Low Free T3 and T4: Hi everyone, I am hypothyroid... - Thyroid UK

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Low Free T3 and T4

Tigerlily2 profile image
16 Replies

Hi everyone,

I am hypothyroid and being treated with 60mg of Armour Thyroid. My doctor just ran labs. My TSH is normal (kind of low, actually, at 0.15). But my Free T3 is low (2.57) and my Free T4 is also low (0.61). I also feel like I did before I even started Armour: dragging, tired, heavy, and have put on a few pounds.

Any idea what is going on with these numbers? My doc just wants to increase my Armour.

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Tigerlily2
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16 Replies
SeasideSusie profile image
SeasideSusieRemembering

Tigerlily2

We can't interpret your results without the reference ranges so if you could please add them it would help us to understand where in the ranges your levels lie.

However, when taking NDT TSH will be low and often Free T4 tends to be lowish. The important result is Free T3 and this is usually in the upper part of the range when taking NDT.

How long have you been on Armour?

How do these results compare with previous results?

You say your Free T3 is low and this will be causing your symptoms and suggests you need to increase your dose of Armour. As you say "My doc just wants to increase my Armour" do you disagree or are questioning his judgement?

Have you had your nutrient levels checked - Vit D, B12, folate and ferritin? These all need to be optimal for any thyroid hormone to work properly.

Tigerlily2 profile image
Tigerlily2 in reply to SeasideSusie

Thanks for your reply.

The reference range for TSH is 0.49-4.67. Reference range for Free T3 is 2.50-3.90. Reference range for Free T4 is 0.61-1.60.

Before I started any treatment, the problem was TSH that was too high. My other labs were a little low, but not this low.

I have been on Armour since last November (8 months). I haven't had those other labs checked recently, but a few months ago all those were normal except my ferritin was low, Vit. D was borderline. I take a super prenatal vitamin for all that.

I disagree somewhat (I had been on a higher dose of Armour when I first started, and I had hyperthyroidism symptoms, scared me pretty good with heart palpitations, chest pain, etc). I guess it all doesn't make sense to me, just wanted some other opinions.

Thanks!

SeasideSusie profile image
SeasideSusieRemembering in reply to Tigerlily2

Before I started any treatment, the problem was TSH that was too high. My other labs were a little low, but not this low.

That would indicate hypothyroidism if TSH was over range. Are you in the UK? What were the actual results? Were you started on Levo originally or did you start straight on Armour?

So you have

TSH: 0.15 (0.49-4.67)

FT4: 0.61 (0.61-1.60)

FT3: 2.57 (2.50-3.90)

So these results indicate you need a dose increase. 60mg Armour is quite a low dose, many people are on 2 or 3 grains (120-180mg).

I disagree somewhat (I had been on a higher dose of Armour when I first started, and I had hyperthyroidism symptoms, scared me pretty good with heart palpitations, chest pain, etc).

Why do you disagree with the increase?

Have you had thyroid antibodies tested? If they were raised that would indicate autoimmune thyroid disease aka Hashimoto's and because fluctuations occur with symtoms and test results you can swing from hypo to "hyper" with Hashi's and dose adjustments may be needed until things settle down again.

I haven't had those other labs checked recently, but a few months ago all those were normal except my ferritin was low, Vit. D was borderline. I take a super prenatal vitamin for all that.

What were the levels - normal doesn't mean anything except that the result is somewhere within the range. It's said that ferritin needs to be at least 70 for any thyroid hormone to work properly. What does your prenatal vitamin contain?

Tigerlily2 profile image
Tigerlily2 in reply to SeasideSusie

My TSH was just over 5. I am in the US. Yes, I was originally started on Levo, but it made me feel so much worse.

I disagree with the increase because I was on 90mg of Armour, which caused me to have the hyper symptoms. It was too much. My TSH fell to less than. 01!

My antibodies were never elevated. Thyroglobulin was 1.0. TPA was less than 1.

Ferritin was 12, Vit D was 44.

My prenatal has basically everything! Vitamins C, D, E, K1, B1, B2, B3, B6, Folate, B12, biotin, B5, Calcium, iron, iodine, magnesium, zinc, selenium, copper, manganese, chromium, molybdenum, potassium, boron.

Marz profile image
Marz in reply to Tigerlily2

Your Multi may have all those things - but are they in large enough quantities to make you feel well and for your thyroid hormones to be well utilised in the body. If you increase to have more VitC say - then you may increase something that is harmful in a higher dose. What are the fillers ? Iron and calcium together is a bad idea and should be taken well away from your Armour ...

What is the brand of your pre-natal ? Your Ferritin is LOW - range ? Am assuming your VitD is measure in ng/L as you are in the US - so would be better around 60. Your Hyper type symptoms can also be hypo ones and low ferritin could be also be a cause ...

SeasideSusie profile image
SeasideSusieRemembering in reply to Tigerlily2

I disagree with the increase because I was on 90mg of Armour, which caused me to have the hyper symptoms. It was too much. My TSH fell to less than. 01!

My antibodies were never elevated. Thyroglobulin was 1.0. TPA was less than 1.

Taking Armour will lower TSH and even suppress it, it's the T3 element of it, it's just what it does. You could have gone up 1/4 of a grain (15mg) rather than 1/2 a grain. Apparently it's possible to have Hashi's without raised antibodies.

As Marz has mentioned, multi's are not a good idea, they tend not to contain enough of anything to help low levels of nutrients, they often contain the wrong and least absorbable form of ingredients, and we should only supplement iodine and calcium if tested and found to be deficiency. Iodine and hypothyroidism are not good bedfellows, iodine used to be used to treat overactive thyroid so can make hypothyroidism worse, particularly if Hashi's is present. The iron in the multi affects absorption of everything else, iron should be taken 2 hours away from any other supplements and 4 hours away from thyroid meds.

A ferritin level of 12 in the UK is below range, our range is usually 13-150 for females, and this would require investigation into iron deficiency anaemia.

Tigerlily2 profile image
Tigerlily2 in reply to SeasideSusie

My multi is Prenatal SAP. Recommended by my naturopath.

Yes, I separate my meds/vitamins. I take my prenatal at least 8 hours after Armour.

Batty1 profile image
Batty1 in reply to Tigerlily2

Hi tigerlily2, when you were on the higher Armour dose were you taking them at the same time? I take 120mcg or 2 grains was taking together when I first started them oh boy did it cause me grief and then I split them one early morning one late morning and all my hyper symptoms disappeared.

Tigerlily2 profile image
Tigerlily2 in reply to Batty1

Interesting... I never thought about splitting up the doses. I am glad that helped you and perhaps I can suggest that to my doc if the dose increase makes me hyper again.

Thanks!

Batty1 profile image
Batty1 in reply to Tigerlily2

I take my 2 pills 6 hours apart .....it's the T3 in Armour that revs your heart up. Doctors never suggest anything they simply say you can take them together it's fine...not

dbrowning02 profile image
dbrowning02 in reply to Batty1

Batty1 I just started doing that and am going for new bloodwork next week. What time do you go when you get your blood drawn to get a correct reading?

Batty1 profile image
Batty1 in reply to dbrowning02

I always go first thing in the morning and I don't eat or drink coffee before the blood test and take my thyroid pill with me so I can take it as soon as my blood drawl is done.

Correct reading depends on many things. I just follow the recommendation of other here for best time to get the best results possible but I'm sure others here will have suggestions too.

dbrowning02 profile image
dbrowning02 in reply to Batty1

I read on here no longer than 8-12 hrs and my last draw was 24hrs so that is why I started splitting dose and retesting.

Batty1 profile image
Batty1 in reply to dbrowning02

I take my last Armour Thyroid pill at 10am test the next morning at 8am I think this is plenty of time 8-12hrs to get somewhat proper results ...however because of the T3 my TSH is scraping the bottom along with everything else and it doesn't seem to matter to Endo that all my numbers are low just that the tsh is low and they start the reduction of my meds.

dbrowning02 profile image
dbrowning02 in reply to Batty1

Thank you! Just want to not waste money since the last one is useless. My Doctor is talking about maybe having my med compounded but needed to have correct measurements first. I'm glad I have this option I feel bad for you guys 😔.

kiefer profile image
kiefer

From what I understand, low iron / ferritin and or low cortisol can cause an inability to raise desiccated thyroid dosages. You'll experience what appears to be symptoms of too much thyroid hormone but your lab values of Free T3 don't support that conclusion.

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