Worth giving T3 a shot?

[Portia1974]

Have received latest Medichecks bloods back (ranges in brackets) :

TSH (0.27 - 4.2) 0.902mIU/L

FREE T3 (3.1 - 6.8) 3.92pmol/L

FREE THYROXINE (12 - 22) 15.6pmol/L

REVERSE T3 (10 - 24) 16ng/dL

FT3 : RT3 (> 15) 15.95

Am currently on 100mcg of Levo. (Not taken on the morning of the blood test. Blood drawn around 9:15). On the surface these results seem fine. But I am still hugely fatigued despite also now being replete of iron, vit d, folate and b12. It seems to me that there might still be room for improvement on my ft3?? What do you all think? Really I'd like it at optimal/max. Is that a decent conversion rate??? (I have no idea). Anything that can help my appalling energy/fatigue. My TSH has been much lower than this (as low as 0.1) even on just 100mcg of Levo. So am wondering if adding in t3 (rather than increasing levo dose) would be worth exploring or are these result so perfectly fine that I'm grasping at straws? Idk. I feel like I've addressed everything we thought was causing this crushing fatigue....and yet it remains. Can anyone see anything that could be more optimal on the thyroid side? Or should I just call it job done??

[greygoose]

There's room for improvement with the FT4, too. You're under-medicated. Your FT4 is well under mid-range.

[Portia1974 in reply to greygoose]

What do you think about a tsh of 0.1 (on a previous test) with 100mcg. If I increase t4 do I risk wiping out tsh completely and even if it did...would that even be a problem?

Also, any thoughts on conversion rate?? Can't remember how thats calculated, lol!

[greygoose in reply to Portia1974]

I never think about TSH. The TSH does what it does when you take a high enough dose of thyroid hormone to make you well. If it becomes suppressed, so be it. There's not much you can do about it. It may affect conversion or it may not.

Your conversion isn't brilliant, but that could be because you don't have much T4 to convert. And increase in dose would give you a better idea.

[Portia1974 in reply to greygoose]

Ok great. Thank you so much as always! Px

[greygoose in reply to Portia1974]

You're welcome.

[SlowDragon Administrator]

FT4 is only 36% through range

Looking for FT4 to be around 70% through range as minimum

Useful calculator for working out %

chorobytarczycy.eu/kalkulator

Suggest you ask GP for 25mcg dose increase in Levothyroxine (or 100mcg/125mcg alternate days) as first step

If they refuse, then ask for referral to endocrinologist for trial of T3

[Portia1974 in reply to SlowDragon]

Thank you as always! Could you tell me how far through the range ft3 should be as well please? According to that calc mine is 22% into range. That should be higher too right?

Is there a link you could share with regard to optimal "percentage through range" and optimal conversion rate etc please?

Many thanks! That calc is a great resource. Thank you!

[SlowDragon Administrator in reply to Portia1974]

Everyone is different....but generally we need FT4 at least in top third of range and FT3 at least half way in range

On just Levothyroxine, you may need FT4 right at top of range, or even just over top of range in order to get FT3 high enough

Obviously GP is often reluctant to prescribe Levothyroxine at dose that causes high Ft4 and suppressed TSH

But the alternative of prescribing T3 via referral to NHS endocrinologist ....at vast expanse.....might persuade them to allow "trial increase" in Levothyroxine