Hello Everyone I hope that every one is doing well. I just got my Lab Results, they seem to have gone wacky , can someone please help me understand what’s going on? I am very confused I am on a compound T4 50-T3 35 Sustained Release, my first increase of 5 mcg Liothyronine I felt energized, but only temporarily, my T3 was still low so my dr added 10 more mcg. I take my compound then and 10 mcg in the morning 7:30, then at 3 pm I take the other five, my hair and nails are growing but I can’t sleep. My numbers are crazy and I can’t sleep. I would appreciate if some one can look at my numbers and give me some insight. Thank you in advance for your assistance. Here are my Numbers
9/16/21
TSH - 1.07 Range 0.4-4.5
FT4 - 0.5 Range 0.8 - 1.80
FT3 -2.0 Range 2.3-4.2 I know optimal should be 3.5
RT3 -8 Range 8-25
TPO 4 Range <9
Thyroid Glub 1 Range <1
I believe that’s why the dr increased Liothyronine from 5 to 15 mcg I will see her on 9/30 but would like to try yo understand what is going on. It’s been hard for me to sleep since she added the extra 10 mcgs. Can someone please share there knowledge.
Written by
Milagroscrs615
To view profiles and participate in discussions please or .
It's not clear from your post how much T3 you're taking. Is it 35 mcg or 15 mcg?
TSH - 1.07 Range 0.4-4.5
This would suggest that you're slightly under-medicated, because taking T3 usually suppresses the TSH - especially a dose of 35 mcg - if that's what you're taking.
FT4 - 0.5 Range 0.8 - 1.80
Taking T3 reduces FT4 levels. And you're only taking a small amount of levo (T4), so not surprising this is low. It might be enough for you - it would be too much for me! We're all different and can only find out how much we need by trial and error.
FT3 -2.0 Range 2.3-4.2 I know optimal should be 3.5
Who on earth told you optimal was 3.5??? Whoever it was knows very little about thyroid. There is no optimal number. Optimal is how you feel. Yes, yours is very low, so unlikely to be optimal, but don't get hung up on the numbers. For all you know, your optimal might be 5!
RT3 -8 Range 8-25
Useless test, not worth the expense of doing. Doesn't give you any extra information. It will tell you if it is high, but not why it is high, and there are many, many reasons for high rT3, only one of which has anything to do with thyroid. And your FT4 is so low, the T4 is unlikely to be converting to excess rT3, anyway.
TPO 4 Range <9
Thyroid Glub 1 Range <1
These are negative but don't necessarily mean you don't have Hashi's, because antibodies fluctuate all the time.
So, what these numbers are saying is that you're not absorbing your hormone very well. How do you take it? Do you always take it on an empty stomach and wait at least two hours before eating or drinking anything other than water? Do you take any other medication/supplements at the same time as your hormone?
Sustained release may not be the best option for you. It doesn't suit everyone. Depends a lot on the efficiency of your transit.
Hi Greygoose I was hoping you saw this because I know you tell it like it is thank you for responding. I take in compound T4 50 T3 35 Sustained Release every morning along with Two 5 mcg Liothyronine. I get up at 7 am to take those then go back to sleep. I wake up at about 10 am that gives me a clean window on eating. I take metforman 500, Wellbutrin 150 mg, zinc 10 mcg magnesium malate 1000, selenium 100, after breakfast , after lunch at 130 or so I take Holy Basil leaf for my cortisol you know the stress, I think you recommended that one by Swanson not sure, and my omega 3 oil. Then at 3 pm I take my third 5 mcg of Liothyronine. After dinner about 7 pm I take my D3 5000, MK7, and my b12 2500 and C 1000 becaus me that ny most most heavy fatty/protein meal of the day, I know that as soon as she added the first 5 mcg of Liothyronine ny hair started to grow back, but when she saw in 6 weeks my TSH and T4 dropped she added 10 more mcg of Liothyronine and on top of that 50 mcg of synthyroid I stopped the synthyroid because all my hypo symptoms came back. Then when I saw her in July that’s when she added the 10 mcg of Liothyronine so out side of my compound it’s 15 mcg. I wanted the Liothyronine because I know my body can’t tolerate I’ve 50. My biggest problem is I can’t sleep I know everyone here suffers from that, but the reason I asked for the Liothyronine is because Dr Westin Child on YouTube says it 3-4 times more effective than T4. For sure the first 5 mcg of Liothyronine my hair started to grow and my nails, but it takes time for your body to get use to Liothyronine since I’ve been on the compound of T4 T3 SR for almost a year. Now my my T3 went from 3.2 to 2.0 and I can’t sleep I feel very up, and can’t seem to wind down then all day I am sluggish and can’t do anything I am a mess. My dr is a smarty pants and everytime i try to be helpful with the research or tell her I speak with the compound pharmacist she gets on a high horse and ask me if I’d like to write my own prescription. I tolerate Her because in the end she does what I ask. Not before she stresses me out, I dread going to see her and I shouldn’t feel that way. I even created an excel sheet for my self to keep track and gave her a copy because she’s not consistent with the labs she does. I tell her that I need the TSH, T4, T3, TPO, and thyroid Glub. Those are important. I am trying so hard to find a dr here in Florida but all integrated, and functional drs want to bleed you dry and take your money. I can’t afford that so until I can find some one nicer I am stuck with her. Do you think it’s the additional 10 mcg Liothyronine Thats not letting me sleep? Or maybe the Low Dose Naltrexone Thats not letting me sleep it’s like my circadian is all off. Today I took my normal compound and only 5 mcg of Liothyronine to see if it makes a difference with the extra 10 I have no energy in the day cause I can’t sleep. I hope that clears some of your questions. Thank you again for answering me I really appreciate it 🙂🙏
I had also read that about what you said about taking T3 reduces T4 I told the doctor she was chasing a rabbit for the very same reason you stated, I am focusing more on my symptoms which she feels are complaints about her treatment, I keep at her though!
I take in compound T4 50 T3 35 Sustained Release every morning along with Two 5 mcg Liothyronine.
So, if you’re taking a total of 50 mcg T3, your FT3 really ought to be higher than it is. So, really does sound like you have an absorption problem.
• Do you know if you have low stomach acid? A pretty good way to tell if you have is to get your nutrients tested: vit D, vit B12, folate and ferritin. As you take vit d and B12, I imagine you got them tested first. If so, what were the results and ranges?
• Have you been tested for Celiac Disease?
• Do you know if you have leaky gut?
• Have you had any kind of gut investigation?
after lunch at 130 or so I take Holy Basil leaf for my cortisol you know the stress, I think you recommended that one by Swanson not sure, and my omega 3 oil.
Wasn’t me recommended Swanson Holy Basil, I don’t take Holy Basil. But, you do realise that Holy Basil reduces cortisol, don’t you? Do you have high cortisol after lunch? Have you don’t 24 hour cortisol testing? If so, what’s it like first thing in the morning?
After dinner about 7 pm I take my D3 5000, MK7, and my b12 2500 and C 1000
Not a good idea to take vit B12 and vit C at the same time because the C stops the body using B12 correctly.
Also, taking vit C that late in the day could be affecting your sleep. It would be better if you could swap your vit C and your magnesium around. Magnesium in the evening might help you sleep better.
Then when I saw her in July that’s when she added the 10 mcg of Liothyronine
She should not have increased your T3 by 10 mcg in one go. Maximum increase is 5 mcg. That might have stressed your body a bit.
the reason I asked for the Liothyronine is because Dr Westin Child on YouTube says it 3-4 times more effective than T4.
That is somewhat misleading. Makes it sound as if they are the same thing only different! Lol T4 is a storage hormone that basically doesn’t do much until it is converted into to T3. T3 is the active hormone. Trying to work out how much T3 is equal to T4 is a bit of a lost cause because it all depends how well you convert. So, I think that was rather a stupid thing for him to have said.
People usually take T3 straight if they have a problem converting T4. If your conversion is good, taking T3 is of no special advantage. But, if you’ve never taken T4 only, you cannot possibly know how well you convert.
Now my my T3 went from 3.2 to 2.0
Sounds as if your absorption got worse. Do you have an irritable bowel (IBS) or constipation, or any other bowel problems?
My dr is a smarty pants and everytime i try to be helpful with the research or tell her I speak with the compound pharmacist she gets on a high horse and ask me if I’d like to write my own prescription.
I would probably have said ‘yes please!’ lol
I tell her that I need the TSH, T4, T3, TPO, and thyroid Glub.
You don’t need to have antibodies tested every time, there’s no point. Do you know if you have Hashi’s? If you’ve had three negative tests you probably don’t. But if you’ve had just one positive test then you have Hashi’s and it isn’t going to go away.
Do you think it’s the additional 10 mcg Liothyronine Thats not letting me sleep? Or maybe the Low Dose Naltrexone Thats not letting me sleep
Well, your labs aren’t showing over-medicated, so probably not.
All my numbers 9/16/21 labs/nutrients are in my bio, I don’t know how to copy and paste, if you go to my page you will see it all. I do have hashimotos, I use to be constipated but since taking T3 I have been good since the beginning of this year now I go normal, I have taken the saliva cortisol test that’s posted here too, in 2019, my morning cortisol were good but at night my levels were high that’s why I started taking holy basil leaf. When I was first diagnosed with Hashimotos endo put me on 25, 50, 75 mcg of Levo I just didn’t want to live I felt so horrible my body was not Tolerant of that dose, he said lab are good and that’s what matter, so I made him change my dose to 50 because I could tolerate that but then I never saw him again. That’s when I went on Amour thyroid 30, the 60 them my heart rate was very fast and they wanted to put me on high blood pressure meds I said no, then we switched to compound T4 25 T3 5 and so on until we got to my current dosage. I have not been tested for Celiac, I have done a 7 day cleanse last year same time I did the cortisol test, to detox my gut, and started removing certain things from my diet. I went to the nutritionist and she was helpful on what what I should be eating I also went thru a whole month of intermittent fasting until I could fast for 24 hrs once a week. So I don’t think I have leaky gut I am limited to what I can eat, organic, grass feed meat and only 20 of my meal is protein, rest is salads and vegetables. I have lost 35 lbs thru this process, and feel better gut wise I believe the fasting really helps. I will switch up on the vitamin c and magnesium as you indicate I didn’t realize that. Yes I agree she added 10 which made it 15 Liothyronine and added 25 more synthyroid since I had already gotten my compound. I completely regressed with the addition of synthyroid in 2 1/2 weeks I stop taking the synthyroid and just continued with my normal compound and the addition 15, but I agree she should not have done that it was too much all at much and it thru me way off and then adding 10 instead of 5 Liothyronine I think that was wicked of her. Again when I find a replacement I will dump her like a hot potatoe lol. I started off with Levo my body does not tolerate it well. I can only take 50 in the compound. It’s it true that if the Dr increases your T3 she needs to reduce your T4 ? I got that from some one on here but you. Thanks again for breaking it down for me really appreciated. Since I can’t sleep well my days are sluggish it’s a horrible feeling 🙏
No, you've mixed me up with somebody else. I referred to your extremely low FT4 levels but you are only medicating a low amount anyway and with T3 in sr.
But fyi, yes if FT4 is very high it can be reduced to allow room for T3 meds to be added.
Sorry about that Radd, I am always researching and asking questions if it was you, I am sorry I was just trying to find out so when I see my dr I can be prepared! Thank you!
Content on HealthUnlocked does not replace the relationship between you and doctors or other healthcare professionals nor the advice you receive from them.
Never delay seeking advice or dialling emergency services because of something that you have read on HealthUnlocked.
Interpreting thyroid test results
Help with Thyroid test results
Test Results - no thyroid problem
New to Pigs thyroid, test results?
Cholesterol and thyroid test results
