Need of advice

[uchi]

Hi.

I am on a combination Levothyroxine & Cynomel (=Cytomel/T3).

These are the results I got today.

Any suggestions?

It seems to me that I need to reduce the Cynomel in order to activate the Thyroid.

Would be grateful for any advice. Thank you

[SeasideSusie Remembering]

uchi

It seems to me that I need to reduce the Cynomel in order to activate the Thyroid.

I'm not quite sure what you mean by that.

How much of each are you taking?

Taking T3 is going to lower FT4 anyway.

When on combination hormone replacement, some people need a decent FT4 level, some people do well with a low FT4 level, it's up to the individual to find out what they need of each for them to be optimally medicated.

Your FT3 is exactly 50% through range, I would find that too low for me (I take a combination of Levo plus T3), and I need my FT3 nearer 70% through range (I also need FT4 to be fairly well balanced with it to feel well).

If those are my results I'd be increasing Levo then retest in 6-8 weeks to check levels then reassess. Extra Levo will increase your FT4 level and depending on how much natural conversion you have it could also increase your FT3 level.

[uchi in reply to SeasideSusie]

Dear SeasideSuzie,

Thanks for the reply.

I am taking 450 mcg per week Euthyrox (5X50 +2X100) and 0,025mg Cynomel (Liothyronine sodique) a day (divided into two-taken morning and afternoon).

I am feeling OK, despite having horrendous EIGHT MONTHS due to Corona-related issues.

I am just really hoping 🙏 that now, with reduced stress level, I will be able to reduce some medication 🤞

Uchi

[SlowDragon Administrator]

For full Thyroid evaluation you need TSH, FT4 and FT3 plus both TPO and TG thyroid antibodies tested. Also EXTREMELY important to test vitamin D, folate, ferritin and B12

Low vitamin levels are extremely common, especially if you have autoimmune thyroid disease (Hashimoto's) diagnosed by raised Thyroid antibodies

What vitamin supplements are you currently taking?

When were vitamin levels last tested

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)

If/when also on T3, make sure to take last third or quarter 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?

Private tests are available as NHS currently rarely tests Ft3 or thyroid antibodies or all relevant vitamins

List of private testing options

thyroiduk.org/getting-a-dia...

Medichecks Thyroid plus vitamins including folate (private blood draw required)

medichecks.com/products/thy...

Thriva Thyroid plus antibodies and vitamins By DIY fingerpick test

thriva.co/tests/thyroid-test

Thriva also offer just vitamin testing

Blue Horizon Thyroid Premium Gold includes antibodies, cortisol and vitamins by DIY fingerprick test

bluehorizonbloodtests.co.uk...

If you can get GP to test vitamins and antibodies then cheapest option for just TSH, FT4 and FT3

£29 (via NHS private service ) and 10% off if go on thyroid uk for code

thyroiduk.org/getting-a-dia...

monitormyhealth.org.uk/thyr...

[uchi in reply to SlowDragon]

Thank you for the reply.

To put it shortly, I have Hashimoto's, quite high antibodies around 700 TPO.

Taking all supplements (as specified above and more) advised by a functionalist doctor. Four years gluten and dairy free.

Because of the usual GP/endo problems, I am being treated in two continents and soon three, without them being aware of each other. Quite a headache at the beginning. But feeling fine. That's what brings me to ask for some advice as to fine-tune the T4 and T3. That is, do the numbers indicate the possibility that there is too much T3 in the system and, therefore, there is a suppression of TSH & T4? 🙏

[SlowDragon Administrator in reply to uchi]

TSH is almost always suppressed on any dose of T3

Many people would find your Ft4 results too low

Was last dose levothyroxine 24 hours before test and last 5mcg T3 8-12 hours before test?

Everyone is individual.....it’s trial and error what level suits you best

Personally I find Ft4 at least 50% through range

Ft3 at least 60-70% through range is about right

[uchi in reply to SlowDragon]

yes

[SlowDragon Administrator in reply to uchi]

How much levothyroxine are you currently taking?

Perhaps consider increasing by 25mcg and retest 6-8 weeks time

[uchi in reply to SlowDragon]

I am taking a total 450 mcg a week. What do you think of the possibility of reducing the T3 and increasing the T4 ?

Also, If I feel fine with these numbers, staying on the same dosages as now, how can it affect me? sorry for the so many questions 😔

[SlowDragon Administrator in reply to uchi]

If you feel fine....don’t change

[uchi in reply to SlowDragon]

Thank you 🙏