Advice on T3/T4 combo bloods: Hi all Appreciate... - Thyroid UK

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Advice on T3/T4 combo bloods

jsy_girl profile image

Hi all

Appreciate your thoughts on my blood results. I feel like there’s been a slight improvement in my general fatigue but my pins and needles has returned albeit not as bad. I think also I am slightly feeling hypo towards the end of my first dose in the morning of T3.

But my blood results look worse than the previous ones despite increasing T4.

Previous results on 100mcg T4 / 15mcg T3

TSH 0.52 (0.27-4.20)

T4 16.9 (11-26)

T3 4.6 (3.9-6.8)

Current results on 112.5mcg T4/15mcg T3

TSH 0.33 (0.27-4.20)

T4 16.0 (11-26)

T3 4.5 (3.9-6.8)

Both done 9.05am ish fasting, with last T3 11.5 hours before, and T4 24 hours before.

I stopped biotin and vit c one week before. My vitamins were all in a pretty good shape, if anything b12 slightly over. Getting a b6 test done soon as I had Dutch test done where urine results pointed at b6 deficiency but given it also said I had b12 deficiency and b12 was over thought a blood test would be safe. Anyway I digress...

Suspect my doctor will allow for a dose increase but seems wary about giving what he quantifies as a large dose. Says it will do more harm than good. I shall remind him I am tall and curvy and not even half way through the ranges, and that I do know what hyper feels like and won’t want to be there either. I’m already getting in a Tiz prepping for the conversation ha ha.

19 Replies

Hi jsy_girl

I know others will be on to give you help. I can’t! But isn’t that strange. A raise in dose and yet a drop in levels. I know my ft3 was 4.5 last test and I feel rubbish so I’m not surprised you feel symptomatic at times.

I will be interested to read your replies as I would think you have room for another increase in levo but it didn’t seem to do much last time by these results and I’m pretty sure my endo would raise lio instead. It’s so hard to work out what’s best especially as it’s another 6-8 weeks before you know.

I am sure you will get some help here again though and you’ve obviously come some a long way so I can only offer you my positive wishes and lots of luck with the doctor. x.

Thank you Yeswithasmile

It is strange. I felt sure they’d be loads better and he’d use it to say “oh now they’re fine” but hopefully this at least gives more room to try an increase.

And this is also true I am better than I was and I have come a long way. And the deck chair manoeuvre has helped as suggested by others before. I’m also just happy I can take T3 without negative side effects now. Haha.

Hope you are well too!

Bonus to be able to take t3 without side effects 👏🏻👏🏻. It is completely different to t4 I have found so I’m very pleased for you.

I know levels can fluctuate but I wouldn’t have expected it to be the same let alone less so interested to read others opinions. You’re right though at least he will have to do something for you.

I have come seen the deck chair manoeuvre mentioned but can’t for the life of me recall what it is. Not unusual for me, I’m constantly surprised I actually remember to find my way home these days!!

Ha ha that made me laugh. It was in reference to taking the same quantity but spacing out different. Tantamount to rearranging the deckchairs when the titanic was sinking 😂

I went from 6am, 12pm 8pm(I think. Can’t even remember now haha) to 7am, 3pm, 10pm

Seems better like maybe they overlap less. Just finding I need a bit extra in the morning as seems to wear off about 1-2pm.

SlowDragon profile image
SlowDragonAdministrator in reply to jsy_girl

Suggest you request 5mcg increase in T3 and take 10mcg 7am, 5mcg at 3pm and 5mcg at 10pm

Or 5mcg 6am, 5mcg noon, 5mcg 6pm and 5mcg 11pm approx

jsy_girl profile image
jsy_girl in reply to SlowDragon

Will try 10mcg first thing in morning I think. Thank you!

Oh that’s right. I remember that now. Lol. Do you think it made that much difference? I can’t help but feel that’s being undermedicated. Surely you need more in your system to even it out rather than taking it throughout the day? Or is this just how you are dealing with it at the moment?

I think my problem was I was afraid to take it too late in day whilst I was suffering side effects. The more I could tolerate it the more I could space it out so it sort of was a bit of both probably

I can relate to that. I am hoping for an increase and then wondered if I might try (in a few weeks) taking in one hit 🤷‍♀️. Some people seem to do that and it seems that if it is possible it would be so much easier. I almost forget so many days!! Blinking brain.

It would definitely be easier but having tried the extra 5 in the morning today and feeling slightly eurgh again and I know I’ll get used to it so that’s fine, just can’t imagine taking it all in one go. Just doubt that I’m one of those people sadly.

Sorry it’s made you feel ‘eurgh’ again. Whilst you know you’ll get used to it, it’s still a disappointing isn’t it? I imagine it’s because our bodies have been starved of what they need for so long but you’d think sheer determination to feel better would over come all!! I’ll probably be like you. Never be able to take it all at once. Small price to pay I suppose for the benefits 🤞🏻🤞🏻🤞🏻. Good luck with it x.

Your TSH becomes high when you are not making enough T3 and T4. After you increase your dose and get to normal levels, the TSH goes down because it doesn't have to stimulate your thyroid as much.

But isn’t that strange. A raise in dose and yet a drop in levels.

This Instagram post by Dr Eric Balcavage may give you an answer. I’ve been in this situation too. Still am to some degree.

Dr Eric Balcavage

Hi serendipitous.

It is interesting but it doesn’t really answer the question properly does it? Or am I missing something. I mean, where to start? Have you managed to gain some improvement? I note you mentioned that you are still in that situation to some degree so may i ask what you have tried?

I wonder how realistic it is to suggest that this subset of people that appear to need t3 are the only ones with ‘chronic cell danger’ that isn’t due to polymorphism of DIO2. Surely if this were the case the subset would be greater affecting more people? Or am I reading this incorrectly?

Obviously I am only just starting out on trying to learn and any info is great fully received! However it just seems to me the more I read that the t4 at first surpressed becomes more able to block t3 ?? It’s a mine field!!

Do we need to improve the delivery of T3 or just add more T3 and hope the body will accept it? That’s something to think about and goes back to the cell danger response. Just adding more and more medication isn’t the answer for everyone. Perhaps it works for some people. Problem is for many, thyroid issues need to be managed by a functional medicine perspective which our standard medical system cannot do.

I was referring to the element of stress and the cell danger response. Stressors can come in many forms, physical, emotional, chemical and environmental. I remember when I was chronically stressed nothing helped. No medication of any type, my sleep was bad too. I was constantly on edge, always sick.

As my stressful situation improved so did my symptoms and health. So right now I’m a lot less stressed and able to manage stress better than before, however I am nowhere near what I used to be. I need to manage whatever stressors I still have. I think that’s why I am still not able to feel as well as I want to, no matter what dose or medication I try.

Yes. I understand that stresses can trigger various responses and I am sorry that you’ve continued to struggle with this. It’s very disappointing to persist in trying to balance your body just to find that nothing seems to work 100% .

I have more bloods to be done next week and endo week after. I will be looking forward to finding out what he’s prepared to do next and see the blood results. Another few times and I can start to work out how my body deals with it 🙄. Then I’ll be full blown menopause 🤞🏻and have to start again!!


Thank you, yes its a struggle but without constant learning I and many others would be nowhere. Perimenopause itself can cause all manner of issues especially for those already suffering with thyroid problems, manifesting in CFS and fibromyalgia like symptoms. Progesterone supports the thyroid whereas oestrogen can have the opposite effect and during perimenopause we have less or we lose progesterone.

Good luck with your appointment, hope it goes well.

You're not high in either ranges so could take more of either. I see someone suggested an extra 5 lio which would likely do something but I also wonder if a good increase in Levo might work... I'm experimenting similarly myself. Anyway clearly you can take more meds and need them if still suffering symptoms.

I don't think your drop in t4 is significant really - it wasn't much of an increase in meds and could have been you'd eaten something that stopped absorption...

jsy_girl profile image
jsy_girl in reply to JAmanda

I think I tend to agree. I think I need my doctor to appreciate I might need a larger dose than someone else. Of both!

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