Told T3 is fine, but is it?

[Annaoj]

Morning,

My medichecks results have come back with comments saying I am well within normal range, but I’m concerned that my T3 is on the low side given that I still have neurological symptoms of brain fog, fatigue and low mood and I think I’ve seen people here recommend that it should be in the upper part of the range - though I can’t find any official guidelines documented anywhere.

I am currently taking 100mg of Levo and supplementing various vitamins recommended by this community.

Any help or analysis would be gratefully received.

Medichecks comments:

“I note that you are taking this test to investigate symptoms. You mention you have recently been diagnosed with hypothyroidism and are currently taking 100mcg levothyroxine. I'm sorry to hear you are still experiencing symptoms. You are interested in finding out your thyroxine and T3 levels to investigate your symptoms further.

I'm pleased to say that your thyroid stimulating hormone, free thyroxine and free T3 levels are all well within normal range.

These results suggest that your current levothyroxine dose is appropriate and your symptoms are therefore unlikely to be due to an under treatment of your hypothyroidism. I would suggest consulting further with your GP to explore other possible causes of your symptoms.

[greygoose]

They do make me laugh! As if you needed a doctor to tell you that your levels are 'within range'! If you've got eyes, you can see that for yourself. The fact that they need to be in the right place in the range for you to be well goes completely over their heads! Nor do they understand that you need to take all three results into consideration as a whole, not three separate results.

So, your TSH is good, but that's because your FT4 is well up in the range. But, your FT3 doesn't follow the same pattern, because you don't convert very well. So, it might be that 'your current levothyroxine dose is appropriate', but if you can't convert it, it's no use to you.

Did you also get your vit D, vit B12, folate and ferritin tested? Poor conversion can sometimes be due to low nutrients.

[Annaoj in reply to greygoose]

Hi Greygoose

Thanks for your reply.

I had those tested last time and my B12 and Ferritin were on the low side. I’m supplementing B12 now, along with Selenium, and considering zinc too. I’m trying to increase my ferritin levels by eating more iron rich foods.

I’m not sure what else I can do to get my T3 levels up. I was planning to take my results to my Dr and ask for a referral to an Endo, but I suspect he’ll say no given that my results are ‘in range’

[greygoose in reply to Annaoj]

If your doctor doesn't say no, the endo probably will! They're very fussy about who they see. Complete divas!

Do try zinc. Hypos are usually low in zinc, and it is important for conversion. Are you taking a B complex with your B12? And how about your vit D? Are you eating enough calories?

[Annaoj in reply to greygoose]

I’m taking Thorne Basic B Complex.

I stopped supplementing Vit D as my ranges were okay, and I thought it interfered with something else?! Should I restart?

I could probably eat more calories.

[greygoose in reply to Annaoj]

I don't know about vit D interferring with anything else. But, whether or not you should start it again, depends on your level. However, if you do start it again, you should also take vit K2-MK7 and magnesium, the cofactors of vit D.

[TaraJR in reply to greygoose]

I just wonder if a test for zinc is needed first, before supplementing? Is there a test for zinc level? Can it be dangerous to take too much, as it is with Vitamin D?

[greygoose in reply to TaraJR]

A lot of people just take zinc without testing, but there is a test.

With vit D, it's dangerous to take too much because it is fat soluble, and therefore levels build up in the fat and aren't excreted. As far as I know, excess zinc is excreted.

[jimh111]

These resutls are perfectly normal for someone on levothyroxine only therapy, we would expect fT3 to be just below mid-interval. It may be that you need some liothyronine (L-T3) to restore your cognitive function, there are studies that show some patients have cognitive problems that are resolved with some T3. It could be that a small increase in levothyroxine would do the trick, bringing your fT3 up a little. I think this is not so likely but I would give it a go before going to your doctor and asking for liothyronine. Try taking an extra quarter levothyroxine tablet each day for a couple of weeks, if it sorts you out you can then let your doctor know what you did and get a prescription. I think it's a better approach that asking for an increase first and then coming back saying it didn't work, save your energy for bigger battles.

The comment about 'your current levothyroxine dose is appropriate' is silly, it probably isn't especially as you are supplementing vitamins (B12 and D?). If I get a blood test I tick the box to say I don't want a doctor's comments, I can't see the point of extra incorrect information being put on my records.

[Annaoj in reply to jimh111]

Thanks for your reply.

Yes, that sounds like a decent plan, although will I potentially tip over into hyper given that my TSH is very low?

At what point should I retest T3, and how much of an increase should I be looking for? My lab has refused to test for T3 so far, so I’m paying privately.

Thanks in advance

[jimh111 in reply to Annaoj]

I wouldn't waste money on retesting until you have either settled on a different levothyroxine dose or had been on a trial of some liothyronine (initially 10 mcg daily?). There's a temptation to subconsciously think that more blood tests will improve outcomes, it took me a while to learn to resist too frequent testing.