Hi
I got my results back from this week. Saw Endo yesterday, she has suggested I change from 88mcg T4 and 5mcg T3 to 75mcg T4 and 10 mcg T3 (one 5mcg morning, one 5mcg 2/3pm)
TSH 0.53 range 0.2-4.5
FT3 5 range 2.5-4.5
FT4 15 range 9-21
Endo did mention FT3 slightly over the range at 5 but not sure if that will be ok with this dose alteration. I asked this yesterday but would like some more replies as I am really unsure what to do,
Thank you 😊
Previous thread with replies here for those who didn't see it yesterday
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 it is, I would increase your Levothyroxine not the T3. Your FT4 is pretty low.
How much Levothyroxine were you on before T3 was added? What was FT4 result on that dose
What are your vitamin levels like? They need to be optimal
When were they last tested?
Do you have Hashimoto's?
Hi
They were fasted and not had thyroid meds for around 15 hours before. Yes I have Hashimotos, vitamin levels are ok I am working on them, iron was low but has increased with Ferrous Fumarate. I also am ok for Vitamin D and B12, I was initially on 50mg T4 and 10 T3 and felt ill, so Endo changed me to 88mcg T4 and 5mcg T3 and now has said to change to 75mcg T4 and 10mcg T3
Would increasing the T3 not help up the FT4? x
Would increasing the T3 not help up the FT4?
No, why would it? T4 (the storage/inactive hormone) converts to T3 (the active hormone) by losing one atom of iodine not the other way round. Taking T3 tends to lower FT4. Take more T3 and it will most likely lower FT4 that bit more.
Thanks Susie. It sounds like perhaps I may need to up T4 and not up T3? But only taking 5mcg T3 does it seem worth it?
Although I don’t think I’d do well on 100mcg T4 and 5mcg T3
You probably need to increase both T3 and Levo
But it's recommended to only increase one at a time
If your last dose of T3 was 15 hours before blood test, that was too long. It's given a false low result.......though in your case, that's still a rather high FT3
Last dose of T3 should be 8-12 hours maximum before blood test, even if it means changing time of T3 dose the day before test
Some people only take 3mcg of T3.....Others might take 60mcg ......we are all very different
Your results suggest your FT4 is low, especially as you took Levothyroxine at 15 hours before, not recommended 24 hours. So it's slightly higher than would be at 24 hour gap.
Also some people find they need small dose T3 for a while to sort of "kick start" everything. Then they can get Levo dose high enough. Sometimes then don't need to continue the T3
It's all very experimental
Best to keep good written records of how you feel on each dose and also make sure to keep good records of the test results and ranges on each dose
I took the Levo at 7 am the day before so it would have been 24 hours apart blood tests were 8 am the next day. So would this affect the FT4 reading?
That's about right time gap
FT4 is on low side. On Levothyroxine alone most people need FT4 up around 19-20
With addition of your tiny dose T3 you might not need FT4 right at top of range
But we are all different. It's why it's so hard working out what each individual needs
If those results were your results would you just leave as is and not adjust the T3? x
Personally I would put the Levothyroxine dose up to 100mcg and retest in 6-8 weeks
I had terrible symptoms when FT4 dropped low, even though FT3 was fairly good.
My Levo was reduced by 25mcg (from 125mcg to 100mcg) when T3 was added. Before dose was reduced FT4 was always right at top of range as the only way I could function - typically around 20 (12-22)
After 4 months on T3 and reduced Levo dose, FT4 had dropped at each test, and was down to 14 (range 12-22)
I increased Levo very tentatively, by 12.5mcg. Saw some reduction in symptoms . .....retested after 8 weeks. FT4 had stopped dropping but hadn't risen. But FT3 had risen a bit
So I put Levothyroxine up futher 12.5mcg (back to what it was before T3 was added) Waiting another 8 weeks. FT4 went back to where it was most comfortable (for me) - at about 18-20. FT3 also rose.
Recently because FT3 was right at top of range, as an experiment I tried reducing Levo by 12.5mcg.....again return of same problems as FT4 dropped
If I have to reduce anything in future, it will be the T3 (I take 20mcg as 3 doses 8 hours apart. 10mcg, 5mcg and 5mcg)
Therefore I am investigating if can get 5mcg T3 on NHS....and cost compared to 20mcg
sigmapharm.com/products/lio...
Initial investigation suggests 5mcg tablets are cheaper
Obviously difficult to cut 20mcg into 3 x 5mcg per day reliably .....especially as apparently only 0.025% of each tablet is the active ingredient!!
That’s my problem! I take 5mcg T3 do just one pill also have Sigma Pharm tablets. So if I just take 5 that’s ok as it’s one pill only, if I up to 7.5mcg T3 that’s half a 5mcg pill cut and a full 5mcg pill but going up to 10mcg makes it two 5mcg pills. I think I was on 100mcg T4 awhile ago and had palps but this was before I added T3 and reduced T4. Its all so confusing!!! Thanks for your help, I just don’t want to feel palpy again xx
Palpitations can be due to under medication as well as over medication
Or might be poor conversion
Interesting that you have the 5mcg tablets. Is this private prescription or NHS?
Could you find out from Pharmacy the cost, if NHS ?
We are all different, you will have to make up you own mind.
You could stick as you are and retest in a further 8 weeks. See what has gone up....or down
Always keep good record of how you felt on each dose and record of results on each dose
It’s NHS my Endo wrote to Gp stating I needed them due to the dose also I am lactose free so they are also lactose free. I can try find the cost for you but I think it’s around £100 for one tub of 100 pills or something disgusting like that!
Yes I was told it's £130 for 90 tablets
That's cheaper than the 20mcg tablets even if taking 4 pills per day
I think NHS should be prescribing these for everyone
Sigma Pharma 5mcg T3
£130 for 90 = £1.44 per tablet
20mcg = 4 tablets per day = £5.76 per day = per 28 days = £161.28
15mcg = 3 tablets per day = £4.32 per day = per 28 days = £120.96
Morningside Healthcare
£206 for 28 = £7.36 per tablet
20mcg is £7.36 per day = £206 per 28 days
15mcg is £5.52 per day = £154.56 for 28 days
It’s a disgrace how much they cost when other Countries have them cheaper. I agree though the 5mcg is much more economical. I know another lady who is also on the Sigma Pharm tablets and gets them via NHS.
You could stick as you are and retest in a further 8 weeks. See what has gone up....or down
Always keep good record of how you felt on each dose and record of results on each dose
Thanks very much for your help, a lot to think about ☺️
As I said yesterday, it's an individual thing as to where we need our FT4 and FT3 when on combination replacement.
Have you ever had TSH, FT4 and FT3 tested when on Levo only to see what your T4:T3 conversion is like? That's the only way you'd know if you needed T3 to start with.
Having a quick look back at your posts, I can't see any FT4 and FT3 results together. So how come you started adding T3 to your Levo?
But only taking 5mcg T3 does it seem worth it?
If that's all you need, that's all you need. But your result for FT3 is over range, there isn't room to increase T3. I'm wondering if you actually needed to add T3 at all, but only seeing FT4 and FT3 when on Levo only can tell us that.
My Endo added T3 in as I was extremely lethargic on T4 only. I will try and get the older FT4 and FT3 results I’m sure I’ve kept them somewhere
How much T3 to increase by?
Results after trying to increase Free T3. Please help!
Puzzling Results After Increasing T3 Meds
Increase Conversion of T4 to T3
Increased urination on T3
