Optimum levels of t3/t4?

hi again all,

Last docs tests came back a month ago within range (I didn't chase them for details as it was such a relief feeling well - know I should have...) but started feeling rough again last week so did a medichecks which came back:

TSH -7.96 (range 0.27 - 4.2)

FREE T3 - 4.87 (range 3.1 - 6.8)

FREE THYROXINE - 16 (range 12 - 22)

I'd like to go to the GP armed with all info, and can't remember the optimum levels for t3/t4, could you remind me?

thanks again for all the help X

[SeasideSusie Remembering]

Tillyxxx

Optimum levels are where you feel best. If you felt well when you had your last NHS tests, ask the receptionist for a print out of your results before you go to see your GP. The reference ranges will probably be different from the Medichecks range so work out the percentage through range with this calculator

chorobytarczycy.eu/kalkulator

Use the "hormony tarczycy" tab and it's obvious where the results go, and the bottom/top of the range.

With your Medichecks results:

FT4: 16 (12 - 22) = 40% through range

FT3: 4.87 (3.1 - 6.8) = 47.84% through range

Many people feel best with a TSH below 1 and FT4 and FT3 in the upper part of their ranges.

Don't forget that you have Hashi's so you are subject to fluctuations in symptoms and results quite randomly.

[jimh111]

In most (definitely not all) cases patients do well on levothyroxine when their fT4 is in the upper half and their fT3 around midway with a TSH less than 2.0. So, you are a little under-medicated. In an earlier post you said you are on 200 mcg levothyroxine which would normally give a higher fT4 and low TSH although everyone is different. It is possible you are not absorbing the levo well. This can happen if you have gastrointestinal problems, are taking acid blocking medicine, taking your levo with bran or coffee and some other medicines interfere. It's worth making sure you are taking your levo away from other medicines, bran and coffee. If it's easier you can take levo at bedtime.

[Hidden]

thanks both.

Good advice Susie, I'll ring and get last NHS results today, and appt with GP tomorrow.

Jim, yes still on 200mcg levo. I've got coeliac (well controlled) and Bile Acid malabsorption too, so definitely gastro problems. Though I take my levo well away from the bile binders (I take it at 4am so away from any other meds, and 3 hours before coffee/breakfast), so pretty sure I'm safe on that. Worth a thought though.

thanks again both

Sue

[SlowDragon Administrator]

Have you considered that you might also be lactose of dairy intolerant?

This might explain need for high dose of Levothyroxine too

ncbi.nlm.nih.gov/pubmed/240...

Lactose intolerance was diagnosed in 75.9 % of the patients with HT

read.qxmd.com/read/24796930...

These findings show that lactose intolerance significantly increased the need for oral T4 in hypothyroid patients.

You may eventually need addition of small dose of T3 prescribed alongside Levothyroxine...especially as coeliac

[Hidden in reply to SlowDragon]

thanks SlowDragon - I tried going lactose free when I was trying to work out what was happening when I continued to be extremely coeliac symptomatic even though gluten-free. I didn't notice any improvement with my digestive issues and am now back on lactose, apparently without problems. I am however on (very effective) meds for bile acid malabsorption which I guess may mask it?

I honestly hadn't considered it in relation to my thyroid. How interesting. Wonder if I should bring it up with gp (I can feel them rolling their eyes already...). Thank you.