Should T4 &T3 be at the same percentage.?

[Simplyred57]

Just wondering if both T4 & T3 should be at around the same percentage, I always use the calculator when I get my results and since starting T3 last year my T4 is stable at around 78% on 100mcg and has stayed pretty much there, since introducing T3. But my T3 is consistently high it was 133% on 18.75 so reduced to 12.5 .my latest results are T4 78.7% and T3 103.33 % my Endo said to stay on the same dose but not sure if I should reduce again , any advice would be gratefully received.

[fuchsia-pink]

We're all different, but for many of us a high free T4 percentage and a low free T3 percentage is a problem. Some on this forum are on lio-only and have high free T3 and very very low free T4 and are happy with that. You have a nice high free T4 percentage and slightly over-range free T3,

If your endo is happy and you feel well , I wouldn't change a thing; but if you were feeling jittery you might reduce lio a little bit and try to keep the percentages more balanced x

[Simplyred57 in reply to fuchsia-pink]

I’m not feeling jittery , just loads of joint pain , no matter what dose I’m on I seem to be at the top or over range on my T3?

[Tyna20 in reply to Simplyred57]

High ferritin (too much iron in the blood)can cause joint pain. I had this at the beginning of the year.

[Simplyred57 in reply to Tyna20]

Oh I’m not sure I will have a look at my last results.

[DippyDame]

Unless you have a form of Thyroid Hormone Resistance (I was advised that) you should aim to keep your FT3 labs under 100% through the ref range to avoid overmedication

133% on a combo dose is too high

Remember T3 from conversion of T4 is also raising FT3,

However, your conversion with FT4 at 78.7% looks as if it might be impaired, a lower %age on 100mcg levo might be expected with good conversion

As someone who has RTH I now take 50mcg T3 (having now managed to reduce from a much higher dose) My FT3 is well over range but this dose is required to overcome the resistance

Your FT4 is slightly high at78.7%, we are advised to aim a little lower, but it may depend on how you feel

How do you feel on 100mcg T4 with 12.5% T3?

I suspect you need to reduce your hormone intake

[fuchsia-pink in reply to DippyDame]

Agree 133% is too high, but latest result is 103%, so only just over.

Simplyred57 did you leave 8 - 12 hours from previous dose of lio when having the latest blood draw? If longer, you will have a slight "false low" which might mean a little reduction in lio is still a good idea ... It's all trial and error,, but as you're not feeling tip-top, a small dose change may be worth trying

[Simplyred57 in reply to fuchsia-pink]

Yes blood were done as protocol advised on here .

[DippyDame in reply to fuchsia-pink]

I qualified that statement by saying that, "Unless you have a form of Thyroid Hormone Resistance (I was advised that) you should aim to keep your FT3 labs under 100% through the ref range to avoid overmedication"

That comment was based on this reply from diogenes to me a few months ago -

"...above-range FT3 in subjects whose conversion ability is normal or good is dangerous. Of course with T3-resistance of any kind this no longer hold, because the serum FT3 doesn't relate closely to cellular T3. And of course there is the "spike" problem where FT3 rises up high shortly after taking T3 and falls back over the next time period of say 12 hours. I don't think this "spike" is necessarily dangerous because the body's response is quite slow and therefore really should be seen as evening out over the whole period ( Function-wise) regardless of the momentary spike. So it's the long term elevation in normal converters that is the worry."

Problem is Simplyred57 hasn't actually eliminated RTH; if she had then FT3 should be kept in range.....however, her conversion looks questionable!

Sorry, maybe being a bit pedantic!

[Simplyred57 in reply to DippyDame]

No I fully understand what your saying, and will definitely be reading the book , it’s a flipping minefield I thought all my problems would be solved when I started taking T3 and never heard of RTH and just though my conversion would be be sorted , more reading for me x

[DippyDame in reply to Simplyred57]

I think you'll find Hugh H's ebook very helpful, as a starting point.

Good luck x

[Simplyred57 in reply to DippyDame]

Thank you for all your advice x

[DippyDame in reply to Simplyred57]

Just hope it helps....it was other experienced member's guidance that led me towards the road to recovery!

You can do this! x

[Simplyred57 in reply to DippyDame]

Well I don’t feel like I’m dragging myself through life, but I have to say I don’t feel fantastic either, I’ve had loads of problems with shoulder pain now diagnosed as 2 frozen shoulders from a private physio as the nhs physios were trying to diagnose me over the phone, but having further blood tests because burning in my arms which my physio is adamant is not related . Speaking to my Endo he didn’t seem concerned, how do you know if you have RTH ?

[DippyDame in reply to Simplyred57]

Long story, see my profile.....if interested click on my avatar. Much trial and error involved!

On those levels you need to monitor your heart rate and waking temperature to ensure they are not raised so suggesting overmedication.

I had a lot of pain when my tissue level T3 was low, had a steroid injection in my shoulder and years of private CranioSacral therapy

I've scanned through some of your old posts and you seem to be getting nowhere fast with T4/T3 combo.

In your situation I might be tempted to try T3 only, but bear in mind I've been round the block and back on this one! T3 only is the last resort but maybe you've tried everything else. Only you can decide.

The following may help -

You might find this ebook useful. Available on Amazon for £3.56 or free if you have Amazon Prime it is called "Impaired Sensitivity to Thyroid Hormone (Thyroid Hormone Resistance)" by Hugh A Hamilton

Have you considered reading any of Paul Robinson's books including "Recovering with T3."

Another good source is "Your thyroid and how to keep it healthy" by Dr Barry Durrington Peatfield.

healthrising.org/blog/2019/...

I found reading extensively was key to my recovery.

Take care

[Simplyred57 in reply to DippyDame]

Thank you, I’ve just spent the last few hours reading your journey - wow you have been through it 😩I will order the book you recommended, I have to buy my T3 so don’t want to go down the T3 route only unless absolutely necessary, just read a post where SlowDragon said if you are correctly medicated T3& T4 should both be 50 to 60 % through the range maybe I need to reduce both T3 & T4 ?????

[Gophe in reply to Simplyred57]

@Simplyred57 have you asked for a referral to a rheumatologist? Seems worth doing. I don't know much on the topic, but frozen-shoulder like symptoms and burning feeling could correlate to inflammatory arthritis. (If your hypothyroidism is auto-immune, then it's not uncommon to have a second auto-immune condition, e.g. rheumatoid arthritis.)

[Simplyred57 in reply to Gophe]

No I haven’t but inflammation blood tests have been done twice and both came back clear as they originally suspected polymyalgia , my frozen shoulders are improving but the burning isn’t - I’m having blood tests on Wednesday for Vitamins and nerve damage so maybe they might show something 🤷🏼‍♀️