Low TSH, FT4 & Ft3

[GKeith]

I am taking 50 mcg OF T4 & 25 of T3 , My results from a couple days ago are:

TSH 0.40—4.50 miU/L 0.32 L

FT 4 0.8—1.8 ng/dL 0.6 L

FT3 2.3—4.2 pg/mL 2.7 L

Thyroglobun Antibodies < or = 1 IU/mL

I feel fine but stiff neck and some itching. I'm just wondering if I need to bring my FT3 up? But, how do I tell if my FT4 is converting or not? I think I should raise my T4 to 75mcg and lower the T3 to 22.5 or leave it at 25 mcg. Any ideas? I feel pretty good but realize both frees should be higher? Any ideas? I'm seeing my endo in a couple of days and he is stingy as can be on giving any tests other than Frees & TSH

[Lalatoot]

As you are on t3 you can't tell if you are converting. As you say your frees are low. I think you need to increase your meds but only one at a time so you can see how you feel. Many say that they need the frees well over 50%through the range to feel well. Optimal spots being reported at 70 or 80%through. You are only going to find this for yourself by trial and error. For the thyroid hormones to work efficiently we need optimal vitamins. Have you had B12, ferritin, folate and vitamin D levels tested?

[GKeith in reply to Lalatoot]

So, if I'm only taking T4 I can tell if I'm converting, but taking T3 & T4 I cant't tell. I get that but what about RT3? Do you believe that there is such a thing because my endo doesn't. Do you think I should increase the T4 or the T3? And if it's the T4 by how much, for how long, before I can see results?

[greygoose]

Well, I certainly wouldn't reduce my T3! Presumably you're taking T3 because you don't convert very well, no? So, reducing the T3 and increasing the levo would be a very bad move. Increase the T3 by 6.25 mcg and see how you feel. Keep increasing it until you feel well. If you get to FT3 at 4 and still feel unwell, then start playing around with your levo. But, only change one at a time.

[GKeith in reply to greygoose]

Well, I increased the T3 up to 30 but began feeling too hyper, so I went to 25 and felt better. I increased the T4 to 75 mcg for about a month and felt no difference whatsoever but went back to 50 because of the pills I had under the prescription. Why should I not raise the T4 when it's so low? I'm trying to figure out if I'm converting the T4 now or not? I do feel pretty good though, either way. I never had bloods taken while I was on the 75 mcg of T4, so I'm curious whether it will raise or lower the FT4 and what effect it would (will) have? I knbow this seems nitpicking & it probably is but it's hard for me to tell exactly what the relationship between the T4 & T3 is because T3 only has maybe 12 hours & T4 is so hard to figure out.

[greygoose in reply to GKeith]

You can raise the levo if you like, but don't reduce the T3. Your FT3 is already very low. Especially for someone on 25 mcg T3. Do you always take your T3 on an empty stomach, etc. just like levo?

Your FT4 is low because you are taking T3. That always lowers FT4. And, some people feel good like that. Some people don't need any T4 at all. You have to try and find your ideal dose by trial and error.

There's absolutely no way you can find out how well you convert when you're taking T3. It just isn't possible.

it's hard for me to tell exactly what the relationship between the T4 & T3 is because T3 only has maybe 12 hours & T4 is so hard to figure out.

I've no idea what you're trying to say, there. T3 has 12 hours? To do what? Are you talking about the half-life? That's 24 hours. Why is T4 hard to figure out? The relationship between the T4 and the T3 is that T4 is converted into T3. I don't know what else there is to tell.

[GKeith in reply to greygoose]

I mean T4 takes 30 days maybe to totally clear out from your system, while, for me personally, I can feel the T3 is gone totally within 12-16 hours & I need more (T3) I take T3 every 8 hours and feel good on it; it's just the dose I can't figure because as long as I'm taking T4 I can't seem to understand why I feel better with the T4 than without it and why changing the dose by 25 mcg (no little increase) it appears to make absolutely no difference? So, my "problem" is how much T4 should I take with the T3? for an optimum (perfect) dose? Mind you I feel good but the same good as on 75 mcg as 50 mcg and both with 25mcg T3? 30 mcg T3 is too much and 20 is too little. so I've settled on 25.

[greygoose in reply to GKeith]

T3 cannot be gone in 12 hours. It has a half-life of 24 hours for everyone. However, some might have been taken up by the cells, leaving less in the blood. And what gets into the cells stays there for about three days. However, it only does anything when it's in the cells. It doesn't do anything in the blood.

No-one can tell you what you should take for the perfect dose. You have to find that by trial and error. Have you ever tried 100 mcg levo? Or alternating 75 and 100 if you want a smaller increase?

Or maybe you are asking too much, and this is as good as it gets?

[GKeith in reply to greygoose]

I've tried alternating 50 mcg T4 with 75 mcg T4 and couldn't see any difference and the same thing with 22.5 mcg and 25 mcg T3. 30 mcg T3 is too much, I sweat too much when I wake up when the sweat gets in my eyes. At 25 it's seems more normal.

[greygoose in reply to GKeith]

You can't alternate T3. That won't work. It has to be the same dose every day.

OK, so 50/75 mcg levo didn't work, but you said you wanted to increase the levo. So, I suggested 75/100 mcg. How about trying that?

[GKeith in reply to greygoose]

Okay. Do you have any idea why the 50/75 felt the same?

[greygoose in reply to GKeith]

Perhaps because it still wasn't enough.

[GKeith in reply to greygoose]

I'll soon see. I'm also thinking I will try NDT, just to see if it works for me.

[GKeith in reply to GKeith]

BTW, just curious but do you believe in RT3? My endo does not but, reading up on it I think it must mean something. I also go by my temperatures and my blood pressure and RT3 could be when or if your T4 becomes exceptionally high. Some doctors say the T4 turns into RT3 when it stays too high.