High T3

[Rah12]

Hello

I need some help please. I have hashimoto. This is my recent thyroid results. My free t3 is very high. T4 has increased since my last test. My thyroid antibodies has halved since my last test.

What could be causing the t3 to be this high? I still have hypo symptoms. Fatigue being the worst. I have my first oppointment with an endocrinologist coming up soon. I am assuming the GP has referred me because of my high t3. What should I expect at the oppointment please?

I am on 100mcg levothyroxine, 4.5ml LDN and 75mcg thybon. I have cut it down to 60mcg since I found out my t3 is really high. Is this enough or do I need to cut it down further? This is all through a private doctor. My GP has not prescribed me anything and would rather take the wait and see approach.

I am also taking iron, vitamin d and b12.

[SlowDragon Administrator]

See from other posts you’re currently in Portugal

Typical dose of T3 alongside levothyroxine is between 10-30mcg per day

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

Day before test did you split T3 into 3 x 20mcg spread through the day at roughly equal 8 hour intervals and last 20mcg approx 8-12 hours before test

You’re on high dose T3 …..and results show you are still over medicated

Reducing dose T3 by another 10mcg and retest in 6-8 weeks

Meanwhile you need vitamin D, folate, ferritin and B12 levels tested

What vitamin supplements are you currently taking

High thyroid antibodies confirms autoimmune thyroid disease also called Hashimoto’s

Are you on strictly gluten free diet, if not get coeliac blood test done before considering trial on strictly gluten free diet

You may eventually need slightly higher dose levothyroxine

Many people on levothyroxine plus T3 find they need BOTH Ft4 and Ft3 at least 60-70% through range

Currently Ft4 is low suggesting you might need higher dose levothyroxine

But only change one thing at a time …..more important to reduce T3 dose first

[Rah12 in reply to SlowDragon]

Thank you for replying. Yes I have reduced my t3 to 50mcg split it into 3 times.

I am taking iron, vitamin d and b12 with folate. I have been tested for iron but don't have the results yet. I will also be testing my vitamin d level soon. I stopped thyroid medicine a day before the test. I did the test early morning at 9.30. I'll remember to do it before 9 next time.

I am gluten free. I feel very hypo, very tired and really fatigued.

[SlowDragon Administrator in reply to Rah12]

I stopped thyroid medicine a day before the test.

Day before test did you split T3 into 3 x 20mcg spread through the day at roughly equal 8 hour intervals and last 20mcg of T3 approx 8-12 hours before test

If last dose T3 was 24 hours before test, your Ft3 result is falsely low

[Rah12 in reply to SlowDragon]

Checking back now I only had t3 and t4 in the morning the day before the test..so my ft3 should be lot higher. I will have to repeat the test again.

Thank you once again. I really appreciate all your help.

[SlowDragon Administrator]

I am also taking iron, vitamin d and b12.

Iron supplements must be at least 4 hours away from levothyroxine and T3 and two hours minimum from any other vitamin supplements

You need full iron panel test 3-4 times a year if taking iron supplements

How much vitamin D

Test vitamin D twice year when supplementing

[Rah12 in reply to SlowDragon]

I have requested GP for vitamin d test. I am on 800iu daily. And iron 3x daily.

[Buddy195 Administrator]

Im surprised your endocrinologist didn’t raise your Levothyroxine instead of raising your Liothyronine by so much (since your last post). How long were you taking 100mcg Levothyroxine and 75mcg Liothyronine?

You are doing the right thing reducing your Liothyronine as it is not recommended that FT3 goes over range. Are you having symptoms of over medication (eg fast heart rate, palpitations etc)? To get your FT3 back in range you probably will need to drop lower than 60mcg Liothyronine, but I too would do this slowly. Remember to retest thyroid levels 6-8 weeks after being on a consistent (lower) dose.

[Rah12 in reply to Buddy195]

Thanks for replying. I see a private doctor for my hashimoto. Gp wasn't interested and wouldn't prescribe me anything and wanted to take the wait and see approach. I felt absolutely awful. I explained all my symptoms and how awful I was feeling. But he still wouldn't prescribe anything so went to a private doctor. He's the one who prescribed me LDN, Levothyroxine and Thybon. I felt amazing in the beginning. Since then its been up and down. Few months goes really good and then back to feeling hypo again! He told me to increase t3 about 8 months ago and 5 months ago t4 was increased to 100mcg. I will increase my t4 again in a couple of months and see how I get on.

Funny thing is I don't have any symptoms of over medication. I have all the symptoms of hypo. I think you are right. He should have raised my Levothyroxine instead of thybon. I have cut down to 50mcg t3 and will test again in about 8 weeks to see where I am at. Is 50mcg ok for now? Or should I decrease it more?

I have my first endocrinologist oppointment next week. GP must have referred me because of the high t3 level/low tsh level. I was really happy, thinking GP is finally taking me seriously and referring me. And hopefully wouldn't need to pay privately for the medication. But I don't have much hope now 😔

[Buddy195 Administrator in reply to Rah12]

I’m a little confused Rah, as I presumed the private doctor you were seeing was an endocrinologist, but you say that next week will be your first endocrinologist appointment.

The endocrinologist next week will no doubt want you to reduce your medication further to get FT3 and FT4 in range. As SlowDragon indicated, most people on combination treatment take between 10-30mcg Liothyronine daily.

[Rah12 in reply to Buddy195]

Thank you for replying. I will try and reduce my t3 slowly. I'm down to 50mcg now. And will try and reduce it further. Any advice on what to expect on my first endocrinologist? Is there anyway they will prescribe me t3? I'm assuming because of high t3 number I will be most likely told to stop taking t3 altogether. The Gp wouldn't give me levothyroxine and so I have no hope that they will give Liothyronine.

[Buddy195 Administrator in reply to Rah12]

I think the endocrinologist might worry about potential risks to your heart with such an elevated FT3, so may not prescribe Liothyronine, even at a lower dose. As your FT4 is low, he/ she may increase Levothyroxine (at some point)

You need to be on a stable dose of thyroid medication for 6-8 weeks before retesting. Remember to follow instructions outlined by SlowDragon to split Liothyronine dose before the test.

[Rah12 in reply to Buddy195]

Thank you appreciate all the help you both have given me.