Help with self medication 4 week later

[Maty_82]

Hello everybody

after this blood test,

healthunlocked.com/thyroidu...

I started self-medicating with 75mg liquid levothyroxine. These are the results 4 weeks later:

TSH 0.139

FT4. 11.1

FT3. 2.79

my analysis is that tsh went down a lot, t4 went up, but t3 stayed the same and low (am I producing rt3?). In the meantime, my symptoms have even worsened slightly. I also started to have severe chest pain that i didn't have before taking levo

I had thought at this point to lower or completely suspend t4 supplementation, and start taking t3 in a low dose

What do you think, any suggestions?

thank you

[SeasideSusie Remembering]

Maty_82

I started self-medicating with 75mg liquid levothyroxine

Can you clarify. Liquid levo comes in ml. Levothyroxine dose is micrograms (mcg) not milligrams (mg). So are you saying whatever amount of liquid you take gives 75mcg Levo?

These are the results 4 weeks later:

TSH 0.139 (0.27-4.2)

FT4. 11.1 (9-17)

FT3. 2.79 (2.0-4.4)

I have added the ranges from your last post, I assume you've used the same lab and the ranges are the same, can you please confirm so that there is no mistake.

You have tested too soon. It takes at least 6 weeks after dose change for levels to settle.

am I producing rt3?

If you are it's nothing to do with your thyroid. There are many, many reasons for high rT3 and only one of them is to do with the thyroid, that is when there is an excess of unconverted T4 and you do not have enough T4 to be doing that.

I had thought at this point to lower or completely suspend t4 supplementation, and start taking t3 in a low dose

I wouldn't at this stage, you're only 4 weeks into increasing your Levo dose from 50mcg (presumably that was tablets), it's far too early to draw any conclusions yet. I would say you need to gradually increase your Levo - small increments if you are getting side effects - to get FT4 up into the upper half of it's range then see where your FT3 lies in comparison. From now on after any dose change it would be best to wait at least 6-8 weeks, my levels are still settling at 10 weeks. Don't rush things.

[Maty_82 in reply to SeasideSusie]

hi, thanks for the reply

I misspelled the dose, I'm taking 75 mcg. I don't take pills because they have lactose.

Thanks for adding ranges, they are now from the same lab. thanks for the tips 🙏

[greygoose]

(am I producing rt3?)

Of course you are. Everybody does. About 1/3 or your T4 will always be converted to rT3. But, I think what you're asking is: am I producing excess rT3? You could only know that by testing it (see Susie's response above about rT3). But the test is long, expensive and pointless. it will tell you if your rT3 is over-range, but it won't tell you why, and there are many, many reasons for high rT3. But, it's not a problem. rT3 is inert and only stays around for a couple of hours before being converted into T2. So, it pretty much has nothing to do with anything. Forget it.

[DippyDame]

Why are you choosing to take liquid levothyroxine?

You previously took 50mcg levo, then 75mcg, in tablet form....50mcg is a starter dose and looking at your labs even 75mcg wasn't enough to make a significant difference to your low hormone levels.

If you thought the tablet form wasn't working it may have been because the dose was too low!

It is unclear how much hormone you are now taking ....respond to SeasideSusie's query please.

in any case by testing after 4 weeks, you are rushing things. It takes at least 6 weeks for a new dose to settle into the system....often longer.

It is far too soon to even consider adding T3....FT4 would need to be at the top of the ref range with FT3 still low in range.

With both Frees we can then evaluate T4 to T3 conversion status ....ie. high FT4 with low FT3

If FT3 remains low adding T3 may then help.

Before adding T3 we must optimise vit D, vit B12, folate and ferritin to support thyroid function

Only then might we consider adding T3

That comes from someone who needs high dose T3-only to function!

Your chest pain may be your body's reaction to increased levo....and a sign that the dose is still too low.

If chest pains are severe, and not transient, perhaps best to consult your doctor

Just a few thoughts...

[Maty_82 in reply to DippyDame]

thank you,

I took a few days 50 and then immediately 75mcg of levothyroxine. I take it liquid because in Italy the pills have lactose.

The values ​​of vitamins fettitina etc, are above the range even if I am not healthy (I have always found this strange thing).

So you think that my levo dose is still too low, should I try to increase it?

[DippyDame in reply to Maty_82]

Stay on 75mcg for 6, preferably 8, weeks after any increase....it takes that time for a new dose to settle into the system.

Rushing increases simply confuses the body. Your results above on 75mcg may very well rise rise further in the remaining time.....that would be roughly 8 weeks after increasing

i would test again after that interval and only review dose then.

Post any new results if you wish more help.

You may very well need an increase but not before testing first.

The temptation to increase too soon is understandable....been there!

We are impatient to feel better, but that only makes finding our therapeutic dose more difficult

Sadly there is no quick fix for thyroid disease so patience is vital

it is also important that how you feel is part of the evaluation.

Good luck.....we're all here to help you.