Help with results please. What next?

[LynLyn]

Hello members,

I’d be very grateful if you could make suggestions as to what to do next. I’m adding T4 to T3.

Latest results 17.4.21 on 25mcg T4 30mcg T3

TSH 0.21 (0.27-4.2)

FT4 4.95 (12-22)

FT3 4.82 (2.8-7.1)

Previous results 21.1.21 on 12.5mcg T4 30mcg T3

TSH 1.89 (0.27-4.2)

FT4 3.86 (12-22)

FT3 6.01 (2.8-7.1)

Many thanks

[JAmanda]

Strange isn't it that your T3 has gone down? I'd be tempted to add in a good amount of t4 but others seem to disagree and say it doesn't matter how high your t4 is if your T3 is high. Personally I felt I couldn't sleep if my t4 went under range. I'll follow to see what people say - but how do you feel?

[LynLyn in reply to JAmanda]

Hi JAmanda,

It has gone down quite a lot! I wasn’t sure what to expect but this did surprise me.

I’m tired all the time with migraines, headaches and brain fog. I do have a stressful job but try to keep things in perspective with that.

I’m very sensitive to changes in medication so I’m either going to have to add in 12.5mcg of T4 or drop 5mcg of T3.

I ended up poorly last summer doing a 25mcg T4 increase.

Many thanks

[JAmanda in reply to LynLyn]

I reduced my lio from 20 to 15 for two months and had three migraines in that time. Back at 20 I haven't had one. But that's just me and only for now - it could change!

Is it t4 you think you can't tolerate? Most feel it's really hard to tolerate T3. You're on so little t4, why not ditch it altogether and increase T3? Many take just T3 on here, I read. And given your high dose of T3, it's surprising your tsh isn't suppressed yet.

[LynLyn in reply to JAmanda]

Hi. I can’t take anymore than 30mcg of T3. It’s puts cortisol high hence adding back in T4. I’ve read that migraines settle when you get your thyroid doses as you need them - I have some way to go I think! Thank you

[SlowDragon Administrator]

Was this test done as early as possible in morning before eating or drinking anything other than water and last dose levothyroxine 24 hours before test

Day before test did you split T3 dose into 3 x 10mcg doses roughly 8 hours apart and last dose approx 8-12 hours before test

What vitamin supplements are you currently taking

When were vitamin D, folate, ferritin and B12 last tested

[LynLyn in reply to SlowDragon]

Hi SlowDragon. Thank you for your reply. Yes, I follow the advice from the forum for every blood test. I currently take 5000mcg Vit d with cofactors and I also eat 100gms of liver every week.

[SlowDragon Administrator in reply to LynLyn]

Are you on strictly gluten free diet?

[SlowDragon Administrator]

Vitamins looking good in previous post

healthunlocked.com/thyroidu...

Nothing on your profile. Do you have Hashimoto’s?

Are you on strictly gluten free diet?

[LynLyn in reply to SlowDragon]

I’ve worked in my vitamins over the last two years and I’m finally getting good levels.

I don’t have thyroid antibodies. I’ve been told two different things at ultra sound examinations and I’m not sure what to believe.

1) the destruction of your thyroid is in keeping with hasimotos

2) your thyroid looks like it’s been destroyed by an infection.

Yes, I’m gluten free.

I’m wondering whether to increase T4 by 12.5mcg? I do feel more stable with the introduction of T4 and my stamina had improved too.

Many thanks

[SlowDragon Administrator in reply to LynLyn]

So looking like you are an antibodies negative Hashimoto’s patient

It’s trial and error what dose levothyroxine and what dose T3 we need

Generally levothyroxine plus T3 is more common

But some people find they can’t tolerate any levothyroxine

Yes I would experiment with slowly increasing levothyroxine

Retest 6-8 weeks after any dose change or brand change in levothyroxine

[LynLyn in reply to SlowDragon]

Thank you Slow Dragon.

I’ll increase by 12.5mcg of T4.

That’ll take me to 37.5mcg of T4.

I’m due to see the endocrinologist in July so I’ll have tests then.

I’m not sure at what amount to drop T3 to see what’s going on with T4. I work as a primary school teacher so with the summer holidays coming up that’s a good opportunity!

Many thanks

[SlowDragon Administrator in reply to LynLyn]

I don’t think I would change T3 dose at this stage

[LynLyn in reply to SlowDragon]

Thank you so much.

I was quite surprised at how low it was in these latest results!