Treatment for high TSH with high T4

[Lilly12255]

My TSH is too high, but my t4 is also above the normal range. My ft3 is below the normal range.

Has anyone in this situation been treated with low dose naltrexone?

[shaws Administrator]

Can you print your results, along with ranges and they will enable members to respond. If you wish to do so, press on the down arrow, next to More and select edit.

[Jazzw]

I’m not sure that it would do anything. Even if you have Hashimoto’s, reducing antibodies might not make any difference, assuming your results are what you posted a month ago:

tsh at 3.5, t4 at 22.2 (normal range 12-22), t3 at 2.6 (range 2.9-4.9)

For some reason, you’re not converting T4 to T3. A good doctor would probably consider prescribing T3 at this point. Unfortunately, good doctors aren’t always easy to find.

[Lilly12255 in reply to Jazzw]

I seem to remember that I read somewhere that LDN lowers the TSH too. Is that true?

[Jazzw in reply to Lilly12255]

I don’t know, sorry. I think LDN can stabilise Hashimoto’s in some, but I think that’s more about lengthening the amount of time it takes for the autoimmune disease to destroy one’s thyroid.

[greygoose in reply to Lilly12255]

lt's not about lowering the TSH. The TSH doesn't cause symptoms whether it's high or low. It's about raising the T3 - the active hormone, which causes symptoms when it's too low or too high.

So, once you're on thyroid hormone replacement forget the TSH, it's a diagnosis tool. Yours is high for a reason - because your FT3 is too low. Raise the FT3 and the TSH will drop - and if you take T3 it will probably become suppressed, but that's ok because you won't need it anymore.

LDN can't raise your FT3.

[Lilly12255 in reply to greygoose]

Will the nhs prescribe t3?

[Lalatoot in reply to Lilly12255]

That depends Von where you live and the doctors involved. It needs to be started on a trial by an NHS endocrinologist. So the first step is a referral from the GP . You should argue for this on the grounds of high ft4 and low ft3 suggesting a problem converting T4 to T3 as they are out of kilter. If they were in harmony one well up the range would result in the other being reasonably high too.

[SlowDragon Administrator]

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 take levothyroxine in morning before test, this causes false high Ft4

How long have you been on current dose levothyroxine

How much levothyroxine are you currently taking

Do you always get same brand levothyroxine

Have you had ultrasound scan of thyroid

Have you had both TPO and TG thyroid antibodies tested?

Also important to regularly retest vitamin D, folate, ferritin and B12

[jrbarnes]

I share your problem. T4 levels top of range, TSH close to 2 and T3 rock bottom. Even if you try to push your T4 levels higher you'll most likely end up with a T3 deficit. I haven't tried naltrexone. Do you have high antibodies? I only have high thyroglobulin antibodies. I've added Liothyronine to my Levo to bring up T3 levels.

[Lilly12255 in reply to jrbarnes]

Did it help? Yes I have both antibodies. My problem is that I keep miscarrying. I don’t know if the culprit is the high tsh or low FT3. Do you know this?

[jrbarnes in reply to Lilly12255]

It's been difficult to find the balance between the Levo and T3 and is ongoing but the T3 has helped my low moods, pms, cognitive function, body temp and body pain. I never had children but low thyroid hormone affects your sex hormones and adrenals. The TSH is a message from the pituitary gland to the thyroid gland to stimulate the thyroid to produce thyroid hormone. The most important thing is how much thyroid hormone your body has. The higher TSH means your body is still in a state of hypothyroidism. It's possible you may be able to increase your levo 2-3 days a week to see if your T3 increases. For years my FT4 was around 25 with no signs over overtreatment and it increased my FT3 closer to the top of the range, however I was still T3 deficient. Have you checked your progesterone levels around day 21? I'd also suggest testing your cortisol with one of those 4 point saliva tests. I've read that low thyroid hormone can kick your adrenal glands into overdrive which can increase cortisol, adrenaline, and aldosterone. Adrenals also produce DHEA which produces other hormones like estrogen. I think you're going to have to look at this as a whole with your main focus on getting enough thyroid hormone to increase your T3 and that will have a positive effect on your sex hormones.