Two months ago I was finally prescribed T3 by a private psychiatrist as a result of excruciating anxiety and latterly depression as part of my Hashimoto’s. I saw a great improvement in the first few weeks on 10mcg a day of T3. Over the past week I have started to revert to mild symptoms again and would like to increase my T3.
I am aware that iron and cortisol could be affecting things at this stage but both were acceptable at the outset of dosing. I think an RT3 test would be appropriate, but obviously won’t do that in the current lockdown. Does anyone know if one can fill a syringe with blood from endless finger pricks??
My present thoughts are to lower my T4 and raise my T3. Has anyone any better ideas. I really don’t want to bother my doctor over something that could be solved with help from you good people.
Many thanks.
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Rainbow47
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I'm afraid an rT3 test would not be appropriate - but would be very expensive! An rT3 test gives you no useful information. It will tell you if your rT3 is high, but it won't tell you why. And, there are many, many reasons for high rT3. And only one of them has anything to do with thyroid. And, your FT4 is not high enough to be responsible for over-range rT3, even if you had it. So, what would be the point of doing the test?
rT3 does not cause hypo symptoms. It does not block T3 receptors, as used to be thought. I only stays in the system for a couple of hours, and then converts to T2.
Have you had your ferritin tested? And your vit D, vit B12 and folate? What time was your cortisol test done?
You certainly could increase your T3 by 5 mcg. But, you don't necessarily have to reduce your levo, your FT4 is not even mid-range, and it could even be that it's too low already. Needs for T4 vary from person to person, but do you really want yours any lower?
Thanks Greygoose - you’ve more or less confirmed my own thoughts. I’ve been following Paul Robinson for introducing T3 and he keeps mentioning RT3 testing as part of the protocol, but I’ve never thought too much about it before.
I haven’t tested my iron for a while but take supplements for iron, B12, folate etc. Cortisol is a more difficult thing - i yo-yo quite a lot and Psychiatrist suspects to do with my antidepressant which I’m doing a slow withdrawal from. Think I might stay at half dose of that and get the T3 sorted out.
Thanks so much for your advice - I think I’ll just up the T3 and test again in a few weeks time but do full testing this time.
I agree with Greygoose. Don't waste money on an rT3 test, it can only tell you if it's high or not, and if it's high it can't tell you why.
You would have to prick a lot of fingers to get enough blood. I can fill one microtainer easily enough but can't fill two.
If I were you, I'd order a Medichecks ULTRAVIT test today - it's on offer at £79 instead of £101 if ordered before midnight - as this includes Vit D, B12, Folate and Ferritin unless these were included in the test you've had done already. If they were, maybe you could post the results/ranges.
Thanks SeasideSusie - you will see in my reply to greygoose what I’ve decided to do, but you’re right I need to get my ferritin, in particular, re-tested and will do so. Do you need to stop supplements before testing? Can’t remember!
Everything else we can continue but take them after the test on the day, not before.
Remember that there are severe delays with postal services at the moment. Personal experience of standard first class post recently, both outgoing and incoming, it has taken 5-7 days.
Your sample should be posted on the day of collection to arrive the next day so you need to look at Special Delivery by Royal Mail (or maybe a courier). It shouldn't arrive on a Saturday and be hanging around over the weekend. Ask at the Post Office counter what the guaranteed times of this service currently are and the cost, factor this in before doing your test.
I’ve just been looking at Medichecks website and they are sending special delivery labels (I presume) for returns. I’ve asked them if they can be returned without going to a PO - just waiting for a reply. I live out in the sticks and am ‘of an elderly disposition’🤣, not been out for weeks, so could be difficult to return.
Think for now I’ll up the iron anyway, though not sure what’s recommended these days as I only have Spatone.
I've just had a look at Medichecks website and the information about the return service wasn't there yesterday.
They say
"We are now including a tracked postage service in each kit for you to use when returning your sample to the lab. This will ensure that, even in the current environment, samples get to the lab in good time and do not spoil due to delays in transit."
That is a tracked service which will be Royal Mail's Tracked 24 or Tracked 48 and has to be scanned. I don't know if you have to hand this over at the post office counter as it's a service only available to businesses not the general public to purchase.
Special Delivery Guaranteed Next Day is a service the general public can purchase and has to be handed over the post office counter so that a special label can be put on the envelope, scanned and you are given a receipt. The receipt contains the tracking number so that you can go to RM's website to check that it has been delivered. It is scanned throughout it's journey to it's destination which shows on the tracking information which you can see on their Track and Trace page. If it takes longer than the guaranteed time you have paid for then the fee is returned upon you showing them proof.
Just had an email back from Medichecks saying that the tracked sample can be put straight into the letterbox, which is great - I’ll go ahead and order it today even if I don’t use it for a week or two. Thanks for your help SeasideSusie!
I'm glad they've sorted that out. I have a test I've been wanting to do but it was bought in February so only has the normal return envelope and I can't go and queue at the post office to get it sent Special Delivery.
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 third or half of daily 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?
Don’t reduce your levothyroxine, Ft4 is already on low side
Perhaps consider Adding a second 5mcg dose T3 mid afternoon
Important to regularly retest vitamin D, folate, ferritin and B12
As you have Hashimoto’s are you on strictly gluten free diet?
approx 5% with Hashimoto's are coeliac, but over 80% find strictly gluten free diet reduces symptoms, sometimes significantly. Either due to gluten intolerance (no test available) or due to leaky gut and gluten causing molecular mimicry (see Amy Myers link)
Changing to a strictly gluten free diet may help reduce symptoms, help gut heal and slowly lower TPO antibodies
While still eating high gluten diet ask GP for coeliac blood test first or buy test online for under £20, just to rule it out first
Assuming test is negative you can immediately go on strictly gluten free diet
(If test is positive you will need to remain on high gluten diet until endoscopy, maximum 6 weeks wait officially)
Trying strictly gluten free diet for 3-6 months
If no noticeable improvement, reintroduce gluten and see if symptoms get worse
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