The TSH is a pituitary gland hormone not a thyroid hormone and it is the T4 and T3 that counts. If your Endocrinologist is dosing you by your TSH I would find another Doctor because they will keep you ill. Your TSH will be very low if you are taking T3 and your Endo should know this.
I think your endo is a bit confused. He doesn't understand the difference between the high FT3 of hyperthyroid conditions, such as Grave's, and the high FT3 from taking exogenous thyroid hormones.
Having a contition like Graves will give you a very high FT3, and a suppressed TSH, and can be very tiring. But, it's certainly not the suppressed TSH that makes you tired, because TSH does not cause symptoms. It doesn't make you feel anything. Probably not the high FT3, either. It's the condition itself, the over-working thyroid gland that makes you tired.
Slightly over-dosing on exogenous T3 is unlikely to have the same effect.
( 12/4...lab result =160 ...180 being top of range)
That lab test is not FT3. It is TT3. Which means that not all that T3 is available for your body to use, so won't have the same effect as a high FT3, anyway. But, your result is far from being top of the range, let alone over-range.
So, all in all, reducing your T3 is probably going to make you more tired, rather than less. And, your endo is either very ignorant, or is trying to reduce your dose of T3 for some weird and wonderful reason of his own. Personally, if you're really tired, I'd be asking for an increase, not a reduction!
To a certain extent, yes. But, if a doctor prescribes T3, he should know how it works. And, taking T3 is going to lower/suppress the TSH. That's the way it works.
He also seems to be believe that someone who is hypo and on medication for this can suddenly become "sub-clinically" hyper as well. As you imply. not a great advert for endos ...
There is a small bit of truth in what he says. ...Yes it is true that hyperthyroidism and also overmedication, can indeed cause really bad exhaustion... but in hyperthyroidism and overmedication this would usually by accompanied by other symptoms of hyperthyroidism . such as feeling too warm and faster heart rate, feeling agitated, having a slight tremor in fingers, too frequent bowel movements, loosing weight despite increased appetite, muscle weakness in thighs etc feeling similar to having an overdose of expresso coffee . I haven't ever had hyperthyroidism , but do know someone who was , and yes , they did feel exhausted. I have been slightly overmedicated and did have too frequent bowel movements and lost a little weight, and was rather more anxious and irritable than usual, and had a slight tremor, but heart felt normal.
But it does look like he is then twisting this fact to use as an excuse to reduce your T3 dose, especially since he is suggesting that you reduce T3 from 20 to 15 to 10.
This is a huge change , and will certainly have a big effect on how you feel and take ages for your body to settle down again.
I'm not convinced this is a good idea.
If he really had your best interests at heart i would expect a much smaller suggested reduction and see if it improved how you felt, not a stated intention at the outset to cut your T3 dose in half.
I'd also expect him to do the right test... if that is indeed a Total T3 rather than a Free T3, he really can't say your current dose is too high based on the blood test result.
Ask him to look up from the computer screen and examine you for other symptoms of overmedication.
Remember that an fT3 test is very dependent on timing of last dose of T3, if taken too soon after dose it will read quite a lot higher than it will later on. But the TSH will still be similar.
I think 8-12 hours after last T3 dose is the time usually recommended here, and 24 hours after last dose Levo, These timings will show fT4 and fT3 at lowest levels for a dose.
If you want to see the highest levels of ft4 and ft3 for a dose you would test closer to taking the tablets.
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