I saw a different Endo today and he warned me about my suppressed TSH and over range T3. He was good and said I don’t have to reduce my medication but needs to warn me of the risk of a stroke and weaker bones.
I currently take 100mcg and 37.5mcg T3 along with VIT D, iron tablets, selenium and B12.
He asked if I get the shakes, have heart palpitations, get sweaty, have lost weight, feel anxious. I said I’ve put on half a stone, feel cold most the time and I’ve also suffered with some form of anxiety. I get occasional heart palpitations but used to one T4 only.
I’ve never had over the range T3 so I wonder if that is something to worry about? He said I could always go to 25mcg every other day and see how I feel.
My results are below:
Ferritin. 51 ugl 23-300
VB12. 1502 ngl 130 - 1100
Serum Folate. 10.3 ugl 2.7 - 15.0
TSH. <0.01. Mul 0.35 - 3.50
Free T4. 15.1 pmol l. 7.5 - 21.1
Free T3. 7.3. Pmol l. 3.8 - 6.0
Thanks
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Lindsayf
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I would definitely reduce T3 as suggested, as over range is not good. My TSH is always suppressed but I am careful to keep both T4 and T3 in range. I am concert mostly about the effect on the heart.
He said I could always go to 25mcg every other day and see how I feel.
You can't dose T3 like that, it has a short half life so it has to be a steady amount, the same every day.
Your results show that you may be better with less T3 - say 25mcg instead of 37.5mcg, and a bit more Levo, say an extra 25mcg. But alter doses gradually and tweak until you find the right doses and right FT4/FT3 levels for you.
Your ferritin is too low at 51 (23-300). It's said that for thyroid hormone to work properly (that's our own as well as replacement hormone) ferritin needs to be at least 70, preferably half way through range.
You can help raise your level by eating liver regularly, maximum 200g per week due to it's high Vit A content, also liver pate, black pudding, and including lots of iron rich foods in your diet
The weird thing is I’ve been on the same T4 and T3 dose for over 6 months. My last bloods 6 months ago my T3 was in range and my FT4 was lowers now my T3 is over and FT4 slightly higher. I don’t think he will give me any Extra T4 but I’ll try and call the hospital on Monday and see if there is anyway I can have more T4. Is there any where I can buy Actavis T4 from?
My GP changed my iron tablets to a different sort (less amount per tablet) it’s made me constipated so I’ve stopped taking them till I see him in a few weeks.
My VIT D was 15 so I’m now on a VIT D spray with K2 and will re test in a few weeks.
My last bloods 6 months ago my T3 was in range and my FT4 was lowers now my T3 is over and FT4 slightly higher
Do you always do your tests as advised here so that they compare accurately each time?
When doing thyroid tests, we advise:
* Book the first appointment of the morning, or with private tests at home no later than 9am. This is because TSH is highest early morning and lowers throughout the day. If we are looking for a diagnosis of hypothyroidism, or looking for an increase in dose or to avoid a reduction then we need TSH to be as high as possible.
* Fast overnight - have your evening meal/supper as normal the night before but delay breakfast on the day of the test and drink water only until after the blood draw. Eating may lower TSH, caffeine containing drinks affect TSH.
* If taking thyroid hormone replacement, leave off Levo for 24 hours before blood draw, if taking NDT or T3 then leave that off for 8-12 hours. Take your thyroid meds after the blood draw. Taking your dose too close to the blood draw will give false high results, leaving any longer gap will give false low results.
* If you take Biotin or a B Complex containing Biotin (B7), leave this off for 7 days before any blood test. This is because if Biotin is used in the testing procedure it will give false results (Medichecks definitely use Biotin, they have confirmed this and the amount of time to leave the supplement off).
These are patient to patient tips which we don't discuss with doctors or phlebotomists.
Is there any where I can buy Actavis T4 from?
No. It is prescription only in the UK. It may be possible to buy it from overseas, you'd have to make a new post asking about this and for any information to be sent to you by private message.
My GP changed my iron tablets to a different sort (less amount per tablet) it’s made me constipated so I’ve stopped taking them till I see him in a few weeks.
You could ask to go back on the old tablet, you could buy "Gentle Iron" (Iron Bisglycinate) which is supposed to not cause constipation (I was still constipated when I took it).
Do you take your iron tablets with 1000mg Vit C which is supposed to help prevent constipation?
You could eat liver and iron rich foods instead, as mentioned above.
My VIT D was 15 so I’m now on a VIT D spray with K2 and will re test in a few weeks.
Are you also taking magnesium, as advised when I replied about this in your previous post? If you use magnesium citrate this will help with the constipation. I use the powder form - Natural Calm Original - and my constipation problem has resolved. You start low and build up to the dose you need.
Yes I do all of that expect I don’t stop taking my B Complex 7 days before. I don’t no any night shifts now so maybe that could be the reason. I’m going to take 31.25 mcg of T3 and see if I can get an extra 25 mcg of T4.
I take my iron with Ascorbic acid half a teaspoon. I’ll get some more magnesium as I haven’t had any for a long time... I’ll start taking that before bed.
Your results may not be reliable as you didn't leave off the B Complex. Unless we know for definite that the lab doesn't use Biotin in the assay, it's safer to assume that it does and to not take any Biotin/B Compex the week before testing.
Sorry I’m slightly confused... do you mean the whole test could be unreliable as I didn’t stop the b complex or just my B12 results could be unreliable?
Apparently Biotin can affect any blood test result, although Medichecks only mention thyroid. Medichecks don't say how much biotin, they just say it can affect results and they advise to leave it off for 7 days.
Here is the post which gave details of their reply to a member's query
I’ve got to have bloods again in 3 months so I may keep to My current dose and see what happens. I’ll make sure I don’t take any b12 for 7 days prior to the bloods. Is it worth adding 25mcg of T4 or waiting till after my 3 month bloods?
I take Thorne B complex so I think I’ll keep my levels as they are and wait 3 months.... I might buy a blue horizon and re test sooner. Thanks for the help
Well you learn something new everyday.... I didn’t know until I posted this... so I’m now going to order and private blue horizon test and see what that comes back with
I remember reading somewhere how our optimal replacement dose can depend on time of year - needing slightly more in the winter months than at this time of year. I am not sure how big an effect this is, but might be a contributing factor.
Thanks for that I’ve stopped working night and that’s the only thing different
Did you take the blood test and leave of Levo for 24 hours prior and T3 for 10/12 hours prior, this could alter you FT3 result.
When I have been over medicated like your FT3 I have been losing weight, you have not.
My TSH is suppressed and my FT3 at the top of the range. In the last 9 months I have had my heart tested and a dexa scan done to test my bones. These are great and I am nearly 73 years old, scare tactics come to mind.
I take both T4 and T3 at about 7am each morning unless I’m having a blood test and I’ll then take them after blood has been drawn.
I have put on half a stone and don’t have any symptoms over being over medicated but I’ve reduced down to 25mcg to see how I feel. It’s strange how my T3 levels have gone over range this time when I’ve been on the dose for about 1 year.
It's odd certainly that after all this time your FT3 have gone over the top, there might be another reason for it but I don't know what it is. If I got it right you last took your T3 24 hours before testing, is that correct?
Yes I took my last dose of T3 and T4 about 7am the day prior to my bloods and then took my next dose straight after my bloods had been drawn. I always go to the hospital to have my bloods as I get there each time for 8am
The thing is that most of the people on this site state that you should leave off T3 for only 10/12 hours prior to the test, you have left 24 hours. Logically, your FT3 would have been even higher, what do you think?
I have no idea as I’ve always done the same things... must last bloods six months ago I did the same and yet this time it’s shot over. I’m going to do a private test in a week and not take any B complex or iron and see what that says. The only thing different in my life is I don’t work night shifts now. I’ve never been bothered about a suppressed TSH but I don’t want over range T3.
It's certainly a minefield trying to sort it out. I have dropped down since April 4th from 2.5 grains of NDT to 2 and will test in 4 weeks time. My FT3 was over like yours so I will see if this has made a difference.
After I had gone up to three NDT every day, yes, I did have symptoms I was going to the loo more frequently, hence losing too much weight. I never felt quite right on three either. On 2.5 NDT I felt OK it was just that I was over the top range. I did leave off my NDT for 12 hours before the test.
I am now on 2 NDT for about six weeks now I do not feel very different on 2 than I did on 2.5, watch this space.
I may have to take 2.3/4 NDT I hope not two is easier.
My T3 results depend on when I took last dose. Mine goes up to 10 3-5 hours after dose but drops to 2-3 after 12 hours. Most people on T3 will be over range for the window that T3 peaks. If you have no symptoms of over replacement like tremors, urgent need for toilet etc I was told you feel dreadful if you take too much and that there is no doubt.
I would see if you can get your ferritin up a bit. T3 is actually necessary to build new bone, while T4 breaks down old bone - you need the right amount of each. I wouldn't feel happy with over range free T3, but some people do well and seem to need it over range. Why not try raising ferritin and also dropping T3 by 1/4 tablet a day (to 1.25 tablets) and see how you feel after a few weeks. But I would say that 25mcg every other day is far too big a drop AND you must take the same amount every day with T3 - it's not like levo - and many people need to take split doses (multiple times a day). Doesn't sound as though he knows much about how T3 works
I would split my dose of t3 but I always thought I had to have a empty stomach and not eat for an hour after eating plus I take other vitamins during the day so thought I would be impossible to split hence why I take it all in the morning
T4 can be bought over the counter from any pharmacy in Spain. The brand I have is Eutirox, and I take it with UK prescribed 100mcg tablets of Actavis Levo without any problems. (I have since been prescribed 125mcg in the UK, but had acquired a stash while in Spain last year just in case I couldn’t make progress with the medical system here!) I don’t know of a way to buy it remotely, but perhaps a travelling friend could get it for you? You ask for “Levotiroxina di sodio
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