I got my thyroid results back today and the doctor has said I am very overmedicated and I should stop taking meds for a wee and then reduce my dose. The thing is that my T3 is still low normal even though my T4 is high. Is it an issue that my T4 is so high? I asked about T3 and he said i would need to get it privately. If I drop my levo my t3 goes below 4 and I dont feel good
TSH 0.07 (0.27-4.2)
t4 31.2 (10-23)
T3 4.4 (3.1-6.8)
Mj1986
Is it an issue that my T4 is so high? I asked about T3 and he said i would need to get it privately.
I would ask for a referral to an endocrinologist, it's not up to your GP to tell you that you should pay privately for your T3. Your results show terrible conversion and any decent endo would see that immediately.
thanks for this. do you know how long it takes for t4 to drop when you stop t4? Im worried that its such a high level?
Levo has a half life of 7 days, so whatever you take today there will be 50% of it left in 7 days, then 7 days after that another 50% less and so on.
I have never stopped Levo completely but have reduced it. As an example, when an endo wanted my TSH to come back into range from suppressed he reduced my Levo by 25mcg, the FT4 level went from 25.8 to 15.6 in 3 months, that was reducing Levo from 125 to 100mcg. If you stop altogether then it will reduce much more quickly.
Thanks for this. I might stop for a week and then retest. Does the high T4 and low t3 mean I have high reverse t3 or is that not related?
Mj1986
Does the high T4 and low t3 mean I have high reverse t3 or is that not related?
It's possible, but there are many reasons for high reverse T3 and that's just one of them.
OK so a high T4 does not necessarily mean high reserve T3. In theory I could have normal reverse t3 and my issues is conversion?
Mj1986
In theory I could have normal reverse t3 and my issues is conversion?
Yes, that's possible.
Exactly what thyroid meds are you taking?
When did you take your last dose before the test?
Hello Mj1986 :
You are only over medicated when your T3 goes over the range :
You clearly have a conversion problem as your T4 is not converting well into T3 which happens in the body: so therefore your T4 looks high as it is not coverting to T3 :
Conversion can be compromised by low low vitamins and minerals, especially ferritin, folate, B12 and vitamin D plus also any physiological and emotional stress, inflammation, depression, dieting and ageing - so whilst we can'yt hold back time there maybe some issues here that have some bering on your poor conversion.
The logical solution is to drop a little T4 and add a little T3 and to rebalance these to two vital thyroid hormones and to a high enough level in the ranges to give the patient relief of symptoms.
You should not have to buy this yourself, and need a referral to an endocrinologist who should immediately identify your medical need and suggest a trial of T3 - Liothyronine.
T4 is a storage hormone that needs to be converted into T3 and any dose increase/decrease takes around 6-8 weeks to fully leave the body - do not worry - the body knows how to loose excess T4 - which is referred to as reverse T3 - and just like a steam vent on a saucepan to stop the contents boiling over, your body will extrete and loose the excess T4 over a week or two so do not worry,
Thank you for this, really useful. I actually got my levels tested as I am starting fertility treatment soon (IVF) and I need my levels to be in range within the next 10 days. Hopefully stopping levo for a week will help. I will then see an endo at a later date.
Hey there :
I don't know but I would think optimal thyroid hormone replacement and pregnancy go hand in hand - maybe the fertitity clinic can get this sorted for you as well, with a referral to endocrinologist knows and understands the importance of good thyroid health.
Just reread your post. Does this mean I will have high reverse t3 then since my t4 is high but my t3 is low?
I very much doubt it :
Your level of T4 is not that high, and I shouldn't worry as we all have a level of reverse T3 just as we have a level of TSH, T3, T4 - it's a biological fact.
With a high T4 one would expect a proportionately higher T3 :
But your T3 hasn't responded to your high T4 showing poor conversion which may be happening due to low vitamins and minerals as explained above, but ultimately you need to see a specialist who can run the relevent tests and find out why your conversion is low.
P.S. I have Graves Disease and had sustained high over range T4 of around 80 for months and then after RAI thyroid ablation put on Levothyroxine only and when I tested my reverse T3 ( surplus to requirement T4 ) I was over range on my reverse T3.
I now have reduced my dose of T4 and my reverse T3 has dropped back down into the range, and this is simply how the body works.
There are theories suggesting over range reverse T3 can " stop conversion " and if this is the case the endo would need to also sort this out :
Thank you for this that's reassuring. My only concern is that I am already on meds for fertility treatment and due to have an IVF transfer in 3 weeks. I really hope I can sort this out and it won't impact.
Ok then, there is no worry on the thyroid front but I don't know if your other medications can have an impact and vica versa :
Was test done as early as possible in morning before eating or drinking anything other than water and last dose levothyroxine 24 hours before test?
If you took,levothyroxine before test, result is false high Ft4
How much levothyroxine are you currently taking
Don’t stop completely. Reduce dose by 12.5mcg or possibly by 25mcg and retest in 6-8 weeks
What vitamin supplements are you currently taking
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?
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)
Is this how you do your tests?
Private tests are available as NHS currently rarely tests Ft3 or thyroid antibodies or all relevant vitamins
List of private testing options
thyroiduk.org/getting-a-dia...
Medichecks Thyroid plus antibodies and vitamins
medichecks.com/products/adv...
Thriva Thyroid plus antibodies and vitamins By DIY fingerpick test
Thriva also offer just vitamin testing
Blue Horizon Thyroid Premium Gold includes antibodies, cortisol and vitamins by DIY fingerprick test
bluehorizonbloodtests.co.uk...
If you can get GP to test vitamins and antibodies then cheapest option for just TSH, FT4 and FT3
£29 (via NHS private service ) and 10% off down to £26.10 if go on thyroid uk for code
thyroiduk.org/getting-a-dia...
NHS easy postal kit vitamin D test £29 via
Email Thyroid UK for list of recommend thyroid specialist endocrinologists who will prescribe T3
...NHS and Private
tukadmin@thyroiduk.org
The aim of levothyroxine is to increase dose upwards in 25mcg steps until TSH is ALWAYS under 2
When adequately treated, TSH will often be well below one.
Most important results are ALWAYS Ft3 followed by Ft4.
When adequately treated Ft4 is usually in top third of range and Ft3 at least 60% through range (regardless of how low TSH is)
Extremely important to have optimal vitamin levels too as this helps reduce symptoms and improve how levothyroxine works
If/When on T3, day before test, split dose into three smaller doses roughly equal 8 hour intervals. Taking last dose T3 at roughly 8-12 hours before test
I would wonder about RT3 number. When my FT3 was low and my FT4 was over range my RT3 was two times over range (had a suppressed TSH also). Felt like crap and death warmed over. Might be something to take into consideration.
Overmedicated with armour thyroid
Overmedicated with T3? Symptoms feel like it
T4 to T3 conversion troubles 
Am I overmedicated? T3 mono (under endo)
T4 to T3 conversion issue
