Is it time to increase T4 after introducing T3?

[HashiFedUp]

Your advice guys please. I’ve been on T3 now for months and at first I felt amazing. But my symptoms have returned with a renewed gusto! My T4 was reduced to 75mcg when we introduced T3. Is it time to up the T4 again?

[shaws Administrator]

What dose of T3 are you taking - are you taking T3 alone at present?

[HashiFedUp in reply to shaws]

T3 10mcg first thing in the morning and 10mcg after lunch. T4 75mcg first thing with T3.

[SeasideSusie Remembering]

Is it time to up the T4 again?

What are your results, we can comment if we see results for TSH, FT4 and FT3.

[HashiFedUp in reply to SeasideSusie]

All bloods within range but symptoms continue!

[SeasideSusie Remembering in reply to HashiFedUp]

"Within range" doesn't tell us if your levels are optimal, which is why we ask to see results with ranges. FT4 generally has a wide range from about 12-22. So within range could be 13 and most people would be symptomatic at that level, whereas somewhere between 19 and top of range they'd feel well.

[HashiFedUp in reply to SeasideSusie]

I’m out of county for my Endo so my results are with another nhs trust so I can’t see them on patient access : /

[SeasideSusie Remembering in reply to HashiFedUp]

Contact them and ask for them. We are legally entitled to our test results, whoever does them.

[SlowDragon Administrator]

Bloods should be retested 6-8 weeks after dose change

Common to feel rough a few weeks into adding T3

Best to wait full 6-8 weeks before testing thyroid and vitamins

How much was Levothyroxine reduced when T3 was added?

For full Thyroid evaluation you need TSH, FT4 and FT3 (plus both TPO and TG thyroid antibodies) tested. Also extremely important to test vitamin D, folate, ferritin and B12

Low vitamin levels are extremely common, especially if Thyroid antibodies are raised

Recommended on here that all thyroid blood tests should ideally be done as early as possible in morning and fasting. This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, best not mentioned to GP or phlebotomist)

Last Levothyroxine dose should be 24 hours prior to test, (taking delayed dose immediately after blood draw).

If/when also on T3, make sure to take last dose 8-12 hours prior to test, even if this means adjusting time or splitting of dose day before test

Is this how you did your tests?

You are legally entitled to printed copies of your blood test results and ranges

Private tests are available. Thousands on here forced to do this as NHS often refuses to test FT3 or antibodies or all vitamins

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

Medichecks Thyroid plus ultra vitamin or Blue Horizon Thyroid plus eleven are the most popular choice. DIY finger prick test or option to pay extra for private blood draw. Both companies often have special offers, Medichecks usually have offers on Thursdays, Blue Horizon its more random

Medichecks currently have an offer on until end of May - 20% off

thyroiduk.org.uk/index.html