Late at results any advice welcome , I'm concerned I might need a small dose of T3

[Ness21]

TSH (1.27)(0.35-4.94)

FT4 (14.5)(9-19)

FT3 (3.6)(2.6-5.7)

I had thyriod removed last febuaury its taken until now to get my TSH from 0.03 to this point, my T3 has only risen slightly, FT4 has declined from 15.3. Maybe I need a small dose of T3?

Thankyou

[SlowDragon Administrator]

Ft4 is 55% through range Ft3 is 32% through range

Ft3 is Better than previous results

Do you feel better or worse?

Helpful calculator for working out percentage through range

chorobytarczycy.eu/kalkulator

You need folate, ferritin and B12 tested

What vitamin supplements are you currently taking

[Ness21 in reply to SlowDragon]

Thankyou for your reply

I feel alot better however im still fatigued. I'm currently taking vitimin D. The doctor wouldn't test vitimins and I'm unable to get them done. She said my vitimin D at 85 was good.

[SlowDragon Administrator in reply to Ness21]

You can test privately

all thyroid blood tests should ideally be done as early as possible in morning and before eating or drinking anything other than water .

This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip)

Private tests are available as NHS currently rarely tests Ft3 or all relevant vitamins

List of private testing options

thyroiduk.org/getting-a-dia...

Medichecks Thyroid plus antibodies and vitamins

medichecks.com/products/adv...

Blue Horizon Thyroid Premium Gold includes antibodies, cortisol and vitamins by DIY fingerprick test

bluehorizonbloodtests.co.uk...

If you can get GP to test vitamins and antibodies then cheapest option for just TSH, FT4 and FT3

£29 (via NHS private service ) and 10% off down to £26.10 if go on thyroid uk for code

thyroiduk.org/getting-a-dia...

monitormyhealth.org.uk/

NHS easy postal kit vitamin D test £29 via

vitamindtest.org.uk

[Mamapea1 in reply to Ness21]

Are you taking magnesium and vitamin K2 in addition to the vitamin D? They're cofactors, and should be taken. I recommend getting a private test...it's well worth it. Often when the thyroid has no output at all, or has been removed, T3 proves beneficial, but you may have to go it alone to add a bit in. You won't really know if you need it though until all your vitamin and mineral levels are optimal and you've tried an increase in Levo.

[pennyannie]

Hello Ness :

Well a little T3 may well be the answer as you haven't a thyroid, and " lost " your own natural T3 production which is said to account for around 20% of your overall well being and working on the assumption that a fully functioning working thyroid would be supporting you on a daily basis wit trace element of T1 and T2 and calcitonin plus a measure of T3 said to be at around 10 mcg plus a measure of T4 said to be at around 100 mcg.

However your T4 is only 55% through the range and we generally feel at your best when T4 is on the top quadrant at around 75% as this should in theory convert to a higher T3 than when T4 is lower in the range.

I understand you have Graves so it's imperative your doctor does not dose or monitor you on a TSH blood test as in Graves patients post RAI or a thyroidectomy it is acknowledged that the TSH may take months, years, or never recover to so called " normal " level and you must always be looking at where your T3 sits in the range, to learn where you need it be , for you to feel as well as you can.

You can't go " hyper " you are now with primary hypothyroidism and it seems many doctors seem to think hyper is still an option- it is not.

There is a list of both hyper and hypo symptoms on the Thyroid UK website who are the charity who support this amazing forum. It can be confusing as some symptoms appear on both lists, but you will not become hyper again because of your TSH level used in isolation to monitor your progress of T4 - Levothyroxine as the risk is more one of being under medicated.

The accepted conversion ratio when on T4 only is said to be 1 / 3.50 - 4.50 - T3/T4 with most people feeling at their best when their conversion comes in at around 4 or lower:

So to find your conversion ratio when on T4 only you simply divide your T3 into your T4 and I'm getting 4.03 : so you're not far off centre point and improved from when we last spoke, so that's a move in the right direction, as we can see an improvement.

Do you have any idea where your current ferritin, folate, B12 and vitamin D levels sit ?

[Ness21 in reply to pennyannie]

Thankyou for your last reply

I have some updated blood test results, any advice would be welcome.

TSH 4.13 mul (0.35-4.94mul)

FT4 13.8pmol/l (9-19pmol/l)

T3 3.6. pmol/l ( 2.6-5.7pmol/l (wasn't tested this time)

I've started taking omega3 and vitimin D 3,6,9 again.

I'm feeling alot better, not suffering with insomnia. However I'm still fatigued during the day. also putting on weight.

I have sourced my own T3 and considering when to start taking a small dose.

Any advice would be welcome

Thankyou.

[pennyannie in reply to Ness21]

Hello Ness :

Can I please ask that you start a new post with any new results or questions as then all form members can see the question and help you if they can.

Whilst I'm flattered that you have chosen to contact just me, I'm self taught, mostly through this forum, and don't know everything and your deserves a wider audience than just little ol' me.

In my limited experience I think your TSH is much too high and you would feel better when this measure gets down to around 1 which happens when you increase your thyroid hormone replacement dose.

I don't understand these new results as your TSH has shot up and your T4 gone down :

Did you change your dose of T4 ? and you can't just " believe " your T3 is where it was last, as you must test T3 and t4 along with the TSH all ay the same time.

There is plenty of room in the T4 range for a couple of increases and we generally feel at our best when T4 is heading or in the top quadrant of its range, so at around 16 / 17 as this should in theory convert to a nice high T3 and T4 can also be over range if it gives the patient a higher, better T3 reading and improved health.

Having had a thyroidectomy it's very likely you'll need to replace your own " lost " T3 thyroid hormone but I don't take Liothyronine so not really the right person to be advising you since I take Natural Desiccated Thyroid.

I think before you start you do need to know your bench mark T3 and T4 results :

You will also need to have optimum ferritin, folate, B12 and vitamin D to support optimal conversion of any thyroid hormone replacement.

[Ness21 in reply to pennyannie]

Thankyou

I will start a new post.

I appreciate your advice

Thankyou.

[pennyannie in reply to Ness21]

Maybe in the short term try half way between 75 mcg and 100 mcg - maybe you can buy a pill cutter and quarter a couple of 100s if you still have some over or the alternative would be to halve a 25 mcg if you have any spares.

[JAmanda]

I’d be asking for a small increase in Levo.