Should I start taking T3 again. Help with latest test results

[pussycatwillow]

Medichecks test 5 Feb 2021

T4 23.6 (12 -22)

T3 6.55 (3.1 - 6.8)

TSH 0.005 (0.27 - 4.2)

Levothyroxine decreased from 150mg to 125mg

NHS test 20 April 2021

T4 19.2 (11.0 - 21.2)

T3 4.7 (3.1 - 6.8)

TSH 0.03 (0.27 - 4.20)

Surgery want me to book an appointment as blood test says levothyoxine level too high. No doubt they will want to decrease levo.

I did take T3 some time ago but stopped as it became difficult to source. Have not been feeling as well as I used to. Wonder whether to try the T3 again.

[SeasideSusie Remembering]

Surgery want me to book an appointment as blood test says levothyoxine level too high.

NHS test 20 April 2021

T4 19.2 (11.0 - 21.2)

T3 4.7 (3.1 - 6.8)

TSH 0.03 (0.27 - 4.20)

Presumably want to reduce Levo based on these results? If so then they are just looking at TSH which is wrong. TSH is not a thyroid hormone, it's a pituitary hormone, it's FT4 and FT3 that are the thyroid hormones and your FT4 is 80.39% through range and FT3 is 43.24% through range, you are not overmedicated, both are in range, if anything your FT3 is on the low side at the moment.

Your Medichecks test shows FT4 at 11% through range and FT3 at 93.24% through range.

Obviously a big difference in conversion rates between the two lots of tests.

You have Hashi's, this might be playing a part.

[Lalatoot]

I had similar result (with similar ranges) to your 20th April test and was able to get prescribed T3 on the NHS. I prepared notes for the GP (who admits he doesn't know about thyroid) and he understood my explanation and referred me to an endo (who I had seen before over a long period) and she equally understood and accepted my explanation. I was given a 6 month trial on combo by that endo. I live in Scotland but it is worth a try with any NHS area. Below was what I argued incase it helps.

20/6/19

TSH 0.19 mU/L (0.55 – 4.78)

FT4 19 pmol/L (10 – 25)

FT3 4.5 pmol/L (4.0 – 7.0)

Low TSH but FT4 and FT3 in range so not over-medicated. However below range TSH suggests that an increase in levothyroxine might not be appropriate.

FT4 is 60% through the range

FT3 is 16.67% through the range

. Suggests that FT3 is low. Under the normal curve of distribution majority sit around the mid-point so one might expect FT3 to be 5.5 at least. Perhaps slightly higher if it was to match FT4 at 60% through the range.

Low vitamins or a conversion problem?

Vitamins 20/6/19

B12 437ng/L (200 – 700)

Ferritin 129.3 (10 – 350)

Folate 5.6 (3.0 -20.00)

Vitamin D no result

These levels are within range but are not optimal. Optimal levels of vitamins would be at least half way in range and have been suggested to be optimal at:

B12 500

Ferritin 170

Folate 11.5

Vit D 80

Patient continues to be very symptomatic despite 100mcg levothryroxine per day. Has been on current dose for 19 weeks.

Patient is supplementing vitamins to improve levels. Patient is gluten free.

Patient is requesting a trial of T3 in tandem with continuing Levothyroxine.

[pussycatwillow in reply to Lalatoot]

Thank you. My vitamins are all ok as they were done on the Medichecks test.There is no chance of T3 being prescribed on the NHS here ! I think I may just try again with T3 and book another Medichecks test in 6-8 weeks.

[Jazzw]

They are clearly just looking at TSH which is frustrating.

But I see you managed to have an FT3 nicely at the top of its range on 150mcg levothyroxine—is that right? So you can convert reasonably well (if a numpty doctor doesn’t reduce your dose of T4 too much).

I get that FT4 was slightly overrange but to reduce your dosage by 25mcg was a bit OTT. Looks to me that 137.5mcg of levo might be about right for you?

[JAmanda in reply to Jazzw]

Agree! You looked great on 150 - how did you feel?

[pussycatwillow in reply to JAmanda]

I posted another thread about breathlessness recently.Interestingly when I reduced the levo from 150 to 125, the breathlessness improved.

That made me think that I was overmedicated. Now I feel I am under medicated. Perhaps the T4/T3 combo would be better option.

[Jazzw in reply to pussycatwillow]

I’m still wondering whether a halfway house levothyroxine increase would be better. To 137.5mcg levothyroxine.

I think your body can convert—it’s just not being given quite enough raw material.