T3

[Pen1966]

I have been given some T3 to try how do I start dosing

[SeasideSusie Remembering]

Welcome to the forum Pen1966

For us to be able to help you start with your T3, can you please tell us what thyroid meds you already take and post your current test results (including reference ranges) for

TSH

FT4

FT3

This will tell us if you need to adjust your dose of Levo before adding T3.

They need to be current results, not some taken from a while ago.

To get an accurate measure of your levels, the test needs to be done as follows:

* Book the first appointment of the morning, or with private tests at home no later than 9am. This is because TSH is highest early morning and lowers throughout the day. If we are looking for a diagnosis of hypothyroidism, or looking for an increase in dose or to avoid a reduction then we need TSH to be as high as possible.

* Fast overnight - have your evening meal/supper as normal the night before but delay breakfast on the day of the test and drink water only until after the blood draw. Eating may lower TSH, caffeine containing drinks affect TSH.

* If taking thyroid hormone replacement, last dose of Levo should be 24 hours before blood draw, if taking NDT or T3 then last dose should be 8-12 hours before blood draw. Adjust timing the day before if necessary. This avoids measuring hormone levels at their peak after ingestion of hormone replacement. Take your thyroid meds after the blood draw. Taking your dose too close to the blood draw will give false high results, leaving any longer gap will give false low results.

* If you take Biotin or a B Complex containing Biotin (B7), leave this off for 7 days before any blood test. This is because if Biotin is used in the testing procedure it can give false results (most labs use biotin).

These are patient to patient tips which we don't discuss with doctors or phlebotomists.

Also, because we need optimal nutrient levels before starting T3, if not recently tested you need to test

Vit D

B12

Folate

Ferritin

Come back with the results, plus reference ranges as these vary from lab to lab, and we will be able to help you.

[Pen1966 in reply to SeasideSusie]

Ft3 is 5 3.2 to 6.8Ft4 is 22.7 12.to 22

Tsh is 3.93 0.27.4.2

Vit D 129.8

Ferratin 52 12-150

Folate 4.4 2.1 26.8

B12 531 197 771

[SeasideSusie Remembering in reply to Pen1966]

Was the test done as outlined above so that we know those results are giving a measure of your normal amount of circulating hormone?

And what is your current dose of Levo, with last dose taken 24 hours before this test?

What about nutrient levels?

[Pen1966 in reply to SeasideSusie]

Test taken before 9am no levo taken 24hrs before and no food or drink currently on 125mgs on t4

[SeasideSusie Remembering in reply to Pen1966]

What is your current dose of Levo?

[Pen1966 in reply to SeasideSusie]

125 mgs

[SeasideSusie Remembering in reply to Pen1966]

Pen1966

OK, so on 125mcg Levo we have:

TSH: 3.9 (0.27-4.20)

FT4: 22.7 (12-22)

FT3: 5 (3.2-6.8)

The first thing to say is that your TSH is out of sync with your FT4. TSH is almost top of range and one would expect to see a low FT4 with this level of TSH and yours is just over range. One thing to consider is whether there is some kind of assay interference or other reason why your TSH is so high with such a high FT4. I would suggest getting another test from a different lab to check this.

Have you had thyroid antibodies checked - TPO and Tg - which would confirm autoimmune thyroid disease (Hashimoto's) if they are elevated?

Vit D 129.8

Assuming the unit of measurement is nmol/L then this is a good level. Do you supplement?

Ferratin 52 12-150

This is low. Ferritin is recommended to be half way through range (so around 82 with that range) and some experts say that the optimal ferritin level for thyroid function is 90-110ug/L so you need to improve your ferritin level.

You can help raise your level by eating liver regularly, maximum 200g per week due to it's high Vit A content, also liver pate, black pudding, and including lots of iron rich foods in your diet

bda.uk.com/resource/iron-ri...

everydayhealth.com/pictures...

Don't consider taking an iron supplement unless you do an iron panel, if you already have a decent level of serum iron and a good saturation percentage then taking iron tablets can push your iron level even higher, too much iron is as bad as too little.

Folate 4.4 2.1 26.8

This is very low and is recommended to be at leaswt half way through range.

B12 531 197 771

Assuming this is pg/ml or ng/L then according to an extract from the book, "Could it be B12?" by Sally M. Pacholok:

"We believe that the 'normal' serum B12 threshold needs to be raised from 200 pg/ml to at least 450 pg/ml because deficiencies begin to appear in the cerebrospinal fluid below 550".

"For brain and nervous system health and prevention of disease in older adults, serum B12 levels should be maintained near or above 1000 pg/ml."

So your B12 could be better.

My suggestion would be to take a good quality B Complex which should raise both B12 and Folate levels.

My suggestion would be Thorne Basic B which I have used for a long time and always been happy.

If you look at different brands then look for the words "bioavailable" or "bioactive" and ensure they contain methylcobalamin (not cyanocobalamin) and methylfolate (not folic acid). Avoid any that contain Vit C as this can stop the body from using the B12. Vit C and B12 need to be taken 2 hours apart.

When taking a B Complex we should leave this off for 3-7 days before any blood test because it contains biotin and this gives false results when biotin is used in the testing procedure (which most labs do).

At the moment I wouldn't suggest that you start using the T3. I would retest with a different lab to make sure there has been no mistake with those test results, and optimise those nutrient levels that need improving. Once your nutrient levels are optimal look again at your thyroid results.

[Pen1966 in reply to SeasideSusie]

Ok but I have no thyroid gland and am due bloods next wed at gps but they will only test Tsh and T4

[SeasideSusie Remembering in reply to Pen1966]

Even though you have no thyroid gland, T3 is converted from T4 in other organs in the body, not just produced by the thyroid. You are converting somewhat as your FT3 is 51.35% through range.

If you want to check your FT3 and your GP doesn't do it, then the cheapest way is with Monitor My Health which is an NHS lab at Exeter hospital which offers TSH, FT4 and FT3 as a fingerprick test to the general public for £26.10 with discount code here:

thyroiduk.org/help-and-supp...

It may be a good idea to have both tests done close to each other, different labs, compare the results.

Is your appointment with the GP no later than9am?

Have you had thyroid antibodies tested?

[Pen1966 in reply to SeasideSusie]

Test results for thyroid I posted were monitor my health done on the 27th April gp test next week is at 8.20 not had antibodies done ever dint think needed antibodies doing ever if no thyroid gland at all

[SlowDragon Administrator in reply to Pen1966]

What was reason for thyroidectomy?

[Pen1966 in reply to SlowDragon]

Thyrotoxicosis 30 years ago

[SlowDragon Administrator in reply to Pen1966]

So that’s autoimmune

Important to test thyroid and vitamins once year. Cheapest option is Medichecks, this includes both TPO and TG antibodies test anyway

[Pen1966 in reply to SlowDragon]

Didn't think that antibodies needed testing if you had no thyroid