Latest test results - do I need to increase my T4/ T3?

[New2thyroid]

VitD: 151nmol/l (50-174)

Folate : >20ugl/l (no range)

B12: 984 NG/L (180-999)

Ferritin: 94ugl/l (13-150)

TSH: <.02 mu/l (.27-4.2)

T4: 12.6 pmol/l (10.8-25.5)

T3: 4.2pmol/l (3.1-6.8)

Cholesterol: 5.6nmol/l (3.3-5.2)

Please note, my previous T3 was around 5 and T4 was around 16 (I was on 75mcg levo and 12.5mcg T3). I have since been asked to go down to 50mch T4 and 10mcg of T3.

The endo was concerned about my TSH levels and suggested I would end up having heart problems and osteoporosis with the current TSH levels.

I am losing hair (which was also the case with the previous mediction levels but feel it has gotten worse).

Could you please advise if I should remain on 50mcg levo and 10mcg T3 or of I need to up my medication. Also, any idea why the TSH is so low and does it cause heart issues?

Many thanks!

[Yeswithasmile]

Hi New2thyroid

My opinion would be that you need to raise your levo. I admit I am surprised you are taking t3. I would have thought you have plenty of scope to range your levo before you add t3.

Doctors do not like tsh low or surppressed. It is said that it is well documented that it causes osteoporosis and cardiac issues. However anecdotal consensus would be that this is not accurate all the time your ft4/3 levels are within range. It is hoped that this opinion is spreading slowly across to the medical profession but most tow the NHS line.

Tsh is needed to a certain extent in conversion but if you convert badly and raise your medication tsh is inevitably lowered which again doesn’t help with conversion. This is why there are some that need to add in t3.

By taking t3 you will be surpressing your tsh and also lowering your t4. That is what liothyronine does. It’s about getting a balance between the 2 and only you can know what that is. Some people function on t3 only/low t4 and higher t3 but a lot like t4 over half way in the range and t3 in the top 70% apparently. It’s all trial and error and can take a long time to find the right balance for you.

Hope this helps?

[New2thyroid in reply to Yeswithasmile]

Thanks so very much Yeswithasmile. I think i was given T3 because my T4 to.T3 conversion isn't great (although forgetting how the functional doctor came up with that - think she did some urine tests).

Any idea what I could do for hair loss at all?

[Yeswithasmile in reply to New2thyroid]

No. I don’t know how she came up with that either. Your post a while ago with levels didn’t strike me that you need t3. T4 is much easier to take and provides a more even supply than supplementing with t3 as well. I think it was too early to trial t3. I only have this opinion from experience you understand.

I would raise levo for 8 weeks and then test your levels again. You may find that this helps your hair loss and you may find it’s still not enough but you can’t rush this process I am afraid. As frustrating as it is, it takes time for dose increases to stabilise. Some find that it can take 12 weeks but personally I find 8 weeks ok as my changes after that are very minor.

[New2thyroid in reply to Yeswithasmile]

Many thanks once again, Yeswithasmile!

[Yeswithasmile in reply to New2thyroid]

No problem. Just my opinion and others may think differently.

Good luck.

[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

Day before test did you split 10mcg into 3 doses….5mcg waking, 2.5mcg mid afternoon and 2.5mcg app8-12 hours before test

Ft4 is likely too low. Suggest you increase levothyroxine to 75mcg and retest in 6-8 weeks

Do you have autoimmune thyroid disease?

[New2thyroid in reply to SlowDragon]

Many thanks for getting back to me SlowDragon. Yes I was told.I have hashimotos and from my results it seems I have subclinical hyperthyroidism?

In response to your other questions:

1- yes test was done at 7am before any food and drink and before I took thyroxine

2- day before the test, I split the T3 into 2 as difficult to break the 20mcg tablet any further.

I am.pn 50mcg levo and my doctor just asked me to increase my T3 to 15mcg.