Below are the results of my TSH, FT4, and FT3 from a blood draw on July 6, 2022. It was drawn before 9 am and that was 26 hours after the last morning dose of my daily dose of 75 mcg of Levothyroxine and 5 mcg of Liothyronine.
TSH, 0.14 L -- 0.40 - 4.50 mIU/L
Free T4, 1.3 -- 0.8 - 1.8 ng/dL
Free T3, 3.1 -- 2.3 - 4.2 pg/mL
My Endo asked me to lower only my Levo by skipping one dose of it once a week. She said the TSH is too low. I feel fine, other than some palpitations that I have experienced for years.
I am open to any comments and suggestions. Thank you in advance!
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saritadelmar
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If you feel fine there is no need to change anything. Your TSH is going to be low because you take T3, that's just what it does. FT3 is well within range so you are not overmedicated. Why change anything just to satisfy a number that your endo wants to see?
You aren't over medicated with those results. And you feel fine, so that's another big indicator that you are not over medicated.
For me, over medication makes my resting heart rate go up a bit (it's harder to tell for me because I have an arrhythmia that gives me a high and irregular rate anyway, but I can see a different trend if I'm taking too much medication. I am also miserable, have loose bowels and terrible fatigue. The fatigue is in my limbs, and in my head. I am good for nothing.
Thank you for the detailed response on symptoms of overmedication. Could your arrhythmia be caused by your dosage? I have an arrhythmia and the cardiologist said it could be caused by dosage, but he doesn't get involved with changing anything like my Endo. Certainly is a complicated matter. I should probably share these posts with my Endo, she has known I am influenced by this forum, and usually is respectful. I'll ask her what her opinion is about the low TSH not being a problem as long as T4 and T3 are within range and that I am feeling well. I am curious now what she will say about it. Thanks for sparking my thoughts.
My Afib long proceeded me using any kind of thyroid hormone. So no, it's not caused by T3. Too much T3, over range T3 and too little, low or below range T3, can cause Afib. Doctors only seem to have heard about the "too much" scenario and they don't understand how to measure it properly, 12 hours after a dose, and they don't know how to interpret the bloods.
TSH was invented to help diagnose hypothyroidism, it was never meant to be used to monitor doses. If you take any T3 medication, you need to closely monitor your FT3 level.
Forum advice is to ensure that last Levothyroxine dose is 24 hours before the blood draw and last dose of T3 is 8 hours before. Next time you test do remember to split your T3 the day before your test (eg take 2.5mcg Lio 16 hours before the test and 2,5mcg Lio 8 hours before the test).
Taking T3 often suppresses TSH so your endocrinologist should take this into account and look at FT3/ FT4 levels. If you feel well and these are within range, I would not consider reducing your Levothyroxine.
The following were tested on the same day as TSH etc., July 6. I only take a 2,000 to 4,000 IU of vitamin D3 supplement (not always regularly) and once in a great while B-Complex.
Ferritin -- 56 -- 16-288 ng/nL
Vit B-12 -- 402 -- 200-1100 pg/mL
Folate, serum 8.4 -- ng/mL reference range Low 3.4 -5.4, Borderline 3.4- 5.4, Normal 5.4
Thorne Basic B or Jarrow B Right are recommended options that contains folate, but both are large capsules. (You can tip powder out if can’t swallow capsule)
IMPORTANT......If you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 7 days before ALL BLOOD TESTS , as biotin can falsely affect test results
In week before blood test, when you stop vitamin B complex, you might want to consider taking a separate methyl folate supplement and continue separate B12
With serum B12 result below 500, (Or active B12 below 70) recommended to be taking a B12 supplement as well as a B Complex (to balance all the B vitamins) initially for first 2-4 months.
once your serum B12 is over 500 (or Active B12 level has reached 70), stop the B12 and just carry on with the B Complex.
Leaving 26 hours since the last L-T3 dose will give false fT3 and TSH figures. However, you take so little L-T3 it will make negligible difference.
Reducing your L-T4 by 1/7 will make a small difference, you could try it to keep your endo on board but I get the impression they are fiddling around to justify their salary.
The Endo fears I will be thrown into Afib by T3 because I mentioned palpitations. The small amount of T3 I take has actually lessened my palpitations. Thank you for your thoughts.
That's absolute nonsense! Take it from one who lives with permanent Afib. My Afib is worse if my T3 drops too low. The heart needs T3. These endos know so little about this. It's not right.
Wow, that's encouraging. Do you mind my asking your dosage? And do you have an idea of the actual cause of your Afib? Once in a great while my heart speeds to 140 a minute but doesn't last more than an hour. A heart monitor picked up the recurring fast beats that usually are no longer than 11 beats. Happens a few times during the night.
I probably inherited my Afib. Dad had it, so did at least one brother and sister of his and one of his brother's children. Mine was not kicked off by anything in particular when it was still spasmodic events.
I am currently on 45mcg T3 and 25mcg Levothyroxine. But I'm a long standing work in progress trying to get my thyroid hormone to actually reach the cells and do their job.
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