First conversion now absorption problem advice please

[muci]

Hi I had added T3 (a few Upward adjustments in last few months) to synthroid (was reduced from .88 to .75) in February.

My labs then were

TSH 1.01 (.32-4). FT3 2.8 (2.6-5.8). FT4 16 (9-19) REVT3 22 (8-25)

Now they are

TSH 1.12. FT3 2.9. FT4 13

I am currently taking 7 mcg T3 and .75 synthroid.

FT3 has gone as high as 4.4. But has generally stayed in the 3’s despite increasing T3 dose. I take medication at same time in morning one hour prior to food or drink

Dr. now says I may have a problem absorbing suggests to try 1 more mcg of T3 in the afternoon and see what happens. He doesn’t want to increase synthroid due to high reverse T3 and thinks the T3 is high enough for my weight (which is 54kg).

I’m debating taking an extra 2.5 mcg at same time as original dose and hoping that bump up will increase my T3 snd help the symptoms of hypo I still have. Thoughts would be appreciated

[greygoose]

I don't think you have an absorption problem, I think you're just under-medicated.

How do you manage to get 7 mcg T3? The pills usually come in 5 mcg, 20 mcg or 25 mcg. Or do you mean 7.75 mcg? In any case, such a tiny dose is not likely to make much difference to anything You need more. And, quite how your doctor thinks he can add 1 mcg in the afternoon, I don't understand at all.

Your rT3 isn't that high. It's still in-range. And, even if it were high, that is not a problem in itself. The problem is: what is causing high-ish rT3? It's not the levo you're taking, because your FT4 isn't that high. So, what your doctor should be doing is looking for the cause of high rT3. Low ferritin? High cortisol? An infection? Trauma? Low-calorie diet? There are so many reasons, but none of them are an excuse for not increasing your Synthroid. Your doctor doesn't understand thyroid very well.

However, what you really need is an increase in T3. And your weight has absolutely nothing to do with anything. You cannot dose by weight, because weight does not affect how you absorb your T3 at a cellular level. If you don't absorb very well, you need more T3, no argument. So, yes, you could add in an extra 2.5 mcg, but that would only take you up to 10 mcg, which is still a small dose. But, try it and see.

[muci in reply to greygoose]

Thank you. I have been prescribed compounded slow release T3. I have a 7 mcg dose and numerous smaller ones from the past few months of adjusting.

I feel like I don’t fit into the Dr.’s neat calculation box. The other thing he suggested is take a good probiotic. Which I have been doing anyway. As such I feel like I have to decide myself whether to take a higher dose. I just don’t want to make the wrong decision and feel worse. I’ve gotten this far, by that I mean getting a T3 prescription (in Toronto not easy as all the endos I’ve seen do not believe in it) and I feel like I’m back to where I started.

[greygoose in reply to muci]

OK, well that might explain it. Slow release is not always a good idea. It depends on the state of your bowel how much you absorb. If you have gut problems, you might not absorb very much. For example, if you are constipated, the hormone might come into contact with elements it will bind to, in the gut, like iron, or calcium. If you have the opposite problem, it could be gone from the gut before it can all be absorbed. We notice on here that a lot of people who take slow release T3 don't do very well. You cannot predict how much you will absorb at any given time.

That said, you are undermedicated. So, if I were you, I would increase the T3 now, and leave the Synthroid as it is.

[muci in reply to greygoose]

Ok that’s what I will try. I don’t think it would be easy to ask to change the type of T3 it’s been hard enough to get it at all. I take vitamins in the evening do not think I have bowel issues. Would you suggest trying to wake up earlier to take to have more time to absorb or how about last thing at night?

[greygoose in reply to muci]

T3 has to be taken at least two hours away from any supplements - four hours for vit D, calcium, iron and magnesium. I don't know if taking it earlier would help, you could only try and see what happens. It's difficult to predict what is going to go on in a gut.

[muci in reply to greygoose]

Thanks so much will see what happens with increasing as is.

[greygoose in reply to muci]

You're welcome.

[muci in reply to greygoose]

Actually another question, would you increase the T3 now and just leave the t4 as is??