On 13 Dec. my labs were the best ever and on 31 Jan. they changed again, with TSH too high etc. I’m putting them next to each other:
TSH: 4.80 -- range is 0.20 – 5.00 -- then TSH : 5.99 -
FT3: 4.10 – range is 1.8 – 4,5 -- then FT3: 5,12
FT4: 10.01 – range is 7.0 – 20.0 -- then FT4: 9.12
I was alternating every 2 days 63 mcg with 50 mcg levo, Tirosint, plus taking 6mcg T3.
I was low on iron which I’ve been supplementing. Vitamin B & D & Folate, all okay.
Now my endo. says up the levo to 63mcg only and reduce T3 to 6mcg every other day. If FT3 is too high shouldn’t I take more?
I wasn’t feeling good in December and now I’m feeling worse, more brain fog, minus-zero energy etc. and wondering if I should switch from my current additive-free Levo to another brand. Or should I try NDT again? I ordered Thai from Thailand in Sept., took it once, felt so bad that I stopped. However I wasn’t taking any T3 back then. Then again, there are different brands of NDT and maybe “Thai” wasn’t the right one?!
Desperate for advice because I have an appointment with my endo soon and I don’t know what to ask him anymore. He’s been open minded and helpful until he recently advised me to go to a rheumatologist for my increasing joint pains and possible fibromyalgia. Now, I’ve already been given the run-around by other endos: gastroenterologist for bloated belly; ear-nose-throat doc for tinnitus & dizziness; a generalist prescribed anti depressants (stopped after 4 days); eye doc. for blurred vision and so on. I know it’s all linked or caused by my post RAI hypothyroidism.
I am fed up with being an invalid! Brain fog is the worst. If I can’t run around the block (Ha!) then at least I’d like to be able to finish some super important paper work.
To end on a positive note, and for whom it may concern, for the joint pains I’ve started supplementing with tablets containing Glucosamine, Hyaluronic acid, Chondroitin and MSM (sugar & gluten free) and it’s helping.
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TSH: 4.80 -- range is 0.20 – 5.00 -- then TSH : 5.99 -
FT3: 4.10 – range is 1.8 – 4,5 -- then FT3: 5,12
FT4: 10.01 – range is 7.0 – 20.0 -- then FT4: 9.12
You are very under-medicated to have a TSH of 4.8. It should come down to 1 or under - especially if you're taking T3. Your FT3 is high in the second result, it's true, but how long a gap did you leave between the last dose of T3 and the blood draw? If it was less than 8 hours, then that's why your FT3 is high.
Now my endo. says up the levo to 63mcg only and reduce T3 to 6mcg every other day. If FT3 is too high shouldn’t I take more?
He really does not know what he's doing. You cannot take T3 every other day, it doesn't work that way. Your body needs a constant, steady supply of the same dose every day if T3 is going to help. And the fiddling little increase in levo is hardly going to do anything at all. Your FT4 is low because you are taking T3. That may or may not be ok for you. But, if you're going to have an increase in dose, it should be at least 25 mcg.
No point in testing rT3, it doesn't give you any useful information. I mean, it will tell you if it's high, but won't tell you why or what to do about it. And no doctor would know! lol
I just can't imagine that taking the same 6 mcg T3 every day would suddenly cause your FT3 to shoot up over-range, like that. So, do you have Hashi's?
No, I'm hypo after RAI done 10 years ago, after having been hyper for about 20 years. (I say "about" because it would come and go...)
the first year after RAI was difficult and then smooth sailing for 5 years. then tiredness, some weight gain and 2 years ago all sorts of symptoms, increasing.
I still think RAI was a mistake though all endos say it wasn't...
Whether or not it was a mistake rather depends on said endos! If they don't know how to treat hypo, then perhaps it was. But, they could never admit it.
Have you had your nutrients tested: vit d, vit B12, folate, ferritin? Are you taking any kind of supplements?
Yes I had them all tested. Ferritin and Folate were low so I'm supplementing. Also taking Vitamin B complex because it was low a while ago though I haven't retested recently.
Sorry to bother you again, Greygoose. I got it re having to take T3 everyday but I would like to know for sure: does it work like T4 in that the higher it is the more one should take?
By the by, I took 88 mcg this morning and 6mcg.T3 at the same time, had some tachychardia and still very tired but the great thing is that I’m not sad, depressed or anxious at all. I react very quickly to changes of potency so it’s not “all in my head”, (lol).
If tachychardia continues for a few days, maybe I should titrate and alternate with 75mcg for a week or so.
does it work like T4 in that the higher it is the more one should take?
That's not how T4 works. That's how TSH works.
The higher the TSH - Thyroid Stimulating Hormone - the lower the thyroid hormone (T4 and T3) are likely to be. The TSH, which comes from the pituitary, stimulates the thyroid to make your hormone.
Your thyroid cannot respond, which is why you're taking levo and T3. When you take levo and T3, your FT4 and FT3 should rise in the range, and your TSH should drop. You need to take enough levo and T3 to get your FT4 and FT3 up into a place where you feel well, but not too high, not over-range.
So, if the FT4 is low, you need to increase the levo. If the FT3 is low, you need to take more T3. If they get too high, you need to take less.
Normally, one increases levo by 25 mcg every six weeks. But, it depends on levels. Alternating 88 and 75 is a pretty silly dose, anyway, when one's FT4 is as low as yours. So, in your place, I would go up to 75 mcg daily for a couple of weeks, then go up to 100 daily, hold for six weeks and retest. Then see how you feel.
It sounds to me if your body isn't liking being on such a low dose of T4 but that is just my opinion.
You cannot alternate days with T3 - it needs to be a steady dose each day.
I had very bad shoulder pain - bad pain and stiffness in one leg which really hampered my mobility - this all went once I was on a steady dose of t3 so your joint pain may go if you can balance the thyroid hormones.
Why did you start on T3? Have you ever just been on levo alone? The problem with NDT is that it is a fixed ratio between T4 and T3 and maybe it doesn't suit your body.
I am not coeliac but bloating and abdominal pain went once I was gluten free.
Thank you Lalatoot. Greygoose, see above, gave the same advice re increase in Levo and the T3.
I’m sure you’re right about joint pain and hormones, since it first started exactly at the same time as I started gaining weight and feeling overtired.
I was on on Levo only for 9 years and started T3 after reading posts here.
Don’t know about going 100% gluten free. Hard to get here in Greece. I only have a few rusks in the morning, otherwise veggies, fruits, fish, nuts – healthy diet!
I found it so easy being gluten free in Greece as so much is cooked from scratch from fresh produce. Gluten free products have other ingredients which are not always good for us !
Absolutely essential to test vitamin D, folate, ferritin and B12 too
As you are under medicated and hypothyroid these are likely too low
Many people need good levels of Ft4 and Ft3
Recommended on here that all thyroid blood tests should ideally be done as early as possible in morning and before eating or drinking anything other than water .
Last dose of Levothyroxine 24 hours prior to blood test. (taking delayed dose immediately after blood draw).
This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, best not mentioned to GP or phlebotomist)
If/when also on T3, make sure to take last 1/3rd of daily dose 8-12 hours prior to test, even if this means adjusting time or splitting of dose day before test
I followed yr. advice: "all thyroid blood tests should ideally be done as early as possible in morning and before eating or drinking anything other than water" .
I had blood tken at 6:30 am. Before I used to have tea and a few rusks and my blood was taken much later, between 11:00 and 13:00.
Could this explain why TSH & T3 were noticeably higher?
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Thanks a mil’! ( I bet you’ve put a few endos out of business over time…)
Experimenting with switching over from Levo to NDT, advice appreciated 
Switching from Levo to NDT 
Different brands of Levo
Different Brands of Levo
