Does your low t3 increase when levo is added & upped and your t4 isat top of range anyway....

[Cup-cake7]

So sorry

It's probably a block here

So tsh needs to come down from 3.9

BUT t4 result is healthy near top of range

And T3 being at bottom of range

It's all.about the t3 after all to feel well, yes?

....so therefore upping the t4 will bring down my tsh to a reasonable number, I get this And appreciate now that the t4 may go over range in doing so....

But will the t3 go up because I'm adding more and more t4t4? Is this to be expected in most cases!

It doesn't seem logical to increase an already good level of t4 to over the range?

Has my conversion been not happening because the tsh is too high, that is, strain on the system .

Sorry, I know I'm a pain, but I cannot grasp this

I don't convert well this is a given, can this be just because tsh is high?

( not got the gene as have had the test )

Thanks in advance for patience -

Has anyone else had this please?

......HIGH t4 LOW t3 and HIGH TSH and who have gone on to obtain good t3 levels by adding levo over range ? And mainly felt well again......

[greygoose]

If you take your FT4 over-range, it's possible that your conversion could get worse, because more T4 will be converted to rT3 than T3.

There are many reasons for poor conversion, but high TSH is not one of them. On the contrary, with good levels of TSH your conversion should be better. So, it's got to be 'something else'.

Have you had your vit D, vit B12, folate and ferritin tested? If so, are you supplementing anything that is sub-optimal?

Are you on a low calorie diet? About how many calories do you think you ingest in a day?

Have you had your cortisol tested?

Do you take beta blockers?

And, so on and so forth. There are so many reasons for poor conversion that the chances of finding what is blocking yours are pretty slim.

So, the only other solution is to obtain T3 and take that.

[Cup-cake7 in reply to greygoose]

Saying Thankyou and appreciate you have recommended it to me before

Thankyou for taking time to respond

I have to admit I am desperately despondent trying to do everything right for so so so long and being advised differently here,

....as just told in recent post that first and foremost I need to get tsh down with levo even if it goes over range??? Why is this then?

I would appreciate this to be aired once and for all

Do I need to do this ? I'm told its first port of call? And I did ask about rt3.

end of tether

as you know have worked on vitamins, Gut and adrenals, at least I can tolerate levo now

Yes I need my life back

[greygoose in reply to Cup-cake7]

Normally it is the first port of call. But your labs are unusual. In your case getting your TSH down would mean raising your FT4 well over-range, and that won't help much. It's not that rT3 is a problem, it's just that less T4 will be converted to T3 when FT4 is too high, so it doesn't help. Your TSH is probably high because your FT3 is low. Both T4 and T3 affect the TSH.

[Cup-cake7 in reply to greygoose]

Maybe I need pituitary check or gland xray

[Cup-cake7 in reply to greygoose]

Cortisol just done, saliva

Bedtime one over range, ( my stress was huge that day though )

No other drugs at all

Just vits

Weight still high, dropped two pounds recently with effort and putmbck easily

Calories mainly 2k daily I'd say sometimes lower

Remain wheatless mostly

Iron half way

Take D C B mag omega every day folic good last test

[Cup-cake7 in reply to Cup-cake7]

....have butter semi or full fat milk no cuts anymore like time gone by !

[greygoose in reply to Cup-cake7]

What was your early morning cortisol like?

If your FT3 is too low, it will be an effort to lose weight, and you will put it back on easily.

Best to keep calories over 2000.

I don't think wheat or gluten affect conversion.

So, it rather looks as if you aren't going to find your cause for poor conversion. So, that just leave T3 to try.

[Cup-cake7 in reply to greygoose]

Great struggle to loose weight for daughters wedding. 1 and half stones in 9 months stringent monitoring - yes put it back immediately by certainly not excessive eating

But over 2000 a day is above daily requirements for any woman surely ?

I just basically did all I could to support system in every way

Cortisol saliva

10.9. (6-20). Wakening

4.31. (1.5. - 7.6). 12

1.51. (0 - 5 ). 4pm

3.39. (0 - 2). Bed

Although bed was the day before the other 3 day ones!!! (There was a reason for this but told it may not be a good thing to do)

Huge stress situation over last 8 months (screaming in the car situation). So actually thought adrenals ,at not cope at all

I've stopped Adrenavive

It may sound odd decision, I just felt intuitively to give glandular she a rest

I've just bought relax well. L- tryptophan. B3. B6

In hindsight haps I should get ashwandga

I'm now taking holy basil, thinking liver

[greygoose in reply to Cup-cake7]

I'm not sure the holy basil is a good idea, either. It's not that you need to reduce the bedtime level, it's that you need to increase the morning level. If the morning level rises, the bedtime level will fall back into place. By trying to reduce the bedtime level with holy basil, that will possibly have a knock on effect on the morning level.

So, try to always go to bed and get up at the same time. Have a high protein breakfast as soon as you rise. Make sure you get plenty of vit C - are you taking vit C? - and B vits - all of them, not just B3 and B6, get a good B complex with methylcobalamin and methylfolate - and plenty of salt. And, I think an adrenal glandular taken first thing in the morning would be a good thing. If that clashes with the time you take your levo, take your levo at night.

I'm not sure about the tryptophan, and ashwagadha could lower your cortisol even further.

[Cup-cake7 in reply to greygoose]

Thankyou had so much conflicting advise. DHEA has gone from a three to two two in a year

Il just do as you say and stick with it The Medichecks Doctor,said it may be Cushing as my bed time cortisol was over as said I did it the night before

But think il echo some of this,to,endo, don't want to overload I didn't give him my cortisol results as think he may have put me in hospital,omg

He knows t Is near top, he seemed approachable when I said I've followed here so knew more than I wanted to know ,,,

Article in our Mail newspaper my daughter sent me, has TUK had it.

[greygoose in reply to Cup-cake7]

Medichecks' doctors are just as rubbish as any other NHS GP. They don't know about these things. Cushing's would be over-range all through the day, not just in the evening. You have typical adrenal fatigue, where the adrenals struggle to make cortisol in the morning, when you most need it, and when it should be at its highest, and only manage the higher amount in the evening, when it should be lowest. Cushing's isn't like that.

[Cup-cake7 in reply to greygoose]

....at the beginning of my worst hypo symptoms, 2016, falling asleep weights ion eyelid type, vertigo, slowest brain ciogs over emotional etc st that time my levo was still in good range and tsh 5.3. And t3 still 4.

It's never budged really at all

Levo has stopped me being over emotional mostly, also stopped weights on eyelids and falling asleep so much which I find strange as how can this be and if course tsh has come down a little

Maybe it's the tsh reducing that stops,over emotional

[greygoose in reply to Cup-cake7]

So where was your FT4 when your TSH was 5.3? That's very high for someone on thyroid hormone replacement. Could you post all the results with their ranges, please? That would help. I can't remember them.

Why do you find it strange that levo has stopped some of your symptoms? TSH doesn't make you feel anything. It doesn't cause symptoms whether it goes up or down. It only does what it says on the box.

[Cup-cake7 in reply to greygoose]

Well maybe then it's not levo that stopped me being so emotional, but it coincided with taking it I guess

.....A friend said the other day she had stopped crying since taking levo so kind of confirmed the thought

Maybe it did for her if her t four is low

.....My iPad numbers are misbehaving ......

When I had tsh five and six, I wasn't on medication but yes, my t four was a good level

[Cup-cake7 in reply to Cup-cake7]

T 4 has always been good

T3 always at 4 in bottom third

Tsh was an average 4.5 before diagnosis

The doctor said I was borderline and didn't need treating of course bug... the symptoms I'd had for 15 yrs

So really like,you sadly, our systems had a lot,of recovering to make up as it isn't a switch is it?

Years upon years of struggle and strain in fact so the way I view it

I imagine my gland isn't too bad? Will this be right?

Because my numbers aren't worse?

I do believe I'd had degree of hypo since a teenager, I remember feeling the and and brain fog

And of course post natel depression is a mix of all the hormones being in disarray for a while until they sorted themselves out again

Of course at meno there is no returning to your norm, downhill slide which is what happened to me.

Carol,Cauderman tv presenter talks,of her switch going off at meno, this is exactly how I felt

She takes bio identical hormones and back to old self she says

So if, after all this, my switch is still off. I will be marching to Wimpole st too. Money permitting

Her aim is to get nhs to use them instead of horses urine

But first I need to deal with today, if I dig out old results however there is no record of what I took, although I couldn't get past Twentyfive levo until Dr P gave me adrenwvive

[greygoose in reply to Cup-cake7]

I imagine my gland isn't too bad? Will this be right?

Which gland? Why wouldn't it be too bad? I don't follow you, there. Your TSH is too high, and your FT3 too low, and you have symptoms. Sounds pretty bad to me.

[Cup-cake7 in reply to greygoose]

Well I've been a lot worse 🤷‍♀️😘😘😘😘😘😬🙈

Do these numbers mean I'm putting strain on heart and things ? As I am a lot better these days

I was moving area in '17 when went from 4.6 to 5.7 challenging days (had no pension and trying to hold job down falling asleep in lay-bys 😬 )

Gland meaning thyroid gland

I thought if it was wrecked my numbers would be higher?

[greygoose in reply to Cup-cake7]

No, they wouldn't be higher because you're taking levo.

Low T3 is bad for the heart, but I don't know if it can be classed as strain.

[Cup-cake7 in reply to greygoose]

thanks for replies

Il email endo,tomorrow out of courtesy and explain my knew confident knowledge

Il ask for ndt but expect a no

Il impress my continual low t3 results etc

Is the named personal basis still on the go I don't expect you to know gg

(He can hopefully,get back to ,e when he's checked it out)

🙃

[greygoose in reply to Cup-cake7]

You're welcome.

[JumpJiving]

Can you post your actual blood test results, including the vitamins and ferritin (including the ranges)?

If all other tests are in the part of the ranges where they should be, to increase your FT3 without increasing your FT4 any further, the easiest route (if you can get it) is to take T3. If you cannot get hold of T3, but can get hold of NDT, then the alternative (which I am currently doing) is to reduce but not stop your thyroxine and add some NDT. In either case, make slow changes and wait at least 6 weeks after changes before repeating blood tests.

In my own case, today is day #100 since I took control of my own medication. I had high cortisol levels (over range) previously, and high RT3 levels (near top of range). By switching to a combination of thyroxine and NDT and tweaking the doses, I have increased my FT3 to top of range, am in the process of getting my FT4 to near top of range, and have reduced my RT3 dramatically. My cortisol has improved, now mostly in range, but not entirely. As for TSH, it's dropping, but although I monitor it, I'm not hugely interested by it. As for how I feel, after an initial period of serious fatigue, I am now feeling better than I have in years. Weight is reducing slowly too. Depending on how things go, I might take my FT3 just slightly over range, to see if that gives me my mojo back, but if I do it will only be slightly over. Having said all that, it would definitely be slightly easier maths to work with just T3 and T4 rather than NDT and T4, but in practice the cycle of getting blood test results and tweaking doses would be much the same either way.

[Cup-cake7 in reply to JumpJiving]

Thankyou so much for reply

I'm so pleased for,your success

Yes I've got Metwvive and t3 in stock

I will check my vits again to be sure

I don't know,where to start introducing t3

I've jut had endo apptmt

I really want endo on board at heart, the whole t3 thing does scare me

Re palps etc

[Cup-cake7 in reply to JumpJiving]

I won't be able to take charge as much - too many twists for me

[shaws]

Levothyroxine is T4 only and is an inactive hormone. It's job is to convert to T3 - which is the Active hormone - and it is T3 that is required in our millions of T3 receptor cells in order for our body to function as normal.

Sometimes we cannot convert T4 to sufficient T3 and they used to prescribe a T4/T3 combination which helped relieve symptoms. They no longer prescribe T3. I believe only an endocrinologist can but the cost of T3 has risen by 6,000% over the past year.

[Cup-cake7 in reply to shaws]

Thankyou

So it is looking as if I need to take t3

Yes I have some in stock

I also had a dabble with Metwvive

I maybe didn't take high enough and aware it is t regulated the same - I was hell bent on doing it the levo way as sadly there was misunderstanding

[shaws in reply to Cup-cake7]

However you mean to continue, make sure you are doing it safely, i.e. any increase has to be very gradual and take note of clinical symptoms and the relief of them.

[Cup-cake7 in reply to shaws]

Thankyou

I have written to the endo I spoke with last week

I've explained about adding more levo to an already healthy level? And that mt t3 remains low after following TUK advice to promote conversion ......

I have asked therefore he t3 trials me 🙈🙏🏻

If he won't can I report him somewhere please? After all I've taken solid advice from the best source!! ( here) itnis NHS choices anyway

This alone has confused me how there's such differing advice!!

[shaws in reply to Cup-cake7]

I don't know what 'rules' they have to abide by.

It is very difficult for even endocrinologists to prescribe T3 as the cost is prohibitive now. It all depends on several factors I believe i.e. whether or not the patient can convert T4 to T3 or have 'thyroid hormone resistance'.

I assume if a 'private Endo' is consulted and he gives a prescription for T3, it is the patient who will have to pay.

[Cup-cake7 in reply to shaws]

...yes but I would report somewhere I needed it, not a personal attack as such, but then, maybe TUK have done this

I'm happy to say now that I don't convert much, as level not budged in over two years whatever I have done although I don't feel quite as horizontal so to speak!

I can offer to send over all my bloods, if he replies which I'm hoping he will out of coutesey

[Cup-cake7 in reply to shaws]

I'm not private , sorry I don't know

On the other hand, how can they refuse if you not converting..?

Is there a good reference to point me too pls, anybody, to back up the required level of FTthree for well being .? So I can have it at the ready if responses say mine is adequate

[Cup-cake7 in reply to Cup-cake7]

....I'm determined to nibble away at it

[Cup-cake7]

Yes ok Thankyou

I do need advise to get on t3

It seems the time has come

I will though email endo tomorrow to,see if he has input

If say I took t3 alongside my levo, what will I expect number wise? Will my tsh co,e down, yes it will

Will my t4 come down?

And finally will have better t3 reading,

Are they to meet somewhere in middle

[shaws in reply to Cup-cake7]

I have read that a T4/T3 combination, scientists have proven that a 4 to 1 or 3 to 1 ratio works well.

[Cup-cake7 in reply to shaws]

Thanks

I can't equate what this means re my results

Or are you meaning when you take ndt

[shaws in reply to Cup-cake7]

I mean T4 combination/T3. NDT contains T4, T3, T2, T1 and calcitonin and because it's made from pigs thyroid glands, it is more conducive to the human body than a synthetic. Many feel well with NDT or T4/T3 combination.

[Cup-cake7]

......t4 is at 18 (12 - 22)

T3 is at 4 .2. ( 3.1 - 6.8)

[shaws in reply to Cup-cake7]

I think it is better to consider our clinical symptoms and as they are relieved we feel much better. That's the purpose of replacement thyroid hormones, that we feel well again.

[Cup-cake7 in reply to shaws]

Thankyou Shaws

...i havent heard back from email but im satisfied iv contacted etc and explained, its up to him if he turns blind eye

....felt ‘two sheets to wind’ today with levo increase and headache, something iv been blessed not to ever experience

I did try metavive , with hindsight probably underdosing and im unsure about metavive generally, Dr P suggestion.

Back to drawing board

As to where you get ndt?

Can anyone advise pls?

[Cup-cake7]

Also advise how to dose much appteciated

Iv taken 75 levo for a while before upping a few days ago to 100 and reminding i had good t4 readings when not on levo

Hence do i need to take t4 anymore in any shape or form?

(Yes iv tried come what may to make my numbers good )

I dont know how to take ndt once iv found some

Which id the one with least fillers pls?

[shaws in reply to Cup-cake7]

Jeppy, you would have to put up a fresh post asking where to source NDT. Your post will then be closed and if members have information, they'll send you a private message.

I'm not medically qualified but if we change from levo to another thyroid hormone, we take an approx equal dose, i.e. 100mcg of levo for instance is around 1 grain of NDT. We take note of our symptoms and the relief of them and gradually increase by 1/4 tablet every two weeks. If you feel over-stimulated drop back to previous dose and hopefully that's your dose. If symptoms return you increse by 1/4 tablet.

The link below may be helpful:-

naturalthyroidsolutions.com/q%

The main factor when taking thyroid hormone replacements is to relieve all of our symptoms and we feel well again i.e. normal health. Also make sure vitamins and minterals are optimal.

jeffreydachmd.com/2014/01/u...

[Cup-cake7 in reply to shaws]

Thankyou

[Cup-cake7 in reply to shaws]

....thinking/knowing that my t4 was good level naturally but t3 Low, i am unsure what to do re ndt

Do i just need t3? Of course at the moment i only have the Levo picture

Will it work out somehow on ndt?

[shaws in reply to Cup-cake7]

NDT works for many and it was also the only replacement that saved lives after 1892. It was prescribed freely up until the 1960's when the introduction of TSH and levothyroxine were introduced and levo has now taken over from doctors knowing clinical symptoms and the patients being given NDT which was slowly increased until symptoms resolved. NDT contains all of the hormones a healthy gland would

Some of us on the forum have had to trial several different methods before finding the right one. Keeping in mind that thousands do o.k. on levo and will not be on this forum.

[shaws in reply to Cup-cake7]

p.s. 'numbers do not tell us if we are feeling well and symptom-free. It is how we 'the patient' feels i.e. well or unwell.

[Cup-cake7 in reply to shaws]

yesI'm asking if I should just take t3 because in my situation I had good t4 level naturally, it is the t3 that was always low

What say I ditch the levo and just take t3? Just asking where this may take me?

Remembering I had good t4 levels naturally before levo

[Cup-cake7]

‘Is’