I’ve recently had my bloods done and although I had reduced my t3 previously and my FT3 came within range I’m now 7.9 above the top of the range at 6.5 on 50mcg.
Before I was on 63.5mcg 6 months ago and was at 7.8 FT3. Any ideas why when I lower my dose my FT3 has increased again over the last few months?
I’m on T3 only TSH suppressed & FT4 very low. I took half my dose 12 hours before my bloods which were on an empty stomach and no t3 that morning.
I need to keep my FT3 within the nhs range for an operation I’m on a waiting list for which has been delayed due to COVID. Many thanks
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MissFG
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Whether or not it's good or bad depends on how it makes you feel.
Here's a brief rundown of how Hashi's works:
OK, so Hashi's is an autoimmune disease, where the immune system attacks and slowly destroys the thyroid. It is diagnosed by testing Thyroid Peroxidase (TPO) antibodies and Thyroglobulin (Tg) antibodies.
Contrary to popular belief, it is not the TPO/Tg antibodies themselves that attack the thyroid:
"When lymphocytes infiltrate the thyroid gland, mistakenly taking it for a foreign bacteria invader, they damage the thyroid gland and release thyroid peroxidase &/or thyroglobulin into the blood stream. These don't belong outside of the thyroid gland so antibodies are developed to mop them up.
The antibodies are a result of the attack on the thyroid gland, the antibodies don't cause the attack."
After every immune system attack on the thyroid, the dying cells release their stock of thyroid hormone into the blood stream, causing the levels of the Frees to shoot up - FT4 to around 30 something, FT3 around 11/12 - and the TSH therefore drops to suppressed.
There is no knowing how long these high levels will persist, but eventually, they will drop by themselves as the excess hormone is used up or excreted, and not only will you become hypo again, but slightly more hypo than before, because there is now less thyroid to make hormone.
(NB: A Hashi's 'hyper' swing is not true hyperthyroidism in that your thyroid is over-producing thyroid hormone. It's physically impossible to 'go hyper' if you are basically hypo. The thyroid cannot regenerate itself to the point of over production of hormones - or even normal production. Very few doctors appear to know that.)
Therefore, it's very important that your doctor does not reduce your prescription, because you’re going to need it again! If you start to feel over-medicated at that point - some do, some don't - the best thing is to stop levo for a few days, then, when you feel hypo again, start taking it again. It's very important to know one's body, and how it reacts.
There is no cure for Hashi's - which is probably one of the reasons that doctors ignore it - apart from the fact that they know nothing about it, of course!
However, between the 'hyper' swing, and the descent back into hypothyroidism, there can be a phase - quite a long one, sometimes - of normality, where the person is neither hypo nor 'hyper'. This is where people sometimes start talking of having 'cured' their Hashi's, by whatever means. But, it doesn't last. Eventually, you will go hypo again.
But, there are things the patient can try for him/herself to help them feel a bit better:
a) adopt a 100% gluten-free diet. Hashi's people are often sensitive to gluten, even if they don't have Coeliac disease, so stopping it can make them feel much better. Worth a try. Some say that going gluten-free will reduce antibodies – I’ve never seen conclusive proof of that, but, you should be aware that even if you were to get rid of the antibodies completely, you would still have Hashi's, because the antibodies are not the disease. It is not the TPO/Tg antibodies that do the attacking.
b) take selenium. This is not only reputed to reduce antibodies, but can also help with conversion of T4 to T3 - something that Hashi's people often find difficult.
c) the best way to even out the swings from hypo to 'hyper' (often called Hashi's Flares, but that doesn't really sum up the way it works) is to keep the TSH suppressed. This is difficult because doctors are terrified of a suppressed TSH, for various false reasons, and because they don't understand the workings of Hashi's. But, TSH - Thyroid Stimulating Hormone (a pituitary hormone) - tries to stimulate the thyroid to make more hormone, which also stimulates the immune system to attack. So, the less gland activity there is, the less immune system activity there will be, meaning less attacks, gland destruction slowed down and less swinging from hypo to hyper and back.
I shouldn’t change my dose? Or based on the info you supplied maybe don’t take it for a few days like levo?
I’ve felt shaky and not sleeping well even on amytriptyline which usually works. Emotional and anxious where usually I manage this. And my head feels pressure and tension like one long headache. Lost my appetite and occasionally a flutter of palpitations. Otherwise I’m pretty good. I just thought I was feeling a bit rough due to stress.
A gp rang me today to discuss as they can’t advise me how to take my dose due to be over range. It ended up being a discussion about a referral again to Endo to see if I can get t3 on prescription so I’m looked after especially with my operation due.
Best thing would be to stop your T3 for a while until you begin to feel hypo again. It shouldn't be too long. But no way of knowing how long. I should imagine it varies from person to person, like most things to do with thyroid.
If I get worse with my symptoms what would your advice be? A gp is contacting me again, but I don’t know how dangerous being hyper or the symptoms are? So now I’m concerned
Well, the symptoms you have could very well be hyper symptoms. But, there's nothing your doctor can do. You just have to wait for the levels to go down again. I very much doubt you'll get worse. It hits a sudden peak and then slowly drops.
Your FT3 is high, but not high enough to be dangerous, especially not as it's only temporary. I wouldn't worry about it, if I were you.
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FT3- is higher always better? 
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