Latest results on 75t4 and 5t3 both taken 24h prior. My doc wants TSH higher. I have decreased for 8 months now from 100+20 and TSH has gone from 0.01 to 0.04 and Ft3 and ft4 have dropped. Do you think that TSH might increase more if I stay on this dose for a bit longer?
Tsh 0.04
Ft3 3.8 (3.6-6.3)
Ft4 15(12-22)
I might add that my TSH was only 5.6 but Ft3 and ft4 bottom of range when diagnosed. On 50mcg my TSH was 2.85 and on 75 0.14 all these on levo only.
Maybe not. TSH is supressed when on T3. Sometimes it just stays low. I don't necessarily think it will ever be in range and you might just make yourself ill trying to get there. Your ft4 and ft3 are already on the low side.
lisan1
What dose were you on when you felt well? What were the results then?
Only a week ago you told us you were on 75mcg Levo plus 10mcg T3 and that your doctor was fine with a low/suppressed TSH and that
He adviced me to increase t3 from 10 to 20.
healthunlocked.com/thyroidu...
So how come you're now on 5mcg and how come your doctor now wants your TSH higher? How long have you been on the lower dose?
When taking T3 we should leave 8-12 hours between last dose and blood draw, not 24 hours. Your results are showing a false low FT3 due to you leaving 24 hours between T3 and test.
Because it's my GP who keeps on lowering my dose and I contacted an internet Dr to get a second opinion but it's too expensive for me to continue going to him in the long run. I felt well on 100+20 but then got long covid and pots from that so am very ill now. ☹️ That's what makes it even harder to try to get to optimal. I doubt that I will ever feel good again.
I might add that my TSH was only 5.6 but Ft3 bottom of range when diagnosed. On 50mcg my TSH was 2.85 and on 75 0.14 all these on levo only.
You are way undermedicated and you definitely need more T3. TSH is unlikely to rise whilst on T3 (mine was always suppressed on Levo only and remains so on combination replacement).
Thank you! You don't think tsh will increase with time if I stay on this dose? I'm so tired of fighting this thing when I'm so ill from covid.
I think it's very unlikely your TSH will increase even on 5mcg T3.
Thank you ever so much.
One last question if I may. Do you think I can increase by 10mch t3 directly and then after a week another 5 or do I need to increase by 5 each week until I reach 20?
lisan1
T3 should be adjusted by 5mcg increments, so just add another 5mcg now, wait 2 weeks before adding another 5mcg. You don't necessarily need 20mcg, you need to see how you feel after each increment. Low and slow is the way to go, wait to see what the effect is. Personally, based on my own experience, I would go to 15mcg then wait 6-8 weeks and retest, then decide if I need to go up to 20mcg.
Each increase of T3 should take our FT3 higher, but your FT4 is low in range and you might find, like many of us on combination hormone replacement, that you actually need FT4 higher in range and you would need to increase your dose of Levo to do that, and that in turn would also increase your FT3 depending on how much natural conversion you have. Combination replacement takes a lot of time, patience and very gradual tweaking to find our optimal doses.
Thank you so much. When looking back at past results it seems like 5mcg t3 increases my Ft3 by 0.4.
But it also depends on how much Levo you are taking because some will convert to T3.
It seems like 12.5 levo increased my Ft3 by 0.4 also. But I'm planning to stay at 75 levo and start increasing t3 to at least 15 maybe 20 and then retest
Don't forget that levels aren't static, they fluctuate constantly. You could have a test now and a test in 10 minutes and the results wouldn't be exactly the same.
It's impossible to say that a particular increase produced a particular rise in level when you're talking about such a very small amount, and when the range for FT3 is 3.6-6.3 then a change of 0.4 is so minimal it can be disregarded, it's not showing an increase, it's more or less showing there's no difference.
I have increased t3 to 15 now do you think I can increase t4 by 12.5 also before tests? Before covid and Dr started to mess with me I was on 100t4+20 t3
Personally I would test before making any other changes. You need to know exactly how the increase in T3 has changed your levels before doing any other changes, otherwise how will you know what each change has achieved?
Remember, last dose of Levo 24 hours before test, last dose of T3 8-12 hours before test, splitting dose of T3 into 2 or 3 the day before and taking last portion of dose 8-12 hours before test.
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