On combo-dose of levo and NDT. FT4 out of range. What should I increase or decrease?

[dragon51]

Hello everyone would like to run the following by you in order to clarify some concerns I have. Really would appreciate some feedback.

Latest blood results via GP are as follows:

TSH 0.05 0.4 - 4.5 comment on blood form: Over Replaced

FT4 24.9 8.0 - 21.0 : Abnormal

FT3 5.6 2.5 - 6.5 : Subclinical Hyperthyroid

Prior to GP blood test, I combo - dosed with 75 levo and 15mcg Efra daily (split dose) in an attempt to improve FT3 level and hypo symptoms. Clearly FT3 has improved greatly but FT4 is out of range. GP did not know that I was taking NDT alongside 75 levo. Based on the above results GP reduced levo by 25mcg every alternate day (75 one day 50 the following day).

How will the minor reduction of levo alter the results above?

Having been diagnosed with AFib last year, GP was quite concerned about thyroid results causing arrhythmia. I myself, am also concerned about AFib issue which is why I opted to "combo - dose" with levo while also adding a very small amount of Efra, to improve FT3 level. So far, I have had no AFib symptoms at all.

Considering the AFib is my FT3 too high?

I am being treated for the AFIB with anti-coagulants and bisoprolol. Not a happy bunny though because I read a research paper that stated: Beta blockers can decrease the peripheral conversion of levothyroxine to triodothyronine. Seems to me the small amount of NDT i dose with has helped solve the conversion problem.

Have a rewarding day.

thank you in advance

[greygoose]

TSH 0.05 0.4 - 4.5 comment on blood form: Over Replaced

Nope. A suppressed TSH does not automatically mean you are over-replaced. You have to look at the three results in relation to each other. You are not over-replaced.

FT3 5.6 2.5 - 6.5 : Subclinical Hyperthyroid

lol They do make me laugh with their sub-clinical this and sub-clinical that! How can an FT3 of 77.5% through the range be in any way hyper? Hyper would be very, very much over-range. Besides, if you are hypo, you cannot suddenly become hyper. It doesn't work that way. Over-medicated, perhaps. But, you are not over-medicated.

Impossible to tell how that reduction in dose will affect your results. These things are unpredictable because they don't follow a set pattern. Your FT4 should drop slightly, but who knows if it will affect the FT3.

I think your doctor's concerns are unwarrented. T4 is a storage hormone that doesn't do much until converted to T3. It's not going to cause Afib. And, your FT3 is nicely in-range - for some it might still be too low.

Seems to me the small amount of NDT i dose with has helped solve the conversion problem.

Taking NDT hasn't 'solved' your conversion problem, that will still be the same. But, it has side-stepped it in raising your FT3 level. Just thought I'd point that out as some people do believe that taking T3 improves conversion. But, as far as anyone knows, it doesn't.

If I were you, I wouldn't alter anything until you've been on your reduced dose of levo for six weeks, and been retested. But, an over-range FT4 is not really anything to worry about. It's the FT3 the most important number.