Should I add T3 or increase T4?

[Sofie007]

My last blood results made me think I have a conversion problem. Tsh 1.58 (0.27-4.2) FT4 19.6 (12-22) FT3 3.91 (3.10-6.8) I have been on levothyroxine 50 mcg for 7 months, now on 75mcg for 3 months, My weight is 80kilos. I don’t know if I should increase levo or add T3 ? My hair loss stopped since adding iron supplements. But the fatigue and weight gain is still present.

[DippyDame]

You may need to allow longer than 3 months for your dose to settle into your system...we are all different.

But....

High FT4 with low FT3 does indicate poor conversion so yes you may benefit from the addition of a little T3...

However....

Since you have room to first add a little more Levo, that, along with optimised essential nutrients, vit D, vit B12, folate and ferritin, may help.....and may avoid the difficulties that can come with obtaining T3.

Also, avoid soya products which affect hormone function

If that doesn't improve things then I'd suggest adding a little T3 ( 5mcg) to your levo dose

It takes time!

[Sofie007 in reply to DippyDame]

Thanks DippyDame! I know it takes time.. I just feel like I don’t have time.

[DippyDame in reply to Sofie007]

Been there....it's difficult I fully understand.

But ...more hurry, less speed!

I'm not convinced you need T3 right now.

Have you now decided how you wish to proceed

Speak to GP?

Request appointment with an endo?

Self medicate?

With thyroid disease there are no quick fixes....unlike headache/paracetamol

How about....straight away increasing levo to 100mcg, stay on that steady dose for 6 weeks then have a full thyroid test ...

TSH, FT4, FT3, vit D, vit B12, folate, ferritin and thyroid antibodies TPO and Tg

With those labs we can better analyse thyroid function

At very minimum, and not ideal, test TSH, FT4 and FT3

Ensure you optimise essential nutrients

Post any results,with reference ranges, and we can then offer more help.

Also, read your previous posts and replies again to refresh your memory!

[Sofie007 in reply to DippyDame]

I don’t know yet. Next week i’m seeing a doctor, I will ask to do a new blood test. My last results are from August. I have been supplementing iron en D3 since then. B12 en biotin was good. I am willing to take 100mcg levo. Does increasing the dosage of levo help conversion to T3? When I look at my results from 25mcg to 75mcg my T3 didn’t move.

[TSH110 in reply to Sofie007]

I think it’s complicated and involves dioadinases…,

here’s some info on them in this blog that might be of interest. It can be a bit hard going but it’s worth trying to get the gist of it:

thyroidpatients.ca/2020/06/...

…so it could change.

If you get to TSH 0.2 - 0.5 and the T 3 is still very low in range and you still feel unwell, you have a conversion problem