After years of feeling awful and ignored, I had a blood test last week, after a 6 week trial of 30mcg T3 combined with 150mg T4.
My results were as follows:
TSH - suppressed (0.03, I think).
T4 - 7.0 (12.0-22.0)
T3 - 3.3 (I can't remember the range but it was around mid-range, something like 2.5-4.5)
I didn't take my medication prior to the test and I had it at 8.30am without eating first.
Does anyone know what this could indicate? My GP is at a loss and he thinks the endo is also not sure, but has referred me back anyway.
Last year I bought myself Thyrogold and took it for a couple of months on top of 10mg T3 and 150mg T4. I lost 6kg, and felt better generally. That ran out and it's out of stock. I gained all the weight back within 3 weeks and felt dreadful.
Since the trial of 30mcg T3 I've lost 2kg but that's plateaued and I feel pretty much the same.
I am not sure what to talk to the endo about to try and get the appropriate help.
Thanks so much for any ideas.
(NB I tried to search this topic but the results were all unrelated!)
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Kitty1watson
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So, how long was the gap between the last dose of T4, and the last dose of T3, and the blood draw?
Those results are suggesting you aren't absorbing it very well. How do you take your hormone? On an empty stomach, well away from food/supplements/other medication?
I took it in the morning the day before and yes, first thing in the morning, about 2 hours before I eat. I take it and then take my son to school and eat when I get back. I put the T3 under my tongue instead of swallowing it, but I swallow the T4.
Well, that's not a very good way to take T3. It's not meant to be taken sublingually. It is designed to be swallowed, because it needs stomach acid to free it from the sodium molecule it is attached too. Plus, the T3 molecule is too large to cross the muscus-blood barrier. So, that's probably why you're not absorbing it very well.
Just being 'in range' is not always good enough. Mid-range is rarely high enough for hypos. Yes, you are absorbing some of it, but given the size of your dose, one would expect your FT3 to be higher. So, a lot of it is not getting absorbed.
Quite amazing the number of doctors that don't know what to expect when someone takes T3: the TSH becomes suppressed and the FT4 drops low - especially when taking a high dose like 30 mcg. There's no mystery, it's just that your GP and endo are both very ignorant.
Hi greygoose Can you tell me why t4 drops when taking t3 please? Does t4 drop more if you take more t3? Or is it if you take any t3? References if possible. Thank you!
I'm afraid I can't tell you that. Nobody really seems to know. Someone asked that the other day and diogenes replied. He thought that it was because more T4 was converted to rT3 when taking T3, but he didn't seem to be really sure.
It will drop if you take any amount of T3. But whether or not it drops further if you increase T3, I couldn't say. So many unknowns where thyroid is concerned!
The specialist of any disease is the patient that suffers from it. Can't remember who first said that, but I think Dr P quoted it.
We have to learn about our own disease and take charge. Doctors just aren't interested in thyroid. That is a fact. They learn next to nothing about it in med school; rarely come across it when interning in hospitals; and don't believe it's important enough to read up on in their own time. So, we have to do it ourselves.
Absolutely. It's only through hours and hours of research that I was able to present the case for T3 in the first place and I think they're getting really fed up with me, keep presenting them with medical articles. 😬 But my research doesn't help if their minds are closed.
If you saw weight loss with the addition of T3 it was doing something but not enough for full wellbeing. Try swallowing T3 coz if taking it sublingually was the issue, you will notice improvements very quickly. Some members need to split their doses into two or three a day to reduce rapidity of onset and prolong the duration of its action.
Also are your iron and nutrients definitively all optimal?
A suppressed TSH is fine with the addition of T3. You have written your other results as T4 & T3. Did you mean FT4 & FT3?
T4 levels can drop with the addition of T3 but (whether T4 or FT4) yours are too low to make sense of where all that medicated T4 has gone. Are you medicating away from calcium and iron? Are you perimenopausal or taking HRT? Even eating high fibre foods before full absorption will shunt it through too quickly. Otherwise it has to be bound to something unless the test is wrong. Did you stop any biotin supplements a week beforehand as this risks altering results for T4, T3 and TSH.
Which brand of levothyroxine are you currently taking
Do you always get same brand
T3 needs to be swallowed. Not sublingual
Also many people need to split T3 into 2 or 3 smaller doses through day. 3 x 10mcg at equal 8 hour intervals
For full Thyroid evaluation you need TSH, FT4 and FT3 plus both TPO and TG thyroid antibodies tested. Also EXTREMELY important to test vitamin D, folate, ferritin and B12
Low vitamin levels are extremely common, especially if you have autoimmune thyroid disease (Hashimoto's) diagnosed by raised Thyroid antibodies
Do you have Hashimoto’s?
What vitamin supplements are you currently taking
Ask GP to test vitamin levels (and thyroid antibodies if not been tested)
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).
This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip)
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
If you left 24 hours for T3 the result is false low
Hello, thank you, everyone. My doctor believes I have issues absorbing medication through my stomach. They recently tested my vitamins, and, whilst my B12 was in range, it was low, despite taking prescribed tablets every day. I saw a marked improvement in taking T3 sublingually vs swallowing.
I've been in T4 only for years and absolutely nothing changed. I even tried out taking double the dose and honest to god, nothing happened. GP said I might not be absorbing B12 well enough and will need revert to injections. They were stopped because of covid.
My T3 result was mid range, whilst my T4, taken by swallowing, was well below. The GP has increased me back up to 175mcg T4, which I think is pointless, give that it's never done anything.
So, actually, then, my T3 is good, taken sublingually, as I had left 24 hours? It was in range, middling, but if it was falsely low, it would have been higher had I taken the small dose beforehand. It was the T4 which was low (which has longer half life and should be in my system, if it's correct that it should be swallowed). It was very under range. The lowest I've been before is 11.0.
It's all so confusing but I'm very grateful for you all taking the time to give me your thoughts.
Thank you, I take a generic, I believe, it just says Levothyroxine. I feel like everything is a battle with the GP and endocrinologist. I can imagine their faces if I ask for a different named brand.
I didn't know there was a liquid form. That's interesting. I will cut dairy again. I don't get any overt symptoms and I only have cheese once in a while (I have almond milk now, no dairy milk) but I can cut it out.
Thank you, my injections were stopped and I was given tablets but GP has said it's common not to be able to absorb B12 through the stomach. If my levels drop next time, I'm using my stores, apparently, so will have to have injections again.
I have recently added magnesium and selenium, so, fingers crossed! 😊
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Confused :-(
Advice before GP phone consultation, please?
Update: GP Reducing Levo - TSH Low / T4 / T3 in range
Causes of unstable thyroid levels/symptoms
Got my T3 today 
