How do I raise t4

[ASauer91]

What can raise t4

[SeasideSusie Remembering]

ASauer91

As this is your first post and there is no information in your profile, it would help us to help you if you tell us why you want to raise T4.

Have you got a diagnosis of a thyroid condition?

Are you taking any thyroid meds - if so what and the dose?

What are your current test results, with reference ranges, for

TSH

FT4

FT3

Thyroid antibodies

If you have results for Vit D, B12, Folate and Ferritin, please post those also.

[ASauer91]

Okay my doctor did bloodwork over a year ago and the TSH came back at 2.676 range 0.550-4.780 T4 - 2.6 range 4.5-10.9. So she tried to put me on Levo that made me feel like crap. So i researched and said I wanted NDT. So I am taking NP Thyroid now 60mg.

I felt that wasn't doing enough so I added Thyriod I for the last 1 1/2 months have been taking 1 60mgs. before I go to bed, and 2 -60mgs. in the morning. I feel pretty good.

I requested she do more blood work a week ago. So I had the following blood work done. Vitamin D25- 41.4 range 30.0-100.0, Ferritin- 21.4 range 22.0-305.00, B-12 range 246-911 mine was 2000! was really high so I will quit taking the supplement for a while.

My TSH is 0.055 range 0.350-5.500 T4 is 0.8 range 0.8-1.5 T3 free-2.8 range 2.3-4.2

TPA on 6/2018 was 22

My doctor said according the TSH I am over medicated but the T4 is low so she actually recommended a higher dose. Not sure what to respond. Based on what my tests were what do you think?

I have been mostly gluten free for close to a year.

[Sandria in reply to ASauer91]

You can't test b12 while taking it.. .3 months I think it is off and you can test.. your d3 and iron are way too low... May I ask what country you are in to have a descent doctor ?

[ASauer91 in reply to Sandria]

United States

[ASauer91 in reply to Sandria]

I had no idea you had to wait so long before taking a blood test after stopping B12 I think I only stopped for two days before the blood test and the B 12 that I was taking is the dissolvable tablets . As I am researching low iron and high B 12 and the side effects it causes a lot of things are starting to make sense !

[Angel_of_the_North in reply to ASauer91]

It is usual to have low TSH and low free T4 when taking NDT or T3. Sounds like your doctor doedsn't know that. However, your free T3 (the active hormone) is not very high in range so if you still have symptoms, you could increase by 1/4 grain. If you feel well, just ignore the doctor - you are a unique person not a list of numbers on a blood test sheet. I would still want higher vitamin D and ferritin, though.

[Hidden in reply to ASauer91]

"My doctor said according the TSH I am over medicated but the T4 is low so she actually recommended a higher dose. "

At least the doctor understands you need a higher dose! Some doctors would freak out at the low TSH and not consider anything else. That is brilliant that she is trying to understand what is best for you. Your (more important) T3 levels are not that high either, so it seems obvious that she is right on that.

At the moment I am facing a harder task, to convince the doctors that I need an increase in spite of having high T4 and quite high T3 with low TSH. They think I'm overmedicated but hypo symptoms have got worse. Maybe I have a slight form of thyroid resistance.

Accept the increase and be grateful for a doctor willing to prescribe it. If it causes problems you could always reduce again slightly and increase more gradually. Best not to tell her as you are likely to need a further increase in the future that could be difficult to get otherwise.

All the best

[ASauer91 in reply to Hidden]

Thanks for the advise yes I am thankful for my doctor. She does listen to what I have to say I still feel the need to self advocate though. Going for optimal health not just within range. Lol hope you get what you need as well!

[Hidden in reply to ASauer91]

We have to live with thyroid problems, the doctor doesn't. So the best kind of doctor will listen to us when we say we are unwell. They should also respect the fact that we may have researched and taken advice on our particular condition and do have some idea what we are talking about!

If we respect each other we will hopefully succeed. The doctor has done years of training and knows a lot about many illnesses we have never heard of, but we know about the one(s) we have to live with.

[SeasideSusie Remembering in reply to ASauer91]

ASauer91

My TSH is 0.055 range 0.350-5.500

T4 is 0.8 range 0.8-1.5

T3 free-2.8 range 2.3-4.2

So I am taking NP Thyroid now 60mg.

I felt that wasn't doing enough so I added Thyriod I for the last 1 1/2 months have been taking 1 60mgs. before I go to bed, and 2 -60mgs. in the morning.

So this is a total of 4 grains NDT (4 x 60mg) then?

And you feel well.

Your TSH is what one would expect to see when taking NDT as it tends to lower/suppress TSH.

Your T4 - is the Total T4? It's low and again, what one would expect to see when taking NDT so there is no actual need to increase your T4, it's Free T3 that's the important result when taking NDT.

Your Free T3 is actually quite low for someone taking 4 grains NDT and normally one would expect to see it higher in range. However, you have said you feel well, so in that case unless you feel you need to increase your dose I'd stay with the dose you are on. If you are still symptomatic there is room to increase your NDT.

Vitamin D25- 41.4 range 30.0-100.0,

Is that ng/ml or nmol/L.

If ng/ml the level recommended by the Vit D Council is 50ng/ml, and the Vit D Society recommends 40-60ng/ml.

If it's nmol/L then the Vit D Council suggests 125nmol/L and the Vit D Society recommends 100-150nmol/L.

Ferritin- 21.4 range 22.0-305.00,

This is below range and you need to speak to your doctor. Low ferritin can suggest iron deficiency anaemia so you should ask for a full blood count and an iron panel.

B-12 range 246-911 mine was 2000!

Yes, stop the supplement and retest n 4-5 months, that will give you a baseline and show what you are holding on to.

TPA on 6/2018 was 22

Can't comment on this as you've not put the range.

[ASauer91 in reply to SeasideSusie]

Hi there thanks for the reply!

I take 2- thyriod 60mgs in the morning , and 1- np thyroid 60 mgs at night. So a total of 3 grains.

I will say that my morning dose I do eat right after taking them because I have to hurry up and get ready for work . But they are dissolvable I chew them up and let them dissolve rather than swallowing the whole pill I don’t know if that makes a difference .

The vitamin D is ng/ml

The T4 is T4 free

I did have my t3 total checked last year and that was 68 in a range of 60-180.

So would a small dose of t3 benefit me?

[SeasideSusie Remembering in reply to ASauer91]

I will say that my morning dose I do eat right after taking them because I have to hurry up and get ready for work . But they are dissolvable I chew them up and let them dissolve rather than swallowing the whole pill I don’t know if that makes a difference .

Everything I've read (and I don't take NDT) says that NDT should be swallowed with water, so I can't say if it makes a difference or whether you would be better to swallow them and leave an hour before food. Perhaps if you took your NDT as soon as you wake up, then get showered/ready for work, by the time you're ready for breakfast an hour will have passed.

The vitamin D is ng/ml

Then at 41.4ng/ml you are within the range recommended by the Vit D Society but a little short of the recommended level of 50ng/ml which the Vit D Council says.

The T4 is T4 free

That's an extremely narrow range. Here in the UK there are usually 10 points between the bottom and top of the range. However, your level is where one would expect to see it when on NDT.

I did have my t3 total checked last year and that was 68 in a range of 60-180.

Total T3 doesn't tell us anything useful, it's Free T3 that tell us what we need to know.

So would a small dose of t3 benefit me?

That's hard to say. Your FT3 is low in range but you say you feel well, so do you need to change anything?

But your ferritin is dire and needs addressing as mentioned above. 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. And with a below range ferritin, as already mentioned, you could very well have iron deficiency anaemia. It's essential you discuss this with your doctor.

[765nottyash]

My advice is forget the test results and concentrate on how you feel, reduce any stress in your life, forget the negative people of this world, get enough sleep, improve your diet and relax more. Little things can make all the difference, giving up dairy and gluten made me feel great and alive again, intermittent fasting is helping get the weight off and keeping it off.

Live well and happy Denise