Confused again. Help with latest readings please

[Mazzer]

I had a thyroidectomy 2 years ago. I also have D102 variant.

I started T3 in November 21 as I struggled to get well and bloods indicated poor conversion.

I was prescribed 20mg T3 to take in 2 10mg doses and 100mg Levo.

I felt a bit better but not totally and results were T3 5.3 59% hours n range, T4 13.8 18% in range TSH 0.01.

I redid bloods in Early July and results were T3 4.8 46%, T4 dropped to 13.3 13% and TSH 0.03.

Given this I took advice that you suggested in my previous post and added 25mg of Levo.

Retested last week as I started to experience worsening symptoms after an initial inprovement.

I expected low results but this is the result

T3 6.1 81% in range, T4 17.6 56% in range and TSH 0.01. I don’t really know what this indicates. Should I continue and hope I feel better? Do I need more T3 or less or more T3 and less levo?

I don’t think my NHS Endo will

Support more T3 or T3 only as he was keen to reduce my levo at my last appointment due to suppressed TSH. I managed to avoid this so far.

Well done if you got to the end of this and any help will be really welcome. Thank you

[Lalatoot]

Mazzer I don't think you need to increase your T3 dose - 81% ft3 is good.Your results would suit me fine and I'd be happy with them. however some folks need slightly higher ft4 so you could increase levo by 12.5mcg.

Having said that we often just look at our thyroid blood results and how we are feeling and decide on change. Sometimes we need to stop changing doses and let our body heal longer term.

The body is a complex integrated system with chemical and electrical signals passing messages - we tend to forget this in our focus on thyroid hormone levels and vitamins. To survive on low thyroid hormones your body reduces and shuts systems down to survive. Once hormones are again at reasonable levels these 'reduced services' may take time to build up again.

[Mazzer in reply to Lalatoot]

Thank you.

[Musicmonkey]

How soon after your dose did you have your blood tested? Was it early am? I also have DIO2 and need high in range T3 to feel well. If tested soon after taking it would be above range. With DIO2 we don't convert well from T4, so I'm surprised increasing that was suggested. My understanding is that levels of hormone in the blood for DIO2 sufferers isn't very helpful, because it can't indicate how much T3 we are able to convert into the cells.

[Mazzer in reply to Musicmonkey]

Hi I had the blood draw early morning 14 hrs after T3 and 24th after T4. How have you managed this? . Do you ignore readings and go on how you feel only?

[Musicmonkey]

I take my last T3 dose around 16 hours before a blood draw and try to have as early am appointment as possible. I can't rely on my TSH because on diagnosis it was only 2.9 despite a below range T4 (10 in the range 12-22). It is always suppressed. My T3 is usually in range, somewhere between 4.9 and 5.5 and my T4 seems to drop every time, but then I am only on 25mcg of Levothyroxine. My Endo still tries to focus on TSH, but I have challenged him about this and asked him to go by symptoms. I have kept a record of my waking temperature, my blood pressure, heart rate, weight and symptoms and dose of T3/T4 since I started on T3 in 2016. My Endo doesn't like it, but I am still trying to educate him and send him relevant studies/articles supporting my arguments.

[pennyannie]

Hey there again - I think ?

Since you have had a thyroidectomy the TSH reading will not be a reliable measure of anything and must not be used to dose or medicate on :

Your HPT axis - the Hypothalamus - Pituitary - Thyroid feedback loop - on which the TSH reading relies is now disabled as your thyroid isn't there any longer and this feedback loop is not continuous any longer and broken ":

It is essential that you dosed on your T3 and T4 blood tests results with a view to restoring both T3 and T4 to acceptable levels for your good health and you are the only one who knows where that is - and it's not in a blood test result which is simply a snapshot in time.

[Mazzer in reply to pennyannie]

Thank you for your reply PennyAnnie.