I'm currently on 100mcg T4 and 20mcg T3 and have just received the following results:
Thyroid Hormones
TSH: 2.62 mIU/L (Range: 0.27 - 4.2)
Free T3: 5 pmol/L (Range: 3.1 - 6.8)
Free Thyroxine: 12.500 pmol/L (Range: 12 - 22)
I assume Free T4 is so low because I'm converting better now because of the 20mcg T3 I'm taking but I've noticed my Free T3 isn't in the upper part of the range and my TSH is over 2.
Would it my worth increasing my T3 to 25mcg ? Or might it be better to add some T4, perhaps up it to 112.5 mcg ?
Thyroid symptom wise things are fairly good but I still find myself really tired midday and even yawning whilst I'm trying to be more active - like at the gym (I'm sure the other patrons find it hilarious).
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whatevs
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Recommended on here that all thyroid blood tests should ideally be done as early as possible in morning and fasting. Last Levothyroxine dose should be 24 hours prior to test, (taking delayed dose immediately after blood draw). This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, best not mentioned to GP or phlebotomist)
If/when also on T3, make sure to take last dose 8-12 hours prior to test
Is this how you do your tests?
If so, perhaps you need a small increase in Levothyroxine.
Couldn't see any recent vitamin D, folate, ferritin or B12 results in previous posts
When were these last tested?
What vitamin supplements do you take?
As you have Hashimoto's are you on strictly gluten free diet?
Yes no T4 24 hours before and took my last T3 dose at night, over 8 hour before my test.
I'm having issues with Peripheral neuropathy at the moment so currently awaiting results for B12, Intrinsic Factor etc. but I was previously deficient in folate, so am taking prescribed 5mg Folic Acid tabs (I've been very lax taking this, very sporadic, so it may be this that's causing those problems !)
The only thing with increasing T4 is that when i first started introducing T3 I felt horrible and it wasn't until I reduced my T4 from 150mcg to 100mcg and some time had elapsed to get the extra T4 out of my system that I started feeling better.
I'm really surprised that my TSH is (relatively) high too given I'm taking T3.
Can I ask why you recommend taking extra T4 over increasing T3 ?
B vitamins best taken in the morning after breakfast
Recommended brands on here are Igennus Super B complex. (Often only need one tablet per day, not two. Certainly only start with one tablet per day after breakfast. Retesting levels in 6-8 weeks ).
Or Jarrow B-right is popular choice, but is large capsule
If you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 7 days before any blood tests, as biotin can falsely affect test results
Why do I suggest increase in Levo.....Many of us find low FT4 causes symptoms. Your FT4 is right at bottom of range.
Personally I found low FT4 (while taking T3) can increase symptoms of low B12 (e.g. Peripheral neuropathy) despite blood levels of B12 appearing to be ok
As you have Hashimoto's are you on strictly gluten free diet?
Hashimoto's affects the gut and leads to low stomach acid and then low vitamin levels
Low vitamin levels affect Thyroid hormone working
Poor gut function can lead leaky gut (literally holes in gut wall) this can cause food intolerances. Most common by far is gluten. Dairy is second most common.
According to Izabella Wentz the Thyroid Pharmacist approx 5% with Hashimoto's are coeliac, but over 80% find gluten free diet helps, sometimes significantly. Either due to direct gluten intolerance (no test available) or due to leaky gut and gluten causing molecular mimicry (see Amy Myers link)
Changing to a strictly gluten free diet may help reduce symptoms, help gut heal and slowly lower TPO antibodies
Ideally ask GP for coeliac blood test first or buy test online for under £20, just to rule it out first
Trying gluten free diet for 3-6 months. If no noticeable improvement then reintroduce gluten and see if symptoms get worse
"Why do I suggest increase in Levo.....Many of us find low FT4 causes symptoms. Your FT4 is right at bottom of range.
Personally I found low FT4 (while taking T3) can increase symptoms of low B12 (e.g. Peripheral neuropathy) despite blood levels of B12 appearing to be ok"
That's really interesting SlowDragon, I've not heard that before. I have heard lots of conflicting things about FT4/FT3 levels and what they need to be on combination treatment.
I suppose it wouldn't hurt to up my Levo to 112.5mcg a day and see what happens.
That’s interesting Slowdragon...i’m experimenting with T3 only dosing after being on combo T4:T3 ( last on 100: 50) for a year. Been on T3 for 6 weeks slightly raising it from 50 mcg to 70 mcg, and conscious this last week or so of symptoms I might have considered to be low B12 : from vertigo ( and yesterday went to chiropractor to have neck ‘straightened’) , ? ‘sprained wrist’, to tingling in legs. B12 has never been problem, last blood test was, as regularly, slightly over range, but I have taken to supplementing this last week! Very odd this T3 lark...yesterday I found from this forum that it raises blood sugar too. May have to reverse back to combo after all after next blood test!
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latest test results
SLIGHTLY HIGH FREE T3 BUT MANY HYPERTHYROID SYMPTOMS
