Not sure what to do

[Evie7851]

My doctor took me off t3 because of anxiety I was on 112 and 15 mg t3 now I’m on 125 6 days a week and none on Sunday I feel under medicated and I’m gaining weight

Tsh 1.1 range 0.270-4.20

T4 free 1.47 range 0.82-1.77

T3 free 2.0 range 2.0-4.4

How do I get my t3 up increase the tirosint or do a small amount of t3 if she will agree

[SlowDragon Administrator]

Suggest you increase levothyroxine to 125mcg every day as a start

Retest in 6-8 weeks

With Addison’s disease GP shouldn’t be meddling

You4 iron levels were terrible in previous post

healthunlocked.com/thyroidu...

[Evie7851 in reply to SlowDragon]

Sorry I forgot to mention in Dec she had me on 125 7 days a week my free t4 was 1.78 and tsh was 0.60 and t3 was 2.5 this is a new endrocronolist I had high hopes because she specializes in adrenal and thyroid but I ended up with another road block very frustrating

[SlowDragon Administrator in reply to Evie7851]

Well it’s common on just levothyroxine to need high Ft4

Ft3 was still woefully inadequate

You will either need high Ft4

Or try addition of T3 again

Did you split T3 dose into 3 x 5mcg ?

[Evie7851 in reply to SlowDragon]

Yes I did split it 1 in morning 1 at 200And 1 at bedtime

[SeasideSusie Remembering]

Evie7851

There is some room to increase your Tirosint as your TSH could come down to below 1 and your FT4 is 68.42% through range. However, with a bottom of range FT3 your conversion of T4 to T3 is dire.

You could try a small amount of T3 and see how you go.

How are your nutrient levels, these should be optimal before adding T3. Have you got current results for

Vit D

B12

Folate

Ferritin

[Evie7851 in reply to SeasideSusie]

Vitamin D is 63.2 ng/ml and I was taking 10000 units a day which she said was too much ferritin was 65 and B12 830 and folate was 23.5

[SeasideSusie Remembering in reply to Evie7851]

Evie7851

Can you add reference ranges for Ferritin and Folate.

B12 is fine.

Vit D is slightly above the level recommended by the Vit D Society and Grassroots Health, which is 40-60ng/ml so you should reduce to a maintenance dose, maybe something like 2,000iu daily, you're unlikely to need more than that. Do you take D3's important cofactors - magnesium and Vit K2-mk7?

[Evie7851 in reply to SeasideSusie]

I did find my last test was in July and the ferritin was 81 range 8-252 and folate was June 23.5 range>5.4 I also have some 75 and 112 tirosint and some 5 mg t3

[SeasideSusie Remembering in reply to Evie7851]

Evie7851

So we have

Ferritin: 65 (8-252)

Ferritin is recommended to half way through range. Ranges do vary and some experts say that the optimal ferritin level for thyroid function is between 90-110 ng/ml. I have also seen it said that for females 100-130 is a good level. So it might be a good idea to try and improve your level and you can help raise your level by eating liver regularly, maximum 200g per week due to it's high Vit A content, also liver pate, black pudding, and including lots of iron rich foods in your diet

apjcn.nhri.org.tw/server/in...

Don't consider taking an iron supplement unless you do an iron panel, if you already have a decent level of serum iron and a good saturation percentage then taking iron tablets can push your iron level even higher, too much iron is as bad as too little.

Folate level is fine.

[diogenes Remembering]

Once again we see here a doctor treating a patient as if they were an on-off light switch - switching off the T3 (the most powerful hormone of the two) "just like that". It is simply bad medicine. If you were to change satisfactorily it must be done a little at a time, with no abrupt changes such as you describe. In any event your FT3 is at the bottom of its range and FT4 midway up. This indicates poor conversion of T4 to T3, so adding more T4 won't help. except getting low TSH and worrying the poor soul of a doctor even more. If you need to come off T3 then it should be done gradually, noting any adverse changes over time and note down what they are and when you suffered them and are they continuous from the time of change and are they growing..

[Evie7851 in reply to diogenes]

Do you think I should try adding 5 mg of T 3 and see how that goes

[diogenes Remembering in reply to Evie7851]

However you go about it, the first lesson is not to change quickly in one go. I would therefore say that if you are wanting to come off T3, do it slowly. And see how it works out after you do it before making any more changes.

[Evie7851 in reply to diogenes]

She already dropped all of the t3 in December so I’m not sure what to do sorry I should have explained that better also I’ve gained 8 lbs this month and I’m eating less because I’m not as hungry as I was on the tz3

[diogenes Remembering in reply to Evie7851]

You should regain a small amount of T3 and take it from there.

[Evie7851]

Yes those are right I guess my conversion is pretty bad so what is the best way to fix it