T4 decrease & T3 increase with no dose change.

[Girlslovescifi]

I've been on the same levo and liothyronine dosage for several months. My latest blood results show T4 has gone down and T3 has gone up. The only change I've made is my levo brand because I couldn't tolerate Teva and changed to Mercury Pharma two months ago. Results from 27.08.21: Free T4 21.4 (11-23); Free T3 5.91 (3.1-6.8). Results from 03.11.21: Free T4 17.8 (11-23); Free T3 6.35 (3.1-6.8). I always follow the correct protocols as recommended on here for having blood tests. I just wondered what can cause these fluctuations? The last week or so, I have been feeling tired mid afternoon, but on the plus side, my anxiety is tons better!

[pennyannie]

Well that's good news isn't - your conversion of the T4 into T3 has improved :

Probably the main reason is due to the change in brand of T4 medication :

If supplementing any core strength vitamins and minerals maybe these are now all sitting at optimum levels in the ranges ?

Thyroid hormone conversion can also be compromised by any physiological stress ( emotional or physical ), inflammation, dieting, depression and ageing - so other than being able to " stop time " - I just see you in better place, and that in itself alleviates the anxiety and stress.

It can become a vicious circle as no doubt you know.

Just pace yourself as when the nights draw in, it does seem some of us feel we need a little more support, and some of those who self medicate increase their dose a little in the winter months.

[Girlslovescifi in reply to pennyannie]

What a lovely reply! Thank you! You’ve made me feel hopeful! I do take high dose b vits, D3, and magnesium. I always stop the b vits for a few days before the test because of the biotin. I’ve been experimenting with different timings, because of recently adding magnesium at bedtime (diagnosed with osteopenia). I used to take all levo & 5mcg t3 first thing, 2nd 5mcg t3 dose about 2pm and last 5mcg t3 dose at bedtime. I changed 2nd and 3rd doses to noon and 5pm, so it wouldn’t clash with the magnesium.

[Girlslovescifi in reply to pennyannie]

Although my body temp is often below 36c and heart rate is still 60. (I’m 66 and not very fit). Maybe adrenals are playing a part. 🤷🏼‍♀️

[pennyannie in reply to Girlslovescifi]

I'm self medicating with NDT and have been settled on 1 + 1/2 grains for the past 3 years.

On building up my dose I monitored my temperature, pulse, and blood pressure daily :

My temperature rose from 35.4 to 36 .6 where it still hovers and my pulse and blood pressure remained constant.

I started adrenal glandular support around 18 months prior to self medicating in preparation, as i went through the NHS hoops in an attempt to get either NDT or T3 prescribed through the correct channels.

Having had RAI ablation for Graves in 2005 I started reading up and learnt that this toxic substance is also taken up by other glands and organs with in the body, including the adrenals, and then started joining up the dots of my own health issues at that point in time, some 10 years after having this treatment option which I deeply regret.

I do still take adrenal glandular - it's a bit like an insurance policy now.

[Girlslovescifi in reply to pennyannie]

I’m sorry you feel the ablation impacted your health negatively. What do you take for adrenal support? I have taken rodiola and also a complex that had ashwaranga and other herbs.

[pennyannie in reply to Girlslovescifi]

I think if the patient is well and can get by on the AT medication this has to be the best treatment option and the way forward.

After all, we are looking at an auto immune disease - which is a stress and anxiety driven and loosing one's thyroid is drastic action, and can simply compound the patients health. especially when you have no treatment options readily available other than T4 - monotherapy.

I have been more ill since RAI than before, and the symptoms I was dealing with some 6 years ago dismissed - though all my then symptoms are well documented as side effects of RAI in Elaine Moore's first book : Grave Disease A Practical Guide - I gave my doctor a copy of this book but she declined and referred to me as a conundrum.

This was when I saw " red " and started to distance myself from the professionals.

It is a question of degree, there are undoubtedly some cases where a medical intervention is necessary, and surgery should then be the option as it is cleaner, more precise, and the offending gland and it's content removed in total, and not lft festering away in one's body.

RAI is toxic and studies show QOL is worse 6-10 years after RAI :

ncbi.nlm.nih.gov/pubmed/306...

I take adrenal glandular from Nutri Advanced:

[Girlslovescifi]

I’m so sorry your health has been worse afterwards. I wasn’t taken seriously at my former surgery. I was given mental health questionnaires. Eventually, I was sent for a blood test and my TSH was too high. I was started on 25mcg Levo and kept on that dose for over a year! I asked to see an endo, but was told no clinical need, despite my symptoms. I went privately and he took 2 minutes to deduce I was way under medicated. Eventually I switched to NDT but because of all the production problems, I went back to Levo and fortunately the endo also put me on t3. I’ve been taking these for a year, although the t3 was reduced from 20mcg a day to 15mcg. Not sure why. I still don’t sleep well, have very dry eyes overnight, lowish resting hr and low temperature. I tested cortisol a couple of times via 4 saliva tests in 24 period. I was quite a bit over normal. It’s all stress related for me.

[pennyannie in reply to Girlslovescifi]

Whatever you may use - please make sure that any lotions, potions or drops for your eyes are all preservative free :

The eye consultant at our only hospital put me on some with preservative and I had a terrible time - researched myself and learnt another lesson that fell on deaf ears when I queried this prescription, and the worsened state I had tolerated too long.

There are " gunkier " vaseline type ointments you can use overnight, your vision will be a little distorted but as your sleeping it doesn't matter, though can't remember if I could see clearly my dreams !!

I do sleep well, and if anything run myself slightly hypo - still a work in progress, as the goal posts shift with the seasons and life forces : but much improved :

I read of some people taking a little T3 at bedtime ?

I read of others taking their main T3 dose at bedtime ?

It's all trial and error and sometimes I find " not overthinking it all " helps me get some perspective - but I guess I can only say this as I'm feeling pretty good now from where I was when I found this amazing forum.

[Girlslovescifi in reply to pennyannie]

I do try and use preservative free. The best type for overnight is from my optician. It really is trial and error! I know my work doesn’t help but I can’t retire yet (I’m 66). Started exercising but with a trainer and only 30 mins twice a week. She keeps it fairly low intensity because I don’t want my adrenals to get worse. Mainly balance and strength training.

[helvella Administrator Thyroid UK in reply to Girlslovescifi]

Preservative-free isn't (unfortunately) optional but essential.

When I started to get dry eyes, I used any old drops. But something odd happened, the more I used them, the more I felt the need to use them.

In time, I realised that I seemed to be like so many others, someone who became sensitive to preservatives even though I started out without any obvious issue.

[Girlslovescifi in reply to helvella]

Yikes! I didn’t know that. Thanjs

[pennyannie in reply to helvella]

Yes - I can second that !!