Despite the lab results, I don't feel overmedicated

[Lunario]

My last fingerprick test showed that I am a bit overmedicated, although I don't feel that way.

Test in September

150 µg/d + 1 Metavive III

fT4: 1.98 ng/dl (0.04 - 1.7) = 117%.

fT3: 0.46 ng/dl (0.039 - 0.44) = 105 %.

Test in May (150 µg/d, no Metavive III):

fT4: 1.52 ng/dl (0.8 - 1.8) = 72 %.

fT3: 3.18 pg/ml (1.9 - 4.8) = 44 %.

I am not sure if I should reduce by 12.5 or by 25 µg or keep the Metavive III. I am tending to keep the Metavive because it pushes the fT3 and stabilizes my average body temp slightly above 36°.

I welcome your thoughts on this.

[greygoose]

Your FT3 - the most important number - is only just over-range, so if you feel good, I would leave things as they are. A blood test is only a rough guide, how you feel is far more important.

[Lunario in reply to greygoose]

Thank you for your quick response, greygoose.

I'm glad to hear that from you as one of the most experienced members here on the forum.

I've thought about it now and think I'll see how it goes with 5x 150 and 2x 137.5 a week because I occasionally get a bit warm at night, so I'll swap out the duvet with a thin sheet for a while. But all in all, I have to say that I have never felt so good. TSH is suppressed, but I don't give a f___ about TSH, it has to be abnormally low for me anyway in order to have the free levels in the upper third.

I hope next time I get similar lab results from my GP she will accept them.

But it’s very helpful to share thoughts, so thanks again.

[greygoose in reply to Lunario]

You're welcome.

[Hidden]

Just a question: is Metavive III bovine?

[Lunario in reply to Hidden]

Yes, it is.

Unfortunately, no one really knows how much T4 and T3 are in it, so it's a matter of trial and error, which I was willing to do. I chose bovine because it is considered less potent compared to porcine.

[Hidden in reply to Lunario]

Yes, that makes sense as it contains more T4 and less T3 than porcine thyroid.

[jrbarnes]

I often had FT4 levels at 1.94 and FT3 levels near top of range and I was never over medicated. In fact, I still wasn't getting enough T3. Probably similar to your situation where you need the Metavive to give you higher T4 and T3. I don't see anything wrong with these levels. If you want to know if you have too much T4 or T3 in your body then I would recommend getting the Total T4 and Total T3 levels tested as well. One time I was over medicated on Levothyroxine but my FT4 and FT3 levels looked optimal but I was sweating and feeling unwell so they tested my Total T4 levels and found that I had too much thyroxine in my body.

[Lunario in reply to jrbarnes]

That's interesting, thank you for this insight.

[SilverAvocado]

I've recently been reducing my doses, particularly the amount of T4, and finding to my surprise that it has been an improvement. So now I have changed my tune and become an advocate for reductions 🤣

Particularly as your levels haven't slowly eased up to over range, but have jumped up over a short period, so you don't really have the evidence at the moment that you need the numbers over range to feel well. If I were in this position I would want to try and get those numbers a bit lower, just to see the impact it had on symptoms. If you do feel any worse you can always return to this point.

For freeT4 even more than freeT3 I don't like to see it high. FreeT3 is the most important number, so once you have got your T3 into a good place, having excess T4 around can't do any good and it is more likely to be doing harm - such as triggering homeostasis mechanisms in the body that block T3.

If you are considering reduction I would take down the thyroxine/T4 (I assume that is what you are taking in 150 µg/d). A usual dose reduction is 25 µg/d, but if you feel worried about reducing you could do a smaller amount. At the same time keeping the Metavive the same and then seeing how you get on for a few weeks.

I was a bit confusedd by your reply to Greygoose whether you are planning to take different amounts of Metavive on different days? For anything containing T3 it is important to take the same amount every day as T3 is very fast acting and can't be averaged out across days or weeks. T4 is different and is pretty slow acting, so it is theoretically fine to take different amounts on different days, as it will be smoothed out by its slow effect. This can be a good compromise with T4 if you are limited by access to different sized tablets.

[Lunario in reply to SilverAvocado]

Thank you, SilverAvocado, you confirm my thinking on this subject.

And yes, I am reducing T4 and will definitely keep Metavive in its current dose. That was what I meant in my post to greygoose, it’s the higher fT3 that I am aiming for with Metavive and that seems to work pretty well.

I don't want fT4 that high either and will figure out how an average reduction of my weekly T4 dose of about 21,4 µg will work for me (so 125 µg on 5 days and 137.5 on 2 days a week).

I spent just one night pondering this question, but having made a decision is reassuring (thanks to you guys).

Up until now, it has only been about increasing my dose, so this is a new learning curve for me.😉

[SilverAvocado in reply to Lunario]

I have been in a similar position, of increasing for a long time. But dose reducing can improve symptoms just as much as an increase if it is the right change for you, even though I think it can be scarier!

Good luck with your new dose