Test results help

[JacqS71]

Looking for some advice please.

I am on T4 (100) T3 (one 25 over three days, so about 8 per day). I am under a helpful consultant but sourcing own T3 which he is happy with.

My results:

T4 16.6 (12-24)

T3 3.8 (2.9-6.1)

TSH less than 0.02

Vit D 107 (50-200)

Folate, B12, Ferritin all at least mid range. I looked on his screen but didn’t get it all written down.

Bottom line is the consultant thinks I am over medicated. I don’t! He has ordered me an osteoporosis test as he says a low TSH is concerning. He wanted me to drop to 75 but I said no and he was ok as I don’t have palpitations etc. Personally I would like to take 25 more T4. Before I went combo I was 125 T4 and the issue was low T3. Always borderline on the bottom. I think more T4 would up the T3 and T4 as I do convert but not well.

Any advice or thoughts pls? I feel I could do with a little more T4.

Thanks, Jacqui

[greygoose]

When you add T3 to T4, the FT4 is going to drop. Whether or not you need your FT4 higher, is something you're going to have to decide when you're on a decent dose of T3. Because, at the moment, your FT3 is still rather low - a long way off mid-range.

However, I don't understand your dosing of T3. How do you spread 25 mcg T3 over three days? Or do you mean your take 1 x 25 mcg pill every three days? Is that's what your doing, that is not going to do you any good. T3 has to be dosed equally and evenly on the same dose every day. You can't do alternative days like you can on levo.

How do you take your T3? Do you take it on an empty stomach, etc. just like you would levo? If so, then you need to increase your T3. How about 12.5 mcg every day?

Low TSH is not of concern, it's low because you're taking T3, which means that you don't need TSH to stimulate the thyroid, so the pituitary stops producing so much. That's perfectly normal, and nothing to do with osteoporosis. Good that you're having a bone scan, because you could have bone problems anyway, but nothing to do with your TSH level. Your endo believes in fairy stories.

[JacqS71]

I split a 25 into 3. I take it on an empty stomach at 6 am with my T4 daily. Do you think I should increase T3 and leave T4 for now?

The reason I was trying to increase T4 is that T3 is getting harder to get.

Thanks for your help. Jacqui

[greygoose in reply to JacqS71]

Very difficult to split a pill into 3, I should imagine. I think you should increase it to 1/2 a pill every day, and leave the T4 as it is.

I do understand your reasoning, but not much point in increasing the storage hormone if you can convert it into the active hormone. You won't be any better off.

[greygoose in reply to greygoose]

BTW, on this forum you need to reply to someone by clicking on the blue 'Reply' button under the response you're replying to. Otherwise, the person will not be notified that you've responded.

[JacqS71 in reply to greygoose]

Ok. I appreciate your help. Sometimes I get so bogged down I don’t know what to do!! And the consultant was so convincing that TSH was the only important measure ... Thank you 👍👍

[greygoose in reply to JacqS71]

That's what he was taught in med school, for various reasons that I won't go into. But, we, the patients all know that's not true. The most important number is the FT3, because T3 is the active hormone, which gives you symptoms if it's too high or too low. TSH doesn't make you feel anything. It has two jobs: a) stimulate the thyroid to make hormone - so you don't need it for that if you're on a decent dose of thyroid hormone replacement. b) stimulate conversion of T4 to T3 - so you don't need it for that if you're taking T3. TSH has nothing to do with hearts or bones. But doctors, even endos (or maybe especially endos!) know so little about thyroid they do tend to get confused and muddle things up.

[SeasideSusie Remembering]

I agree with what Greygoose has said.

If you are taking 1 x 25mcg T3 tablet every third day then it will be of no use. Quarter the tablet and take 1/4 each day. You'll may find that wont be enough so you could then increase that to 1/2 tablet each day. I quarter my Unipharma tablets easily with a pill cutter, some people use a craft knife.

Remember the correct timings of last dose before blood test:

Levo - 24 hours

T3 - 8-12 hours

And if your endo is happy to monitor you on self sourced T3, then he really ought to know how it affects blood test results.

[JacqS71 in reply to SeasideSusie]

Thank you. It was 24 hrs for both. Do you think that would have lowered my T3 result?

[SeasideSusie Remembering in reply to JacqS71]

Do you think that would have lowered my T3 result?

Definitely. This was explained in replies to a previous post of yours asking about when to take T3 before a blood test

healthunlocked.com/thyroidu...

[SlowDragon Administrator]

Impossible to be getting equal dose per day trying to cut into 1/3rds

Suggest you increase dose to 1/2 a tablet per day (12.5mcg) taking as 2 x 6.25mcg doses per day. 1/4 tablet on waking and 1/4 tablet mid afternoon

retest in 6-8 weeks TSH, FT3 and FT4

Last dose of T3 should be 8-12 hours prior to blood test, so day before blood test move last dose of T3 to 9pm

Graph showing why to take T3 approx 12 hours before blood test

healthunlocked.com/api/redi...

Research Paper data comes from

ncbi.nlm.nih.gov/pmc/articl...