Hi hope everyone is well. Went to my dr to check thyroid bloods. I was on 112 T4 and 25 mcg of T3. My dr. Raised my T3 meds from 25-50.

[Nanny23]

Is that too large an increase all at once. I’ll give results below thanks. Total T4-5.1. Range 0.27-4.20. Free T4 1.3 Range 0.9-1.8. Free T3-2.44. Range1.80-4.60. T-3 71. Range 80-200. This was red flagged and caused dr. To raise my T3 meds. TSH is 0.01. It’s always that low as I have secondary hypothyroidism. Basically my pituitary isn’t telling my thyroid I need hormone. I always thought I had regular hypothyroidism. Antibodies checked not Hashimotos. My vitamin D levels are good. I take B12 C magnesium and selenium. I am gluten free and do not buy packaged foods. Try to eat well. I really don’t understand secondary hypothyroidism that well. I was surprised she raised my T3 25 Mach’s all at once. Any knowledge or thoughts much appreciated.

[cardsnut]

I think your doctor is doing the right thing. Your Free T3 and Total T3 are both very low. Your Free T3 should probably at least 3.2 or higher to be optimal. Keep an eye on your resting heartrate after the increase. Let your doctor know if your heart is racing, develop anxiety, have excessive sweating, or other hyperthyroid symptoms after the increase. The extra T3 that you will be taking should reach a steady state within about 5 -7 days, so you will know pretty quickly how you are tolerating it.

[Nanny23 in reply to cardsnut]

Thanks so much. So far I’m tolerating it ok. I appreciate your advice.

[Lalatoot]

Nanny that is too much of an increase all at once. Increases in t3 are usually in 5mcg increments. This is so it is gentle on the body and also so that you don't go jumping past the dose you need.

[greygoose]

It is much, much, much too much in one go. Shouldn't be more than 5 mcg every two weeks maximum. Not saying you don't need it increased, by not like that.

Total T4-5.1 (0.27-4.20)

Free T4 1.3 (0.9-1.8)

Free T3-2.44 (1.80-4.60)

T-3 71 (80-200)

TSH 0.01

All that really interests us here are the Frees. Total results don't give us any useful information. So:

Free T4 1.3 (0.9-1.8) 44.44%

Free T3-2.44 (1.80-4.60) 22.86%

Your FT3 is very low, considering you were taking 25 mcg. How do you take it? Do you always take it on an empty stomach, well away from other supplements/medication, just like levo?

Anyway, presumably you now have a prescription for 50 mcg T3. Don't knock it! But, you don't have to take the increase in dose all at once. You can cut your tablets into pieces, and increase slowly by your self. Cut a tablet into 4, and take an extra 1/4 every day for 2 weeks. See how it goes. If you feel the need, you can then add in another 1/4 tablet. Maybe wait three weeks before deciding if you want to increase again. Just do it slowly. And, the advantage is that now, you will always have a little spare T3 in hand for emergancies.

I take B12 C magnesium and selenium

Not a good idea to just take one isolated B vit. They all work together and need to be kept balanced. So, best to take a good B complex, one that contains methylcobalamin (B12) rather than cyanocobalamin, and methylfolate.

Don't take the B12 and vit C at the same time. The vit C will affect how your body uses B12.

I really don’t understand secondary hypothyroidism that well.

Secondary hypothyroidism is when you have a problem with the pituitary rather than with the thyroid itself (Primary Hypothyroidism).

The pituitary (a gland inside your brain) produces TSH - Thyroid Stimulating Hormone. Without TSH to stimulate it, the thyroid cannot make thyroid hormone. So, when you do labs, the results will come back with low TSH and low Free T4 and Free T3.

With Primary Hypo, you would have high TSH and low FT4 and FT3.

That's the difference. But, the treatment for both is the same: thyroid hormone replacement of some kind.

[Nanny23 in reply to greygoose]

Thanks for explain g secondary hypothyroidism. I do take a B complex not just B 12. Sorry I wasn’t clear on that always appreciate your input.

[greygoose in reply to Nanny23]

You're welcome.

[SlowDragon Administrator]

Was test done early morning, ideally before 9am

Last dose levothyroxine 24 hours before test

Day before test did you split T3 into 2 or 3 smaller doses spread through the day, taking last dose approx 8-12 hours before test

If you took last dose T3 24 hours before test, Ft3 is false low result

Essential to test folate, ferritin and B12

[Nanny23 in reply to SlowDragon]

Hi thanks for responding. I couldn’t get an appointment before 11. Last dose was 24 hours before.

[SeasideSusie Remembering]

Nanny23

I agree with the other members who say the increase of T3 from 25mcg to 50mcg in one jump is way too much, it should only ever be 5mcg at a time - low and slow is the way to go so that you gradually increase over time and don't overshoot your sweet spot. By increasing that much you could become ill with symptoms of overmedication, and it could be a backward step because it's likely to be more than you will ever need and you then have to go back to reducing the dose to find what's right for you. That will take far longer than increasing slowly.

I would guess that your doctor hasn't got a clue about treating with T3. Are you paying for such ignorance?

[Nanny23 in reply to SeasideSusie]

My insurance pays for my dr. Visit and I have a $20. Co.pay. My original dr. Retired. This dr. Is new to me. She seems very thorough. My T-3 on last test was on low side also. I have been taking the 50 mcg. For 6 days. I don’t notice much of a difference. Grey goose said to split tablets. Sounds like a good idea. I thank you so much for responding