Adding T3 or increasing Levo? : Hello, I've been... - Thyroid UK

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Adding T3 or increasing Levo?

Alejandrita17 profile image
15 Replies

Hello,

I've been on Levo for 12 months but I still don't feel good. My last test resulta are:

TSH: 1,77 (0,5-5)

Ft4: 1,45 (0,7-1,7).

T3: 2,58 (2-4,4).

Vit D, folate and b12 are ok. Still working on increasing Ferritin (14). I'm taking 75 mcg Levo. At this point, which is the Best strategie? Adding T3 or increasing Levo at the risk of TSH being suppresed?

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Alejandrita17
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15 Replies
Lalatoot profile image
Lalatoot

Is the t3 result total t3 or free t3?A TSH of 1.77 suggests that you need an increase in levo first. Once your TSH is down to nearer 1 or under it is then appropriate to look at ft4 and ft3 results to consider whether or not you would benefit from the addition of liothyronine t3.

It is unlikely that an increase in levo at this stage will reduce TSH below range.

Alejandrita17 profile image
Alejandrita17 in reply to Lalatoot

It's free T3. It seems to me I am a poor convertir. That's why I have doubts about increasing Levo.

Lalatoot profile image
Lalatoot in reply to Alejandrita17

Before thinking about adding t3 liothyronine you have to have the foundations in place...that is ferritin, folate, b12 and vit d all at good levels plus TSH on levo of 1 or lower.

SeasideSusie profile image
SeasideSusieRemembering

Alejandrita17

Still working on increasing Ferritin (14).

This is likely to have an impact. Ferritin is recommended to be half way through range with some experts saying that the optimal level for thyroid function is 90-110ug/L. With a ferritin level this low it will be difficult for your thyroid hormone to work properly and aid conversion. How are you working on increasing it?

Alejandrita17 profile image
Alejandrita17 in reply to SeasideSusie

I started supplementing with iron pills. But ir seems to me I am a poor convertor..

SeasideSusie profile image
SeasideSusieRemembering in reply to Alejandrita17

Alejandrita17

I started supplementing with iron pills.

From your GP?

Or self supplementing?

How much are you taking?

Has an iron panel been done to confirm iron deficiency? And a full blood count to see if you have anaemia?

You are not going to be well with a ferritin level of 14 and conversion of T4 to T3 will likely be impaired if ferritin is below 70.

I have read in one article that females who brought their ferritin level above 100 saw their persistent hypothyroid symptoms relieved, and another article suggests that a level of 100-130 is good for females. I also mentioned above that some experts say that the optimal ferritin level for thyroid function is between 90-110 ng/ml.

Alejandrita17 profile image
Alejandrita17 in reply to SeasideSusie

Yes, it was GP recommended. In fact, a couple of months ago my ferritin was just 8. I have no anemia. My Hemoglobin is ok.

SeasideSusie profile image
SeasideSusieRemembering in reply to Alejandrita17

OK, so you have iron deficiency without anaemia. Is GP actually prescribing and monitoring levels regularly?

Alejandrita17 profile image
Alejandrita17 in reply to SeasideSusie

Yes, i'm gonna be measured again in february. Full iron panel. He said that I have no anemia, but my ferritin is very low. Interestingly, the hematologist said ferritin in 14 is now ok (range is 15-300). Saturation% went from 21% to 26% now. Who should I believe?

SeasideSusie profile image
SeasideSusieRemembering in reply to Alejandrita17

If you are in the UK then I would believe the NICE Clinical Knowledge Summary and ask the haematologist why he thinks a below range ferritin is OK:

cks.nice.org.uk/topics/anae...

Interpreting ferritin levels

In all people, a serum ferritin level of less than 30 micrograms/L confirms the diagnosis of iron deficiency.

JAmanda profile image
JAmanda

I’d go for 100 Levo then see how you feel. And retest.

Stevie profile image
Stevie

I do agree your ferritin is awful, that will make you feel rough, it needs to be 50 just to make your hair grow I’ll never understand why these ranges are allowed they are appalling, I think you’ll have a nice supprize how you’ll feel heading to 70, do give it a try

Alejandrita17 profile image
Alejandrita17 in reply to Stevie

3 months ago it was just 8!

Stevie profile image
Stevie

You must have felt very poorly, I’ve been a 9 & I didn’t know what I was doing. I’m from a family of 10 all hypothyroid, you’ll find you’ll need to keep an eye on ferritin, folate & b12 for life really, hypothyroid cause’s malabsorption I really would drop a tiny bit & I think you’ll be fine, take care

Alejandrita17 profile image
Alejandrita17 in reply to Stevie

The crazy thing is that I don't have Hashimoto. I caught a virus in 2017 (probably mumps), got completely inflammmed to the point I couldnt even swallow (De Quervain Thyroiditis). They just told me to use ibuprofen, and that my Thyroid would heal by itself. It didnt. I became hypo afterwards. 2 months before this episode, my thyroid was perfectly fine (as reported in my annual check). Anyways, becoming angry with the doctors that treated me (they should have prescribed PREDNISONE) is just pointless.

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