Another private blood test for advice please

[Sherry5]

Hi all,

I’m not quite sure if I’ve gone from one extreme to the other with TSH maybe in the last few months. Here is my latest test result (done early without meds etc)

(I’m Graves’ disease, had RAI 2017 and currently on 100 levo and my own added T3 which I’m not sure I should drop this or reduce the levo?)

My weight has increased and I’m getting more headaches than usual.

Always thankful for your advice.

[SlowDragon Administrator]

Previous post with results from 4 Months ago on just 100mcg levothyroxine

healthunlocked.com/thyroidu....

So how much T3 are you currently taking

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

Last 1/4 tablet of T3 approx 8-12 hours before test

Taking almost any dose of T3 results in TSH dropping very low

Ft4 often reduces a bit too

[Sherry5 in reply to SlowDragon]

Ah sorry, test done at 7am after nothing but water and last meds 24hrs before. Taking one t3 tablet daily 25mcg on the box I think.

[SlowDragon Administrator in reply to Sherry5]

So are you splitting your T3 into 2 or 3 smaller doses spread through the day

Even if you normally take it as single dose….on day before test ALWAYS split into 3 doses ….taking last 1/4 tablet 8-12 hours before test

If you took all the T3 in morning, 24 hours before test, you have falsely low Ft3 result

[Sherry5 in reply to SlowDragon]

Apologies for delay, for some reason I've had computer problems and I lost access to my posts. I didn't realise this & thought not to take it on the actual day so it looks like it will be false from your advice. I will wait for my next one and follow your advice on splitting into 3 and timing correctly before the next test. Thank you as always for your help.

[pennyannie]

Hey there again Sherry :

So these results are with a T4 x 100 mcg daily and T3x25mcg daily - all taken together first think in the morning ?

Please ignore your TSH readings - you haven't a thyroid, as you had RAI thyroid ablation for Graves Disease and your HPT axis broken and which is the feedback loop for a TSH reading .

The TSH known as an unreliable measure of anything especially if with Graves Disease.

The TSH reading will be suppressed if you take any thyroid hormone replacement containing T3 - it's just what it does, so ignore the TSH - though your doctor may well disagree.

I thought you planned to increase your T4 - Levothyroxine first, and build it up to at least around the top quadrant of the range.

T3 has a much shorter life span within the body and to get an accurate reading you need to take a measure around 8-12 hours after ingesting - so these results don't really say anything - except that they both look much to low.

You T4 is only at 15.40 and around 34% through the range and this needs to be up at around 20 and at least 75% through the range.

Your T3 reading is much too low but isn't an accurate reflection as your waited 24 hours rather than around 12 from taking the Liothyronine.

I had terrible headaches on a brand of T3 I purchased from Mexico and had to give this bulk buy away.

Have the headaches only happened since taking the T3 ?

Maybe splitting this dose into 2 might allay the headache?

Weight is an obvious symptom of hypothyroidism and of a slower than normal metabolism.

How are your core strength vitamins and minerals, ferritin, folate, B12 and vitamin D as these need to be maintained at optimal levels to support conversion of thyroid hormones.

[Sherry5 in reply to pennyannie]

Apologies for delay, for some reason I've had computer problems and I lost access to my posts. I didn't realise about the T3 so looks like this will be false as I last took 24 hrs prior. I will wait for my next one and now try splitting into 3 and timing correctly before the next test and I was also thinking of trying alternating 125 and 100 daily as if I'm understanding correctly 125 was too high and 100 looks too low. I don't think the headaches occurred since then but will try the different method of taking them. I didn't get all the vitamins etc tested this time as they have always shown as perfect but will see how I go next time. Thank you as always for your help but one more question if I may, how long should I leave it before my next test if I'm trying different dosage?

[pennyannie in reply to Sherry5]

Around 8 weeks :

Why don't you split the 25 mcg T4 tablet into 2 and not have to worry keep changing the dose every other day.

T4 - Levothyroxine is a storage hormone so either way it shouldn't really matter.

Maybe you already have a pill cutter as I presume you built up to 25mcg T3 in stages.

I used a pull cutter for T3 as was advised to start with just a 1/4 of a 25 mcg tablet and build up the dose slowly.

Maybe the headaches occurred when you introduced the T3 as you would have been on T4 for a good while before then wouldn't you and presumable without this symptom ?

Only change one thing at a time otherwise you will not know which one worked or not.