I am on 75mcg of levothyroxine & 6 weeks ago I added 5mcg of Liothyronine & 2 weeks ago I went up to 10mcg.
These are my results before starting the T3.
TSH 0.707 (0.27-4.2)
FT3 3.47 (3.1-6.8)
FT4 17.700 (12-23)
Reverse T3 48 (10-24)
These are my results today.
TSH 0.022 (0.27-4.2)
FT3 4.65 (3.1-6.8)
FT4 17.200 (12-22)
I have a appointment with my endocrinologist next week to discuss the results.
How do you feel? If these were my results I would like Ft3 to be higher so would be increasing my Lio. But if you feel ok then they are fine.
I still don’t feel too good. I feel good after my morning dose of Liothyronine but get a slump at about 2pm & need to lie down. The feel good again after my 16.40 dose & into the evening. I’ve noticed my temperature is better after each dose but then goes down again as the dose wears off. I’m planning to increase my Liothyronine to 15mcg next week & do 3 doses of 5mcg every 4 hours.
Redporti
6 weeks ago I added 5mcg of Liothyronine & 2 weeks ago I went up to 10mcg.
It would have been better to wait 6 weeks after increasing T3 to 10mcg before retesting. It can take 6-8 weeks for levels to stabilise, even for T3.
I couldn’t wait unfortunately as I have a endocrinologist appointment next week & she wanted bloods done this week. I understand it would have been better to wait.
I hope she understands that takingT3 tends to lower, even suppress TSH. Be prepared for her to freak out with your TSH level.
I know I’m waiting for the fallout. I’ve read it’s not dangerous so hope she knows that too. I’m hoping she will decrease my levo & increase my Liothyronine as my reverse T3 is so high.
What does a suppressed TSH mean? What is happening in the body?
TSH is almost always suppressed on any dose of T3.
TSH is the message from pituitary asking thyroid to work. It’s irrelevant
The most important results are Ft3 followed by Ft4
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).
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 did your tests?
Obviously, as you know testing after 2 weeks is too soon. Ideally you would test again after 6-8 weeks
Plus recommend including vitamin D, folate, ferritin and B12 if not tested for 3-4 months
Personally I find 3 doses per day at 8 hour gaps gives smoothest results.
After test test re.....When/if you are considering adding another 5mcg dose you could go to 3 doses per day
Redporti
Suppressed TSH is when the result is below 0.1.
TSH is a signal from the pituitary. When the pituitary detects there is enough thyroid hormone, the TSH level is low. When it detects there is not enough thyroid hormone then TSH level will be high.
I’m hoping she will decrease my levo & increase my Liothyronine as my reverse T3 is so high.
Your rT3 is not necessarily linked to a problem with your thyroid. The only reason thyroid would be involved is when there is a build up of unconverted thyroxine (T4). When your rT3 level was 48, your FT4 was 17.700 (12-23) so it wasn't high enough for there to be a build up of unconverted T4.
Other conditions that contribute to increased Reverse T3 levels include:
· Chronic fatigue
· Acute illness and injury
· Chronic disease
· Increased cortisol (stress)
· Low cortisol (adrenal fatigue)
· Low iron
· Lyme disease
· Chronic inflammation
Also selenium deficiency, excess physical, mental and environmental stresses. Also Beta-blocker long-term use such as propranolol, metoprolol, etc. Physical injury is a common cause of increased RT3, also illnesses like the flu. Starvation/severe calorie restriction is known to raise RT3. Diabetes when poorly treated is known to increase RT3. Cirrhosis of the liver. Fatty liver disease. Any other liver stress Renal Failure. A fever of unknown cause. Detoxing of high heavy metals.
FT4 17.200 (12-22)
With your FT4 currently only 52% through it's range, if that was my result I wouldn't want my Levo reduced. We're all different as to where we need our FT4 when on combination hormone replacement, some do well with it low in range, others need it much higher in range. T3 is going to lower FT4 anyway, so if you get an increase in T3 your FT4 could very well go lower.
Yes I did the blood test under all the rules you stated. Thank you for the explanation. I was going to take the T3 in three doses of 5mcg every four hours. The reason being that I take my first dose at 8.40am & my second at 16.40. But at about 14.00 I get really tired & need to lie down. So if I did a second dose at 12.40 then that might help me with the slump.
This reply is meant for SlowDragon
I find T3 still better on empty stomach and nothing for 30-60 mins after ideally
....so I take (roughly) 7am ....2.30pm and 11pm
Omg really? So maybe armour or ndt is not good then for me?
Why do endocrinologist freak out when your TSH is as low as mine?
I have no idea because the TSH is a pituitary hormone not a thyroid hormone and means nothing imho. The reason I say this is because when my TSH was 0.70 my T4 and T3 were very low and I felt very ill they refused to treat me. Now my TSH is 0.38 and my T4 is at the top of the range I feel well. I wish the NHS would stop using the TSH as a guide because it is keeping a lot of people very ill. Unfortunately my Endocrinologist was just as bad and I am now looking after my own thyroid health because after 12 years I am still not getting any help from the NHS. Just to add they are doing and wonderful job looking after all the COVID-19 patients.
So if my Endo starts panicking them I must insist that she doesn’t lower my T3 meds. In fact I think they need increasing. I guess I am old enough to increase my T3 meds on my own but I would like to do it with her approval.
I doubt you will get her approval because she is following NHS guidelines. My GP told me he would be struck off if he gave me Levothyroxine because my TSH was 0.70. My hair was dropping out and I was virtually bedridden but all he was interested in was the TSH. I showed him a plastic bag of my hair that I had collected for a week and he simply was not interested. I had no choice but to buy my own NDT and self medicate. I am not alone in having to do this because I was fighting for a good quality of life. He had no interest in my physical symptoms at all.
That’s terrible, it really shouldn’t be that way. My Endo has been open to me trying Liothyronine so I hope she knows about how it works.
I hope she is but if you read my profile you will see how I have been treated or not treated for the past 12 years. I don't trust any doctor with my thyroid health now and I am not the only one because that is the reason this site exists.
I’ve just called the endocrinology clinic to get an appointment with my Endo to discuss my results. I was told I can’t speak to her until June!!!! When I pointed out that these blood results would be irrelevant by then she told me I would have to get them done again. I explained it was costing me £40 a time to get these bloods done & if she wasn’t going to give me an appointment why did she tell me to get my bloods done this week so they could give me an appointment. She had no answer. So now it’s been left that they will put my results on her desk & she might call me or write a letter if she thinks she needs to. I asked what should I do if she doesn’t do either & she didn’t know what to say.
So I guess it’s down to me now to manage my own hypothyroidism. I have learnt lots of things from this site & another I belong to on Facebook & I feel confident enough to medicate myself. It really is disgusting that it’s come to this.
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