Is my FT4 too high to add T3?

[Thyca63]

I’m from the USA and glad I found this group.

So I had a thyroidectomy for papillary cancer. I’ve been on T4 synthroid for 3 years. Various dose changes throughout. The goal is to suppress the TSH. No matter the dose change, my FT4 hangs at the higher range. In July 2021 I had central left neck dissection removing 27 lymph nodes which 6 were positive for papillary. Due to my age and other medical issues they want my TSH below 1. but not deeply suppressed.

My endo feels I’m not converting properly and has now added T3 (5 MCG) to start since I’m so drug sensitive. She’s keeping me on the .100 synthroid but moved me from 7 days to 5 days and two days to .88. I decided to split the T3 in half as I’m not sure how I’m going to react to it. My plans are to take my synthroid and a half of the T3 at my usual time, 6:30 am. Then the second half of the T3 about 6-7 hours later (in the afternoon). Of course I’ll be taking it with food as it will be my lunchtime. I’m posting my latest lab work back in November 2021. My TSH creeped up to 1.450 from 0.875. Not sure if the cough medicine I was taking caused this. According to my endocrinologist, the cough medicine did not have iodine in it so it should not effect my TSH.

My question is, will taking the T3 push down my T4 more? She’s trying to suppress my tsh by adding T3 and to help eliminate symptoms.

My FT3 was:

Standard Range

FREE T3

2.0-4.4 Range

Mine was 3.1

[meadow53]

I don't know. I was allergic to levothyroxine, levoxyl, synthroid. I have only taken natural desiccated thyroid like armour or a mix of natural with liothyronine/T3. You need to be educated and logical when asking your doctor what you think you need by how you feel. I wish I could be of more help. Research, but I agree with your doctor. T4 turns into T3 so if you take t3 you will not need to convert T4 to T3. Any t3 or t4 can suppress your TSH, mostly t3 so you don't have to convert. Mine has been suppressed on desiccated thyroid for 15 or more years and keeping nodules under control. I take 180 mcg Armour & 5 mg liothyronine (t3) daily. I have autoimmune Hashimoto's hypothyroidism that may masquerade as hyperthyroidism early. It is not given enough attention. Best of luck and hope more knowledgeable people will be of more help.

[Thyca63 in reply to meadow53]

Thank you. I agree about Hashimotos, my mom had it and suffered a lot.

[fuchsia-pink]

I'd suggest you reduce the T4 meds first, and add the T3 after a week or two. You are only planning on taking a very small dose of T3 meds, so while we usually suggest splitting the dose and taking part first then adding the next dose, this usually applies to tablets split to create a 5mcg dose, so if you think you will be very sensitive, you might try it, but otherwise, taking 2.5 mcg in split doses should be fine.

Once you are used to the meds, you can experiment with timings and see if you want the later dose nearer to bed-time. I have read on other forums that it is better NOT taken with food or drink (ie like T4 meds) - but see what suits ou (and what you find easy to remember!)

Taking T3 meds inevitably reduces TSH and is likely, along with the reduction in T4 meds, to reduce your free T4 blood result. But these are all just numbers. It's important that you feel properly well too! x