New Blood results from Endo today.
TSH 0.84 (0.34-5.60)
FT4 1.03 (0.61-1.24)
TOTAL T3 74 ( 60-181 )
I asked for ft3 but she stated ft3 isn't accurate and said she tests for total t3.. These labs were taken 24hrs after last levo dose. Do I have room to move up another 12.5mcgs? Even if it's just a couple days a week? Or stay where I'm at? Thank you
Best regards Brandon
On those results, I would say you have room to go up a bit, but the T3 result would confirm it. Your Endo is wrong - T3 is more stable than TSH or T4, so you may like to suggest she has a look at the latest research and buys a subscription to one of the Thyroid medical mags.
Its the first time I heard someone say total t3 is more accurate than free t3. It was odd to me when she said it.
You are right and she is wrong. You measure what your body is using, the T3 not what is bound to the proteins.
Lots of info on private tests on here - you may like to check your vits and iron levels while you are at it. You will soon know if you have gone to far in upping the dose by holding your hands out and if there is a slight shake, back off a bit on the increase. Do this when you are calm though, not shaking in anger at watching the news!
'Accurate' versus 'Useful'
i suspect some endo's comments that FREE T3 testing is inaccurate might be partly based on the acknowledged technical difficulties involved in 'Free ' thyroid hormone assays.
There ARE variations in Free test results between different test methods / platforms.
TOTAL T3/4 assays probably don't suffer from the same degree of 'Accuracy' problems, because the amounts of hormone they are measuring is many times greater for a 'total ' assay , than for a 'free' one, and more importantly they don't have to fiddle about separating the free bit from the bound bits, and then estimating the result .. or whatever it is they have to do .. (it's bit over my head TBH )
So i think ? this might be partly where this 'inaccurate' comment comes from .. it's certainly not the first time i've heard it.
I think some of it is historical ie. when first invented there used to be bigger problems with different Free test methods that have since been improved to some degree, but not totally.. so the idea still hangs in there.
We would rightly say that Free T3 is more useful even though there is still some acknowledged variation between 'free' test results done using different platforms/methods. ... if you test on the same method/ platform then the results are at least comparable with each other, ( so can still be used to monitor increase /decrease in levels for dose adjustment purposes) even if testing with different platforms still presents inaccuracies / variations in reported levels.
The 'total' results may well be more 'accurate '... but they aren't very 'useful' because you can't tell how much is free and how much is bound.
(... and of course it's also possible the endo doesn't know any of this and is just ignorant / unhelpful / both)
Problems with comparing 'Free' (and TSH) tests between different assay platforms:
healthunlocked.com/thyroidu...
healthunlocked.com/thyroidu...
Ahh the way you explained it makes sense. Well she denied me a dose increase even though my t3 appears low. I'm going to have to manually do it and just get a private test in 6 weeks to show them I'm still "in range" but a more optimal range for me. Going to try 125mcg 2 or 3 days a week. Then retest in 6 weeks but privately.
I still dont feel right. I guess now I know I definitely dont need to go down and take baby steps up in levo and maybe down the road if I still have a conversion problem add t3 in there. Its a shame we have to resort to this but what else can I do? I find it weird my tsh is that low with a total t3 level so low. Youd think tsh would be higher with t3 being almost lowest in range. Always appreciate your insight and info 🙏 Thank you.
Hi Brandon.. some questions :were you on 100mcg for these blood tests or 112.5 ?
how long on ? dose before test ?
just looked back through you posts / doses.... off the top of my head, i'm getting the impression you should probably stick at 112.5mcg for a few months and stop fiddling about trying to increase back to 125.
last time you tried 125 again you went 'wrong' pretty quick ... why would it be different now ?
you only tried 112.5mc for about 6 weeks before trying to go higher ...your heart went funny again then you had to back to 100 in order to feel better.
if 112.5mcg is going to be right then 6 weeks is really only the starting point for finding that out ..... but you went up at that point .... you didn't give 112.5mcg enough chance to allow you get settled and start to feel better,( and possibly sleep better)
Sounds to me like you're about to make the same mistake again ...
What have you got against 112.5 mcg ? it's a perfectly 'normal' dose ...... i take it , and i used to need 150mcg.. helvella takes it and he's a bloke.
my sleep improved a lot on 112.5 (down from 125), but it did take several months before i thought "oh .. i'm sleep better" . I'm damn sure if i'd gone back up to 125 after 6 weeks i'd never have found that out .
i know it's hard to get your head round the fact that you might need less than you used to , but covid could have changed something , or bashing your head could have changed something , or 'not being 35 any more' could have changed something , or 'whatever is messing up your sleep could be nothing to do with your levo dose' ... is also a possibility .
By the way ... did you have an ultrasound of thyroid back in Feb ? ... what did it show ?
also what did the cardiologist say ?
'Total T3' is like a massive fuel tanker.... 'Free T3' is like a little petrol can floating around inside that fuel tanker .... it's perfectly possible to have a pretty low fuel tanker with a pretty full petrol can floating around in it.... Free T3 can be high when Total T3 is low ... (and vice versa)
I recon you should stick at 112.5 mcg for at least 4 months (until August) , and get a Free T3 / Free T4 /TSH once you've been stable on it for at least 6 weeks ,,,, and then repeat the Free T3 /Free T4 /TSH in August to see if they have changed... and THEN look at how your symptoms have settled , and what has happened to your sleep, before deciding if you are going to change levo dose , or leave it alone , or consider adding T3 etc .
Sometimes the right thing to change is 'nothing' .
T3 results help please 
Help with Blood results please
t3 results help please
Blood Test Results from Endo Appointment - Comments and or advice please!
Please HELP! Blood test results. TSh, T3, T4
