Doubled my T3 and level has gone down - any ideas?

[JAmanda]

The above shows my T3 which I've been trying to get higher in range, upon advice here. At the highest point on the tracker, I was on 125 of t4 but was over range and felt it, so reduced to 75 t4 and added in 10 T3. I was still suffering a lot with neuropathy and blurred eyes etc so agreed with Endo to go to 50 T4 and 20 T3 a month ago.

Now, my temperature is totally fine (36.5) for the first time in years and I've got nails for the first time in my life so I thought these results would come back optimal! But my T3 is sliding and my T4 is now well under range.

Any ideas why my T3 is lower on 20mcg T3 than when I was just taking t4?

Should I be concerned my t4 is 8.89 (Range 12-22)?

I could try adding in 25 T4 per day as I've got extra?

I talk all meds 6am and don't eat or drink for 1 hour +. Vits all much later in the day and HRT at night

Thanks in advance.

[SeasideSusie Remembering]

JAmanda

It would seem that you didn't need the last reduction in Levo.

When on combination hormone replacement, we are very individual where we need our FT4 and FT3 levels. Some are fine with a low FT4, some of us need it higher in range. Personally I need both FT4 and FT3 balanced around 70% through range.

The reduction in Levo has obviously reduced your FT4 level.

When did you take your last dose of Levo and T3 before the test? Last dose of Levo should be 24 hours before blood draw, last dose of T3 should be 8-12 hours before blood draw (splitting dose and adjusting times the day before if necessary).

[JAmanda in reply to SeasideSusie]

Thanks, yes I did take the T4 and T3 as suggested on here. Thanks for the advice - I've got snouts extra T4 to add in 25mcg TIL I see Endo in Jan.

[SlowDragon Administrator]

Many symptoms return if Ft4 drops too low

Extremely common for endocrinologists to drop levothyroxine dose far too much

Typically dose of levothyroxine only needs reducing 25mcg when adding 10mcg T3

We frequently need GOOD Ft4 and Ft3

Perhaps Aiming for Ft4 as minimum of 16-18 through range.

[JAmanda in reply to SlowDragon]

Thanks.

[SlowDragon Administrator]

Do you split T3 into 3 doses?

If not you certainly need to try that

Doesn’t suit everyone , but generally gives smoother ride

10mcg at 7am, 5mcg at 3pm and 5mcg at 11pm

And you MUST split T3 on day before blood test

If last T3 dose was more than 12 hours before test, you have falsely low Ft3 result

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 of daily dose 8-12 hours prior to test, even if this means adjusting time or splitting of dose day before test

Important to stop taking any supplements that contain biotin a week before ALL BLOOD TESTS too

[JAmanda in reply to SlowDragon]

I tried the splitting but it just gave me ear pain all day. Taking it all at once really works for me. Yes, I did split it on the day before the test - taking half 11 hours before the test.

[SlowDragon Administrator in reply to JAmanda]

When were B12, folate, vitamin D and ferritin last tested?

Personally I find low B12 symptoms return if Ft4 level drops under 50% through range, regardless of Ft3 levels being ok

[JAmanda in reply to SlowDragon]

Thanks that's interesting. I didn't test them this time on grounds of cost but they have been ok this year. I do supplement the B's as am usually low in folate and magnesium. My white blood results are awful - never really hear anyone on here mention them. I might buy a Medichecks ultra vit in the sale and do it in Jan. thx.

[SlowDragon Administrator in reply to JAmanda]

You should see peripheral neuropathy improve on higher dose levothyroxine

Article on low white blood count and thyroid

whitelotusclinic.ca/blog/dr...

[JAmanda in reply to SlowDragon]

Thanks that link was very interesting. I just got some NHL’s blood results and my white blood cells have lifted a little so that’s good. Started 75 levo/20 lio thismorning and will reset everything in Jan. many thanks.

[jrbarnes]

I can't offer great advice as I'm struggling with this but can agree with adding that 25mcg back in. Looks like 20mcg of T3 isn't enough to compensate for the loss of 25 mcg of T4 daily.