.8-1.8 range) and my FT3 was in high range 3.7 from 2.3-4.2 range) so it was converting and needed more T4. At least that's my take (assumption) on it. I'd be very interested in your opinion on this.

shaws profile image
shawsAdministrator in reply to GKeith

Dr Lowe was against T4 for the fact that it was due to 'inducements' to doctors/endos that it eventually took over from NDT (the original replacement).

T4 suits many but it makes some people very ill and that includes me too. To be told there's nothing else available leaves the person nowhere to turn, particularly if they don't have internet connect as many may not. So they've no idea why they are taking prescription medication and feeling worse or even develop more symptoms which will be treated with a 'medication' which is nothing to do with hypo symptoms. i.e. 'depression' is a good example as T3 is rarely checked but will be prescribed with an pill for depression.

GKeith profile image
GKeith in reply to shaws

I agree 100%. In fact the GP's along with many endos, were told that T4, Levothroid, was the miracle drug that would "save them., which, of course, it basically did not and even hurt far too many who could (would) have fared far better on the old prescription of NDT.

GKeith profile image
GKeith in reply to SlowDragon

A funny thing I just thought of. When I first got a referral to an endo, about a year ago, whenever he added more T3, he lowered the T4 dose. The problem, actually, was that I had been under=diagnosed for 26 years, just by TSH, and so he should have added to the Levo, instead of subtracting from it. You know what, SlowDragon, I have wondered, ever since I took my first T3 pill, as to this question: if T4 is an inactive ingredient, it is, and T3, is the only active ingredient, it is, then why should we, anyone hypo, take any T4 at all: if it's just going to convert "turn into" T3 anyway?

SlowDragon profile image
SlowDragonAdministrator in reply to GKeith

I don't think they really know exactly what we need

Some can't cope with any Levo

Others need small dose of Levothyroxine

Some, like myself, seem to need quite high FT4

We are all very different

I agree ....when I was on only 125mcg Levothyroxine....my results looked perfect, but I could hardly put one foot in front of the other. Crippling, never ending fatigue. Yet my dose of Levothyroxine was still reduced by 25mcg when T3 added

The addition of small dose of T3 (just 2 x 5mcg initially) ..... I was suddenly able to walk 2-3 miles. Virtually no fatigue

8 weeks and blood test later. Dose of T3 increased by endo, to 20mcg, 3 doses - 8 hours apart, starting at 7am. 10mcg, 5mcg, 5mcg

Continuing and ongoing improvement. Minimum 10,000 steps every day (I wear a Fitbit) gardening, gym etc.

Hardly suprising several weeks later, I needed to put Levo dose back up as FT4 was near bottom of range

GKeith profile image
GKeith in reply to SlowDragon

So, did he putput the Levo higher and the FT3 higher at the same time?

Do you think, as my FT4 is at bottom of range, I need more T4? The thing I can't figure out is why we (thyroid patients) even need T4 if it has to convert to T3? Why not just take (more of) the T3?

shaws profile image
shawsAdministrator in reply to GKeith

The very original thyroid hormone was NDT (natural desicated thyroid hormone) made from pigs' thyroid glands. It saved people's lives from 1892 and from then on they didn't die a horrible death.

In the 60's Big Pharma wanted a share of the market and levo was introduced (T4 alone to convert to T3). Some of us cannot improve on T4 at all and those who do improve wont be searching the internet.

shaws profile image
shawsAdministrator in reply to GKeith

Quite a number of researchers have proven that many recover more quickly with a T4/T3 combination.

I think you may find this of interest:-

thyroiduk.org.uk/tuk/testin...

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