New Results! Advice please?: Hi guys! My results... - Thyroid UK

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New Results! Advice please?

cazmania7
cazmania7

Hi guys! My results are in after my Tiromel trial!

I’ve followed the normal protocol of 5mcg for two weeks, increasing after two and so on. Am currently on 25mcg of T3 and reduced my levo from 125mcg to 100mcg.

Paid for iron infusion which is why iron is high.

Shall I increase my T3 now in the same manner as before? Is my levo ok!

Still feel the same at the moment but I know this all takes time.

Grateful for any advice and am so happy that I am trying this. I feel positive!

Thanks guys!

12 Replies
oldestnewest

Replying to myself lol. Right I will increase my levo as my Free T4 has dropped and I understand this needs to be in the upper part of the reference range. Maybe I’ll just stay on the full 125mcg levo as before../

Marz
Marz in reply to cazmania7

Taking T3 lowers T4 - due to the loop back telling the Pituitary there is an adequate amount of thyroid hormone in the blood. TSH lowers so less T4 produced by the thyroid ...

cazmania7
cazmania7 in reply to Marz

Ah. Don’t think I knew that! Shall I leave my levo as is would you say? Thanks for the reply!

Marz
Marz in reply to cazmania7

Am not a Doc and take T3 only so probably not the best person to ask ! Looking at your results I would leave things as they are ...

VitD and B12 could do with a boost !

cazmania7
cazmania7 in reply to Marz

Thanks Marz! I have the Vit D spray and am working on that. I pay for B12 shots now and again, I can certainly have another soon!

SeasideSusie
SeasideSusieAdministrator in reply to cazmania7

cazmania7

Replying to myself lol. Right I will increase my levo as my Free T4 has dropped and I understand this needs to be in the upper part of the reference range

Not really. When you see reference to FT4 being in the upper part of the reference range, this is when a patient is on Levo only and it's a generalisation, often quoted here is:

The aim of a hypo patient generally, when on Levo only, is for TSH to be 1 or below or wherever it needs to be for FT4 and FT3 to be in the upper part of their reference ranges, if that is where you feel well.

So it's not a given for someone on Levo and it's not the case for someone on a combination of Levo plus T3 or even NDT. When taking NDT or T3 then one would expect to see TSH low or even suppressed, FT4 tends to be lower in range and FT3 in the upper part of it's range.

Many people on combination therapy will have a lower in range FT4 with a higher in range FT3 and that's right for them. For me, personally, after a very long time of tweaking both Levo and T3, I've found that I seem to be best when both FT4 and FT3 are around 70-75% through range, but I am in a minority.

Your results currently show FT4 at 20% through range and FT3 at 64.32% through range.

Don't forget that you forgot to split your dose of T3 and took the whole 25mcg 24 hours before your test, so you know you have a false FT3 result with that test. Your true FT3 result is actually higher than that showing.

Also, how long were you on 25mcg before testing?

If those were my results, and speaking purely from my own experience, I would have a problem with such a low FT4 and what I would do is increase my Levo, just by 12.5mcg at this stage, which should increase FT4 and may even increase FT3. I would then wait 6-8 weeks for levels to stabilise and then retest. That is what would be right for me, I'm not saying that you should do that but it's worth thinking about.

Are you working on your vitamins? Vit D would be better at the recommended level of 100-150nmol/L and B12 is recommended to be over 550pg/ml (or ng/L) but your picture isn't showing the unit of measurement.

Hey susie! Thanks so much for your helpful reply as always! I understand now, thanks for the explanation! I will increase my levo as you suggested.

I have been on 25mcg for a full six weeks!

I am working on the Vit D but it’s the one I seem to forget each day!

Sorry for my delay in replying. I’m at work but was super excited to get the results and post them!

Hey again susie, just letting the information settle.

Assuming from last post that my T3 is 10% higher than is displayed because I forgot to split my dose, it is presumably at 75% through the range.

Is there any harm in upping the T3 as well as the levo by 5mcg? (I will up levo 12 and T3 by 5).

I guess I already know the answer: it’s trial and error! The guidance is helpful though... I put the butter in the drawer when I finished with it yesterday, instead of in the fridge! So, mentally I’m still fatigued and on auto-pilot. The advice helps me make better decisions than I probably would alone!! 😂

SeasideSusie
SeasideSusieAdministrator in reply to cazmania7

Assuming from last post that my T3 is 10% higher than is displayed because I forgot to split my dose, it is presumably at 75% through the range.

I think I've seen it said that you add 20% to a result when you take your thyroid meds too far away from your blood draw, and even then it's only a guesstimate so that is not something I, personally, would ever rely on. I'd prefer to repeat the test and get a true result.

Is there any harm in upping the T3 as well as the levo by 5mcg? (I will up levo 12 and T3 by 5).

You shouldn't increase (or decrease) both at the same time. If you do, how do you know which one is making a difference? Just do one at a time. Tweaking doses to get the right combination is time consuming and frustrating, but patience is the key if you are ever to find your sweet spot.

With your false low FT3 being 64.32% through range, you know that your normal level is going to be higher than that. If it was 75% (and remember, it could be even higher) then you really wouldn't want it any higher than that if you're going to increase Levo, because by increasing Levo you will raise both FT4 and FT3, so you could end up with your FT3 far too high.

My suggestion is to raise your Levo now, retest in 6-8 weeks.

Consider the following:

A year or so ago you posted these results on 125mcg Levo only:

TSH: 4.57 (0.27 - 4.20)

FT4: 14.30 (12.0 - 22.0)

FT3: 3.85 (3.1 - 6.8)

Obvious undermedication and an increase in Levo was indicated.

At the beginning of October 2019 you posted results after adding NDT for a few weeks to your 125mcg Levo and your results were:

FT4: 18.8 (12-22)

FT3: 4.8 (3.1-6.8)

so your FT4 increased (thanks to the T4 in NDT) and your FT3 increased (thanks to the T3 in NDT).

On 5th December, in this post:

healthunlocked.com/thyroidu...

you said that you were on 125mcg Levo plus 3/4 of a tablet of T3 (18.75mcg) and that you were thinking of reducing Levo by 25mcg but you didn't post any results.

Now you are saying you're taking 100mcg Levo plus 25mcg T3.

If you look at your October results when you were taking 125mcg Levo plus NDT, you will see that your FT4 was 18.8 (68% through range) and now on 100mcg Levo it's 14 (20% through range). You have lost the T4 that NDT contains plus you have also reduced Levo (T4) by 25mcg.

I think your results clearly show that you should have left your Levo at 125mcg.

Thanks so much susie for your reply! I will re-read this tomorrow when on my day off so that it sinks in more.

I will increase the levo and be patient.

I’m really pleased to say that I managed to wean myself off those stupid anti depressants they stuck me on. I had flu over new year and didn’t take any medication as too sick and just carried on not taking them! Been trying to get round to that for years. Literally.

Thanks so much for your detailed response. It’s kind of you to help others in this way ❤️

Marz
Marz in reply to cazmania7

SeasideSusie will not have seen your reply as you inadvertently replied to yourself ! I know - easily done 🤔

cazmania7
cazmania7 in reply to Marz

Oh cringe! At work and running on coffee and adrenal, thinking I am being really efficient and on the ball, yet replying to myself...D’oh!! Thanks Marz (facepalm)!!

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