Should I increase my T4 or stop T3

[Yoll]

I have been on a low dose of T3 (5mcg x3 day =15mcg)

I'm also taking 75mcgT4.

I have been on T3 for year now, it has improved my sleep and digestion . My latest results are below, they show T4 quite low and of course TSH suppressed.

Should I reduce my T3 intake so the the TSH can recover.

Any idea why my T4 is so low. I am assuming the low TSH is affecting the T4 production. I was on 100mcg but this didn't really improve the results.

Endo wanted me to go on liquid levothyroxine, but I couldn't get it prescribed.

I am not symptom free but not sure if it's menopause or Thyroid .

Thank you everyone

[greygoose]

You'd have to reduce your T3 by quite a bit to get the TSH to rise. And, as you're not even optimal on 15 mcg, you'd be even worse with less.

The FT4 always drops when you start T3, that's the way it works. And, 75 mcg is only a small dose. You could increase your levo, if you think it would help, but if it were me, I would be wanting to increase my T3. Your FT3 is pretty low.

[SlowDragon Administrator]

Taking almost any dose of T3 will suppress TSH, that’s just what happens

Was test done early morning, ideally before 9am and last dose levothyroxine 24 hours before test

Last 5mcg dose T3 approx 8-12 hours before test

Increasing levothyroxine would improve both Ft4 and Ft3

Suggest you try increasing levothyroxine to 87.5mcg daily or 100mcg and retest in 6-8 weeks

Which brand of levothyroxine are you currently taking

Do you always get same brand

When were vitamin D, folate, ferritin and B12 last tested

What vitamin supplements are you currently taking

[Yoll in reply to SlowDragon]

Was test done early morning, ideally before 9am and last dose levothyroxine 24 hours before test

Last 5mcg dose T3 approx 8-12 hours before test

Always. I am on Accord . I was given Mercury Pharma last time and had to go back to change it I had the same reaction with Teva .

My insides are slowly settling again which made me wonder if I needed the T3 at all and if a lot of the digestion problems were due to the regular changes in brands I had over the years, I had mercury Pharma for quite a while in the past.

March 2022 for B12 (614pg/ml (191-663)) Cortisol 662 nmol/L

Vit D I haven't done lately but I do take some Vit D on and off, as well as magnesium and selenium but not every day as some previous results were high

Lately my MCHC has been over the range but I can't find any explanation for it, I wondered if that was why I was still fatigue .

[SlowDragon Administrator in reply to Yoll]

Recommend getting vitamin D, folate, ferritin and B12 tested at least annually

[Yoll in reply to SlowDragon]

dec 2021folate serum 8.05ug/L (Range >3.89)

B12 active > 150 pool/L (range 34.5-188)

vit D 95.40 nmol/L

I have never been low on ferritin

[SlowDragon Administrator in reply to Yoll]

So they’re pretty good

Try increasing levothyroxine…perhaps initially to 87.5mcg (adding 1/2 a 25mcg tablet per day)

[Yoll in reply to SlowDragon]

I was on 100mcg but didn't feel any different so reduced it to 75 , I'll try again with 87.5. I was wondering if I should go T3 only . Not sure how to manage that!

Do I need T4?

[SlowDragon Administrator in reply to Yoll]

Going onto T3 only is absolutely the last resort.

It’s more difficult to manage, and would likely need substantially more than 15mcg T3 per day. Typically daily dose when on T3 only is between 40mcg - 60mcg per day

Having Dio2 or Dio1 gene variation doesn’t mean we can not convert Ft4 to Ft3……it simply means the heart and brain need small extra levels of Ft3 at all times. Therefore patients on just levothyroxine who have these gene variations often feel better with small doses of T3 added to levothyroxine

But it’s still important to be taking high enough dose levothyroxine too

it’s trial and error wether you can manage on low Ft4.

Many thyroid patients on levothyroxine plus T3 need Ft4 at least 60-70% through range

Currently your Ft4 is just 1% through range

FT4: 12.1 pmol/l (Range 12 - 22)

Ft4 is only 1.00% through range

Retest thyroid levels after 6-8 weeks on increased dose levothyroxine

Then consider increasing again

[SlowDragon Administrator in reply to Yoll]

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Showed Ft4 was still low on 100mcg levothyroxine

You can try splitting levothyroxine if you find taking 100mcg in one go is too difficult

Taking 50mcg waking and 50mcg bedtime…..along with the T3

[Yoll in reply to SlowDragon]

I have no trouble taking it I just didn't feel any different, so why stuff myself with chemicals if it makes no difference, was my thinking! but maybe I need to go even higher to feel the difference? my end wanted me to try liquid thyroxine but I can't get it

[SlowDragon Administrator in reply to Yoll]

Correct.

If your car uses a gallon of petrol to do 50 miles and you only put a gallon in the tank….if you need to drive 70 miles….car will run out of petrol

Levothyroxine isn’t a chemical…it’s a replacement thyroid hormone, because your own thyroid is no longer working

A diabetic needs insulin….we need thyroid hormones

[Lalatoot]

You'll your previous results on 100mcg levo and 15lio were higher and for me would be preferable.I would go back to those doses and give it at least 2 months.

[shaws Administrator]

I agree with greygoose I take one daily dose of T3 (not a high dose) and it has restored my life back to normal and am also symptom-free.

[Yoll in reply to shaws]

Have you stopped taking T4? I did wonder about going on T3 only but the management of it seems rather complicated I was on 100mcg but I didn't feel any better for it.

I know I have a gene mutation on DIO1 and DIO2 not sure if that makes a difference as I don't know if they are active.

[Hashimotosucks]

Did the endo tell you why they wanted you to go on to an oral solution of levo? I am on it as i react badly to tablets