Should I be concerned? Low T3 & T4 (with results)

[VancouverGirl]

Hi all,

My lab results are the following:

Thyroid Profile Result Unit Reference Values

TSH 1.470 μUi/mL 0.465 - 4.680

Total T3 ***0.81 ng/ml 0.97 - 1.69

Free T3 3.650 pg/ml 2.770 - 5.270

Total T4 ***4.76 μg/dL 5.53 - 11.00

Free T4 ***0.71 ng/dl 0.78 - 2.19

I put three (***) asterisks next to the results that were low. I'm beginning to take Levothyroxine, 50 mcg. Does this seem adequate based on my above results?

I appreciate any and all feedback, positive or negative. I truly do. Thanks so much!

Thea

[Jazzw]

So have you only been on 25mcg since your last post? That’s far too long to have been left on a starter dose! You very much need an increase in dosage.

[shaws Administrator]

Unless someone is very frail with a heart disease, a starting dose of levothyroxine is 50mcg with a blood test and increase of 25mcg every six weeks until TSH is 1 or lower and Free T4 and Free T3 in the upper part of the ranges. Rarely are the 'frees' tested. You should also concentrate on your clinical symptoms and are they being relieved? That's the aim i.e. that we feel well and have no symptoms.

[silverfox7]

I was going to say that I was started on 25 mcg but I'm not so young anymore so this was a long time ago and things have moved on since then so 50 is now the accepted started dose unless very frail or with a known heart problem so my conclusion would have been that the doctors hasn't moved with the times and not up to date so maybe try a different doctor.

But having read the comment of jassw I looked at your profile and see you have been on 25mcg for three years!!! So he isn't only behind the times he is very wrong! All increases should be retested after 6 weeks to see if we need another increase! We wait the 6 weeks because that is the length of time to get each new dose to get fully into our body so it's frightening to read that you have been on that dose for three years! Have you been tested at all in that time frame?

You should find a new doctor ASAP and also ask to have Vit D, folate, ferritin and B12 tested. These help our thyroid to work much better as help with other issues as well but they must be optimal, not just in range. But please find someone else to test your thyroid levels ASAP and let us know how you get on. Increases should be done by 25 mcg each time.

[SilverAvocado]

VancouverGirl, if you're just starting out on Levothyroxine then 50mcg is fine. It's important to go slow with thyroid hormone, so this is just a starter dose and you will adjust it further as yr goes on.

Best practice is to stay on this dose for 6 weeks, then have a retest and an adjustment in dose, then continue on retesting and adjusting every 6 weeks.

You may feel a bit rubbish on 50mcg at first, but once you've had an increase or two you should start to improve. It can easily take 6 months from first starting on Levo to starting to feel well.