T3 and suppressed TSH: I am taking T3 and have... - Thyroid UK

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T3 and suppressed TSH

hackman profile image
20 Replies

I am taking T3 and have found the right level to resolve all of my symptoms is 3 x 5mcg per day. The problem is that my TSH is suppressed at 0.1 which is putting pressure on my Endo and GP to reduce the dose.

We have tried this and reduced by 1 x 5mcg so I am now taking 2 x 5mcg per day instead of three. My symptoms have returned, my T3 blood levels have dropped and my TSH is still suppressed at 0.1.

Is anybody else in the same position or has experience of this who can share how they have resolved this with their Endo/GP?

Any comments much appreciated. Thanks in advance!

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SeasideSusie profile image
SeasideSusieRemembering

hackman

This is just what taking T3 does - lower, even suppress TSH. If doctors don't know this then they know very little about how T3 works and in that case why are they prescribing it? Makes you wonder. I'm afraid I don't know of any official information/links that backs this up but it's very obvious you need to go back to your original amount so I'd emphasise the difference it makes to your symptoms on the lower dose so you need the higher dose.

hackman profile image
hackman in reply to SeasideSusie

Thank you SeasideSusie - I have actually just found a link from the BTF which confirms this - it might be useful for others!

Paragraph three under the heading "How can blood tests be used to manage thyroid disorders?"

btf-thyroid.org/thyroid-fun...

Squeezie profile image
Squeezie in reply to hackman

Ooo! Good link @hackman. I will keep for future use.

Gcart profile image
Gcart in reply to hackman

Will this info be accepted by GP s as mine is trying to reduce thyroxine.

Marz profile image
Marz

Did they test the FT3 ? You are only over medicated when your,FT3 is over range. Even then some people here are only well when over range ... Best to go by how you feel 🥰

hackman profile image
hackman in reply to Marz

My T3 dropped from 6.1 on 3 x 5mcg per day to 4.7 on 2 x 5mcg per day. Am going back to 3 per day and collecting evidence to provide to my GP to enable her to keep prescribing 3 per day. Thanks for your reply!

SlowDragon profile image
SlowDragonAdministrator

Almost everyone on any dose of T3 has suppressed TSH ...it’s inevitable and not a problem (apart from dealing with ill informed medics)

Most important results are Ft3, followed by Ft4

If Ft3 is not over range, you are not over treated

Essential to regularly retest vitamin D, folate, ferritin and B12 too, especially if you have Hashimoto’s

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 5mcg dose 8-12 hours prior to test, even if this means adjusting time or splitting of dose day before test

Is this how you do your tests?

If you add your most recent results and ranges members can comment

hackman profile image
hackman in reply to SlowDragon

This is how I did my test apart from the T4 which I took as usual in the morning of the test because my endo told me to do this.

My results on my ideal dose of T3 were

TSH 0.01 (0.3 - 4.2), T4 16.3 (12-22), T3 6.1 (3.9 - 6.8)

My results having been reduced from 15mcg daily to 10mcg daily were

TSH 0.01, T4 18.4, T3 4.7 ranges as above.

I also have the gene mutation and as a result of lack of T3 to the brain I suffered terrible vertiginous migraines. These stopped when I reached my ideal dose of T3. Interestingly, the day I received my blood test results on the reduced T3 dose I had the biggest migraine I have ever had with severe vertigo and vomitting. It lasted 12 hours but the effects lasted three days. I have therefore increased back to my ideal dose and will have to have this fight with my gp next week when we have a phone consultation.

jimh111 profile image
jimh111 in reply to hackman

15 mcg is not a lot so should be OK. It's difficult to interpret fT3 when you are taking T3, ideally you would have the blood taken about half-way between doses. Are you taking levothyroxine also?

hackman profile image
hackman in reply to jimh111

I am also on 100mcg levothyroxine.

jimh111 profile image
jimh111 in reply to hackman

It would seem that you TSH is so low because of insufficient stimulation from the pituitary rather than too much hormone. I call this 'subnormal TSH secretion' simply because there is no other name for it. It's not true central hypothyroidism which is usually more severe and usually involves other pituitary hormones.

L-T3 is about 3x as potent as L-T4 so your dose equates to 100 + 15x3 = 145 mcg L-T4 which is not a high dose. Your endocrinologist is interpreting the TSH wrongly, it is insufficient, it is not suppressed. Push hard to keep your 15 mcg dose, it's a modest dose and any (very) minor risks and more than compensated by the harm done by a 10 mcg dose.

SlowDragon profile image
SlowDragonAdministrator in reply to hackman

So next test make sure to take last dose levothyroxine 24 hours before test

8-12 hours gap between last dose T3 and test

Most recent test, as you took levothyroxine before test, the Ft4 is a false high

Yes I have heterozygous Dio2 gene variation. I find it essential to take T3 as 3 doses per days at equal 8 hour gaps. 20mcg per day - 10mcg at 7am, 5mcg at 3pm and 5mcg at 11pm

I also split my levothyroxine 125mcg per day. 100mcg at 11pm and 25mcg at 7am.

If taking any supplements that contain biotin make sure to stop a week before any blood tests (eg vitamin B complex) Biotin can falsely affect test results

hackman profile image
hackman in reply to SlowDragon

I take mine at 7 hour intervals and have been fine with that - but will pay attention to how I am doing and change to 8 if necessary. Interestingly I woke up with the migraine so the long gap between 7pm the night before to 6am was obviously too long although this was on the reduced dose. Now I am back up to full dose I will keep an eye on it.

Thanks!

SlowDragon profile image
SlowDragonAdministrator in reply to hackman

Do you have Hashimoto’s?

Are you on strictly gluten free diet?

hackman profile image
hackman in reply to SlowDragon

I have primary autoimmune hypothyroidism - am not sure whether this is the same as Hashimotos.

SlowDragon profile image
SlowDragonAdministrator in reply to hackman

Likely yes.

If you get Medichecks test, it should include thyroid antibodies testing

SlowDragon profile image
SlowDragonAdministrator

Looking through previous posts couldn’t see any vitamin or antibodies test results

Private tests are available. Thousands on here forced to do this as NHS often refuses to test FT3 or BOTH antibodies

thyroiduk.org.uk/tuk/testin...

For thyroid including antibodies and vitamins

Medichecks Thyroid plus ultra vitamin or Blue Horizon Thyroid plus eleven are the most popular choice. DIY finger prick test or option to pay extra for private blood draw. Both companies often have special offers, Medichecks usually have offers on Thursdays, Blue Horizon its more random

If you have Hashimoto’s, are you on strictly gluten free diet?

Also have you considered Dio2 gene test?

thyroiduk.org/tuk/testing/D...

hackman profile image
hackman in reply to SlowDragon

Yes, thank you for this. My endo (private) has passed my care to my GP (fab) and she asked that I go to the same place as previously for my most recent blood test so that we had a direct comparison. From now on I will got to medichecks as I have a local surgery who will draw blood for them. This will give me all of the vitamins etc checks that I need too.

SlowDragon profile image
SlowDragonAdministrator

Recommend wearing a Fitbit to. Gives clear record of resting heart rate, plus your daily activity levels

If you have low resting heart rate this is strong evidence that you are not over treated.

Can print out weekly summaries and also record of resting heart rate over a month, 3 months or year

hackman profile image
hackman in reply to SlowDragon

My resting heart rate is between 60 and 62 beats per minute. That only changes when I get a migraine when it can race to 92+ beats per minute.

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