Symptoms of low ft4 and upper normal ft3?

[Clara9]

I know some people need both ft4 and ft3 to be in upper range when on combination treatment. How do you fell of your ft4 is low in range and ft3 upper range?

[SeasideSusie Remembering]

Clare9

How do you fell of your ft4 is low in range and ft3 upper range?

For me I feel very unwell, I'm one of those who needs FT4 and FT3 fairly balanced around 70% through range on combination of Levo plus T3.

[Clara9 in reply to SeasideSusie]

Does the symptoms differ for you if it's low t4 or low t3?

[SeasideSusie Remembering in reply to Clara9]

Clara9

I've never let my FT3 get low again after starting to add T3. I just know where I need my levels and keep them there as best I can.

[Giugiugiu in reply to SeasideSusie]

I think I could be one of those who need their ft4 higher in the range, but even when on levo only (75mcg) it has always been below 40% of the range. Now I’m trying with 100mcg t4+ 16 mcg t3 (with TSH suppressed and ft3 at 100% of the range yet didn’t feel well).

Hope this is the right choice, any advise? Thanks

[SeasideSusie Remembering in reply to Giugiugiu]

Giugiugiu

even when on levo only (75mcg) it has always been below 40% of the range. Now I’m trying with 100mcg t4+ 16 mcg t3 (with TSH suppressed and ft3 at 100% of the range yet didn’t feel well).

The aim of a treated Hypo patient on Levo only, generally, is for TSH to be 1 or below with FT4 and FT3 in the upper part of their ranges.

TSH should be 1 or below with FT4 in the upper part of it's range before considering adding T3 (and nutrient levels - Vit D, B12, folate and ferritin need to be optimal before adding T3).

So you should have worked on getting your FT4 high in range by taking more Levo before adding T3.

[Giugiugiu in reply to SeasideSusie]

Thanks seasideSusie, you can call me Giulia btw!

Well, I guess now it’s a bit late since I’m taking t3 since March. At first I instantly felt better on the combo t3+t4 but now I’m not so I’m trying to rise my ft4 by taking more levo.

I know I made a mistake before, but am I doing things right now?

[SeasideSusie Remembering in reply to Giugiugiu]

Guilia

It's difficult to make any meaningful response without seeing your test results with their reference ranges. As long as you keep your FT3 within range you are not overmedicated, but you'll have to experiment to see where you need your levels of FT4 and FT3 for you to feel well, it can take a long time and lots of tweaking to get it right. Retest 6-8 weeks after any dose change, and only change on thing at a time - either Tirosint or T3, never both at the same time as you wont know which has made a difference to how you feel.

Remember that when we do thyroid tests, last dose of T4 should be 24 hours before test, last dose of T3 should be 8-12 hours before test, and if you take a B Complex or Biotin supplement this should be left off for 7 days before testing.

[Giugiugiu in reply to SeasideSusie]

Thanks, I’ll follow your advice.

Btw these are my test results:

Tsh: 0, (0,51-4,94)

Ft4: 1,08 (0,89-1,76)

Ft3: 4, 20 (2,3-4,2)

[SeasideSusie Remembering in reply to Giugiugiu]

Guilia

If you do increase your Tirosint it will very likely increase your FT3 as well as FT4 depending on how much natural conversion you have, you don't have any wriggle room as your FT3 is already at the very top of the range. This will, of course, take your FT3 over range, so if you increase your Tirosint you might want to reduce your T3 a bit first.

[Giugiugiu in reply to SeasideSusie]

Ok thanks SeadideSusie, that’s what I’ve done. I reduced the t3 and upped t4, I’ll post my results in some weeks, when I will retest (and I will also test vitamins level)

Thanks for your time and help, really appreciated

[reliablerebel]

Those would be normal results for me. T3 usually good, and T4 lower end of range. But so long as I feel good and am asymptomatic, then thats good enough for me.

[Lalatoot]

I need both over halfway through their ranges.

When my ft4 is under 50% I get a sore throat and husky voice. If it goes very low I lose my voice.

When my FT3 is low (I like it around 70%) it feels if someone has put a brake on. I feel nauseous, can't eat, breathless, those typical hypo symptoms.

[jrbarnes]

I have to be within 12.5 mcg of my usual Levo dose plus added T3 to feel stable and it would have to be the correct amount of T3 or else I'd start to get carpal tunnel and swelling, however I'd feel best if my T4 was right at the top of my labs reference range and then add some T3 but I'm still experimenting with this because I started a new brand only three days ago, as well I've been taking some supplements, and I don't know where my T3 levels will be so I'm waiting 6 weeks. It's different for everyone. I only have half a thyroid and the other side doesn't work well therefore I feel better with more T4.

On my personal experience, Low T4 and low T3 can result in facial swelling and extreme carpal tunnel due to fluid if you're on a T4/T3 combo. Top of range or slightly under T4 and low T3 on T4 only meds also carpal tunnel, toe pain, hoarse voice crushing fatigue, peripheral neuropathy, inability to think etc. Your symptoms of low T4 or T3 will depend on what type of therapy you're on, for example, T4 only, T4/T3, and natural desiccated.

[Giugiugiu]

My labs were like this when I last tested. I don’t know if it’s low t4’s fault but I feel distracted, brain fog and a little confusion. Also weight gain is happening. Now I’ve upped my levo to see what happens!