Results are in - T3/T4. Does anyone know what the lower ranges for serum ACTH and DHEA are? My area uses 0 so I’m ‘normal’ apparently

[suztango]

Hi lovely people. After my dire saliva cortisol results, my private endo requested some blood tests. But they look like they are pretty much normal? The only thing is, the ranges for ACTH and DHEA start at zero, which I thought was weird. Also, I wouldn’t have tested my TSH, FT3 and FT4 yet as I’ve been slowly raising my T3 dose and got to 20 mcg a few weeks ago. What do you think? Any pearls of wisdom?

Current dose since 10/12/19:

25 mcg levo

20 mcg T3 - 15 mcg taken as CT3M dose at 3am

Dose at the time of the test 09/12/19:

On 25 mcg levo - reduced from 75mg levo only 1.5 weeks ago

20 mcg T3 - 10 mcg of which taken as CT3M dose at 3am (CT3M method started on 30/11/19)

Last dose before test:

Levo - 24 hrs before test

T3 - taken at 10:30 pm night before test. Woke up with banging headache at 4am. (Had insomnia for 3 days afterwards and had to take time off work as I felt so tired and awful.)

Results on 09/12/19 @ 8:30am

Plasma ACTH level 21 ng/L [0.0 - 46.0]

Plasma cortisol level 365 nmol/L (borderline low)

Plasma dehydroepiandrosterone sulphate level 1.9 umol/L [0.0 - 5.0]

Serum insulin-like growth factor 1 level 20.4 nmol/L [7.0 - 28.2]

Plasma LH level 1.2 iu/L

Plasma prolactin level 344 mu/L [57.5 - 561.0]

Plasma FSH level 2.2 iu/L

Plasma free triiodothyronine level 5.7 pmol/L [4.3 - 6.8]

Plasma free T4 level 7.0 pmol/L [7.7 - 15.1]

Plasma TSH level 0.10 mu/L [0.34 - 5.6]

[SlowDragon Administrator]

Your FT4 is very low ....some people on T3 and Levothyroxine cope ok with that ......

But many of us find we need good levels of both FT4 and FT3. After all you're only on small dose of T3.

Personally I would suspect you need 25mcg dose increase in Levothyroxine.....and retest bloods in 6-8 weeks

Many of us have Levothyroxine reduced by only 25mcg when T3 is added....and often even that is too much

You were only on 75mcg Levothyroxine.....so likely Ft4 was already low

Suggest you increase Levothyroxine to 50mcg

Are you taking T3 all in one dose?

Many on us need to split T3 into 2 or 3 doses

After much experimentation I find best option for me is

10mcg at 7am, 5mcg at 3pm and 5mcg at 11pm

But we are all different....

Blood test

On day before blood test you need to split T3 dose ...taking last 5mcg 8-12 hours before blood test....

Levothyroxine 24 hours prior to blood test

Is this how you did the test?

[suztango in reply to SlowDragon]

Hi SlowDragon, thanks for replying.

I am currently taking 20mcg T3 a day, and I split it into a 15 mcg CT3M dose at 3am. This leaves me with 5 mcg taken in the afternoon.

I have tried to taking some T3 before going to bed, but I couldn't sleep. (My previous post shows the dire cortisol results).

I definitely need to wake up at 3am to take it. I tried 10 mcg T3 at first. That helped, so I increased my CT3M dose to 15 mcg.

I haven't increased my daily T3 dose beyond 20mg.

I tried taking 75 mcg levo with my 20 mcg daily dose but didn't feel great so I cut it back.

Seeing the results, I'm 56% through the range for T3 so I'm thinking I'll need to get more T3 in me somehow, whether a increase in T3 or increase in T4 and hope I can take it. What do you think?

[suztango in reply to suztango]

Saying that I didn't feel great with 75mcg levo - I feel really tired now!

[SlowDragon Administrator in reply to suztango]

As only on 25mcg Levothyroxine, you would only increase Levothyroxine by up to 50mcg

Which brand of Levothyroxine do you take?

[suztango in reply to SlowDragon]

Thanks. I’m on Wockhart

[SlowDragon Administrator in reply to suztango]

Increase in Levothyroxine should also raise FT3 as well anyway

Many of us need FT4 at least half way through range

[suztango in reply to SlowDragon]

Thank you Slow Dragon