New doc

[lisan1]

Hi,

I finally contacted a new doctor who understands that it's ok to have low/suppressed TSH when on combination treatment. He adviced me to increase t3 from 10 to 20. What do you experts think?

Results on 75t4 + 10t3

TSH 0.03

Ft3 4.2(3.6-6.3)

Ft4 14 (12-22)

[humanbean]

I finally contacted a new doctor who understands that it's ok to have more TSH when on combination treatment.

Don't you mean "less TSH"? Taking T3 in any form will reduce TSH.

[lisan1 in reply to humanbean]

Yes, of course. 🙈I've changed it now.

[humanbean]

TSH 0.03

Ft3 4.2(3.6-6.3) 22% of the way through the range

Ft4 14 (12-22) 20% of the way through the range

Your results show that you are under-medicated. Many of us on this forum need Free T4 and Free T3 much higher than yours are. Some need them to be 70% or more through the range. But it is a very personal thing.

In your shoes I would want to increase T4/Levo, and ignore the TSH. You might turn out to be a good converter of T4 to T3. At the moment it is impossible to tell though, because both T4 and T3 are too low. It is a hopeful sign that your results are similar in terms of percentage through the range, but there is no guarantee this situation would continue if you took more T4.

With such a low TSH and such low in range Free T4 and Free T3 it is possible that you have a degree of central hypothyroidism - this is where the pituitary isn't capable of producing enough TSH for your needs. The T3 you are taking will be reducing your TSH a lot. It always (or almost always?) does.

[lisan1 in reply to humanbean]

Results on 87,5 t4 +10t3 was

Ft3 4.6

Ft4 18

Same range. Was that enough or shall I increase more? T4 or t3?

[greygoose]

Does look like you need to increase your T3. But, I wouldn't go directly from 10 mcg to 20 mcg, if I were you. Increase by no more than 5 mcg every two weeks.

[lisan1 in reply to greygoose]

Thanks! Do you think it will be enough to increase t3? The doc said that after blood tests maybe we need to increase t4 also.

Ok, so if I feel well after 2 weeks stop or do you think I will need to increase again to 20?

[greygoose in reply to lisan1]

Those are unanswerable questions, because it's all about how you feel. And, only you can know that. Blood tests are just a guide. You might need to increase your T4, you might not. It's a very personal thing. So, just take it one step at a time, and see how you feel after each step. You cannot predict the future, and it's illogical to try.

[humanbean]

Free T3 4.2 (3.6 - 6.3) 22% of the way through the range (same as before)

Free T4 18 (12 - 22) 60% of the way through the range

These suggest you aren't a good converter. An increase in Levo has resulted in an increase in Free T4 but left Free T3 exactly the same.

The problem you have is that your TSH would probably freak out a doctor, being so low.

In an ideal world your Free T4 and Free T3 would be higher. But trying to achieve that is going to reduce your TSH which will upset your doctor.

Have you ever felt well taking Levo alone or Levo + T3? If yes, what dose(s) made you feel well?

Have you got recent results for vitamin B12, folate, vitamin D, ferritin (iron stores). Have you had a Full Blood Count or an iron panel recently?

You might find this link of interest :

healthunlocked.com/thyroidu...

Eventually, you may have to decide...

Are you going to keep your doctor happy by taking such a low dose of thyroid hormones that your TSH is in range and you feel terrible, or are you going to try and make yourself feel well and happy knowing that your TSH might be extremely low or practically non-existent?

[lisan1 in reply to humanbean]

I'm deciding on trying to feel better!All those are good. Tested 6 months ago.

[lisan1 in reply to humanbean]

Oh, I see that you misread. Ft3 was 4.6 when ft3 was 18. Does that make a difference? Shall I still increase t3?