Advice please Dr wants TSH within range.

[lisan1]

My latest results on 87.5 t4+10t3 is

TSH 0.02(0.4-4.2)

Ft3 4.6 (3.6-6.3)

Ft4 18(12-22)

Last dose of t3 and t4 taken 24h earlier. I have been on this dose for 8 weeks. Dr wants my TSH within range. Do you think my TSH will increase if I stay on this dose or shall I lower t4 to 75?

[SeasideSusie Remembering]

lisan1

shall I lower t3 to 75?

I think you may mean shall you lower your dose of Levo to 75mcg as you told us a few days ago you were taking 100mcg levo plus 10mcg T3 😊

Last dose of t3 and t4 taken 24h earlier.

You left far too long between last dose of T3 and blood draw.

Last dose of Levo is 24 hours before.

Last dose of T3 is 8-12 hours before.

You have a false low FT3 result.

You are taking T3, your TSH is going to be very low and probably suppressed, that's just what T3 does, and the doctor who prescribes your T3 should know this. You are very unlikely to get TSH within range when taking T3.

There is nothing wrong with your latest results, even taking into account you have a false low FT3 result there.

TSH is not a thyroid hormone, it's a pituitary hormone. It's the FT4 and FT3 that are the thyroid hormones and tell us what we need to know, and if FT3 is over range we are overmedicated.

You are not overmedicated and you don't need to reduce either of your thyroid meds.

How do you feel?

[lisan1 in reply to SeasideSusie]

Yes, I've edited it now. I have long covid so don't feel well at all. I know it's adviced to take t3 12 h before test but I take it once a day and have read on here that someone else does too and calculate the results by adding 10%.

[SeasideSusie Remembering in reply to lisan1]

10% is not accurate, nobody can say what's accurate, I'd say that was underestimating. Much better to split the dose for the one day and get a measure of your normal circulating hormone so that you can tailor your T3 dose better to your needs. there may be one or two members who continue with their once a day dosing when testing, but I think the majority split the dose.

Anyway, whatever you decide to do about that, adjusting your meds by TSH is wrong and your doctor should know that T3 means a low/suppressed TSH.

[SlowDragon Administrator in reply to lisan1]

Day before test split T3 into 3 smaller doses at equal 8 hour intervals with last 1/3rd dose 8-12 hours before test

TSH is almost always suppressed on any dose of T3

Essential to test vitamin D, folate, ferritin and B12 at least annually

[LAHs in reply to SeasideSusie]

Yes, I was thinking that, "How do you feel?"

[lisan1 in reply to LAHs]

I don't feel well but I have long covid... ☹️

[LAHs in reply to lisan1]

Yes, sorry, I responded to your earlier post before I read down to where you said that. I am very sorry you have long Covid, I cannot imagine having such a drag superimposed upon a thyroid problem. You certainly have a double whammy, maybe with time it will clear up - we just don't have the data to say anything with certainty, we just hope. And I hope things clear up for you.