STILL PROBLEMS WITH LOWISH FT3 AND GAINING WEIGHT :(

[Clara62]

Hello, I am still struggling with lowish FT3, here last labs:

TSH 0,348 ( 0.27-4.2)

FT3 3.65 ( 3.1-6.8)

FT4 18.7 ( 12-22)

I am on 75mcg Thyroxine.

I cannot take T3, even the smallest dosage suppress my TSH and send FT3 too high ( out of the range) while suppressing FT4 too. My vitamins are ok, ferritin a bit low but still in range : 66 ( 40- 250 range). I put on weight and I am feeling tired, more than usual elbows and heels very very dry. I really don't know what to do to improve my condition...I am taking zinc, selenium, vit C and a B complex. What else can I do? Add iodine? I don't know

[greygoose]

Whatever you do, don't add iodine. You'll mess things up even more. What are you doing about your low ferritin? What were the results for the others?

You really have a serious conversion problem there. What do you call the 'smallest dosage'? Taking T3 is supposed to suppress your TSH (it doesn't matter) and lower your FT4. But, why would a small dose send your FT3 over-range? Unless you have Hashi's. Do you have Hashi's?

[Clara62 in reply to greygoose]

Hi greygoos, thank you for your reply.

When I was taking 10 or even 5mcg of T3, Ft3 was over the range, like 8 or 10.

I don't think I have Hashi because my antibodies are always negative, although I have nodules ( multinodular).

I know I have a conversion problem you are right, it is confirmed by the genetic test I did on deiodinase.

I am not doing anything for my ferritin at the moment, what is best way to increase it ? I have constipation so I am a little scared to take iron because I know it can worsen the symptom..

[greygoose in reply to Clara62]

It appears that eating liver once a week is the best way to raise ferritin.

What are you doing for your constipation? Do you take magnesium and vit C?

You don't need a genetic test to show you don't convert well. Just compare the FT4 with the FT3 and you can see it. Your FT4 is 67% through the range, and your FT3 only 14.86%. They should be more or less equal.

Having nodules doesn't prove anything, but you can have Hashi's without ever having raised antibodies.

Given how low your FT3 is, it really might be a good idea to try taking T3 again - just a small dose. It doesn't matter that much if your FT3 goes slightly over-range - better than having it sliding along the bottom of the range, like that. And, who knows, that might not happen next time.

[Clara62 in reply to greygoose]

Thanks again greygoose.

I will have to chose another way to improve ferritin, because I don't eat meat, I do eat fish. I will do something about it.

I take Vit c and magnesium for constipation, but they don't always work so sometimes I add a bit of senna, I know it's not the best thing but it works.

I might have to go back taking a bit of T3, it doesn't look like I have other options. A bit scared though...

[greygoose in reply to Clara62]

Nothing to be scared of - what's the worst that can happen?

Fish contains iron. Just make sure you have some form of vit C at the same time. There's no limit to how much vit C you can have. Do you eat seafood? Because shellfish is high in iron. How about eggs? But, always, always include some source of vit C at the same time, for absorption.

[Clara62 in reply to greygoose]

My endo wasn't happy for me to have a suppressed TSH and FT3 too high. I have osteopenia and he said that having a suppressed TSH has been scientifically associated with the development of osteoporosis, and I've been reading some functional medicine doctors saying the same. I wish I could have a not suppressed Tsh and an optimal Ft3 but it doesn't happen...tried many different dosage in the past years, with t4 and t3, different combination and I always end up having a suppressed TSH and FT4 ...I will speak with my endo again, probably adding a bit of T3 once again. Thank you greygoose!

[greygoose in reply to Clara62]

Oh what rubbish! No such thing has ever been scientifically proved. Ask him to link you to his sources for saying that. Because we have a load of links saying the opposite.

You can't have a decent level of FT3, one that makes you well, without it suppressing the TSH. And, the reason is: because you don't need it. The pituitary produces TSH when it senses that theirs not enough thyroid hormone in the blood. When it senses that there is enough, it stops producing TSH. TSH has two jobs: 1) stimulating the thyroid to produce thyroid hormone (hence its name) and if you're taking enough exogenous hormone you don't need it to do that; and b) to stimulate conversion of T4 to T3, and if you're taking straight T3 you don't need it to do that, either. So, why would the pituitary keep on producing TSH? Waste of energy and resources. TSH has no connection with bones.

What has been scientifically associated with osteoporosis is the long-term high levels of FT3 in people with hyperthyroidism. Which, of course, would suppress the TSH. But, taking exogenous hormone does not have the same negative effects as high levels of endogenous hormone. That has been scientifically proved, too.

Call his bluff. Ask him to prove it.

Oh, and just taking T3 from time to time won't help at all, and could make things worse. You need a continuous, steady daily dose for it to do any good. And to hell with the TSH. If he doesn't like it, fire him.

[Clara62 in reply to greygoose]

I will speak with him about all this! He also added that T3 is not a reliable medication because it’s too unstable having a short duration and this fluctuation during the day it’s definitely bad for the bones ...I guess he was scared because my Dexa result worsened in the last 4 years while being treated with t4+t3 combination. Thank you for all your info, I will definitely speak about all this with him. I need to have my ft3 higher to feel better!

[greygoose in reply to Clara62]

More rubbish. T3 does not have a short duration. It has a half-life of 24 hours in the blood. But, what gets into the cells stays there for about 3 days. If you're topping it up daily, none of that matters. Obviously it doesn't stay around as long as T4, but it doesn't do the same job. And, that should not be a reason for not taking it. And certainly doesn't mean it's bad for the bones for that reason! Why would fluctuating T3 be bad for the bones? I think he's making it up as he goes along - any excuse is good enough. Does he even know that TSH fluctuates throughout the day?

And, besides, the T3 made by your thyroid might fluctuate - although less than TSH - but the T3 that you take in a pill won't fluctuate if you take the same dose every day. And, you can take it several times a day to cut out the peaks and troughs. I don't think this man has any idea what he's talking about!

[Clara62 in reply to greygoose]

Wow I am utterly astonished about the fact that this doctor, who is a well known specialist that works in a high valued clinic , told me a lot of bs! But why? Why he would do this? It’s really sad . The ironic thing is that he was recommended by someone who got t3 prescription from him. Thank you grey goose for all the precious info

[greygoose in reply to Clara62]

Perhaps he's been got at by the powers that be. They don't like T3 being prescribed because it's so expensive. But, they have to come up with some excuse because it's not acceptable to just say it's too expensive.

[greygoose in reply to greygoose]

What's more, it's more dangerous for your bones to have low FT3 than to take T3.

[Clara62 in reply to greygoose]

Unfortunately it’s not even that because I can have it free of prescription in Italy and he knows this. I guess it’s even worse: lack of real knowledge. I will challenge him next week with all your info

[greygoose in reply to Clara62]

Ah, OK. Well, then he just knows nothing about T3.

[Clara62 in reply to greygoose]

It seems so 😔

[greygoose in reply to Clara62]

But neither do any of the others, so he doesn't stick out as abnormal.

[Clara62 in reply to greygoose]

So true! So many hypothyroid people quite sick around 😔

[Clara62 in reply to Clara62]

Hi greygoose, one more question if you don’t mind, what do you think of LDN? Would it be worth trying it? Thank you.

[SlowDragon Administrator]

How much and how did you take T3?

As 2 or 3 Split doses?

Recommended on here that all thyroid blood tests should ideally be done as early as possible in morning and fasting. This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, best not mentioned to GP or phlebotomist)

Last Levothyroxine dose should be 24 hours prior to test, (taking delayed dose immediately after blood draw).

If/when also on T3, make sure to take last dose 8-12 hours prior to test, even if this means adjusting time or splitting of dose day before test

Is this how you did your tests?

Canadian Thyroid association On Low TSH

thyroidpatients.ca/rational...

Canadian Thyroid association on low FT3 in causes of Osteoporosis

thyroidpatients.ca/2018/07/...

[Clara62 in reply to SlowDragon]

Thank you SlowDragon. Actually I am not taking T3 any longer. I stopped last March when with only 5mcg T3 daily the FT3 reached 10 ( way out of the range). but since I am back with only T4 I gained weight and have extremely dry skin, I am probably under medicated now. thank you for the links