Step backwards despite including T3...any thoughts

[Ste1]

Hi all, I have an appt this week with my Thyroid Specialist and would like to get some views on what is causing the reductions in my bloods FT4 and FT3 results and a worsening of symptoms.

I follow all of the protocols prior to getting bloods done as advised here.

Bloods 15th June

My bloods results Medichecks 15th June, 125 mcg Levothyroxine daily.

TSH 0.04 (0.27 to 4.2)

FT4 18.9 (12 to 22) 69% through range.

FT3 5.76 (3.1 to 6.8) 72%.

Folate 19.8 (3.89 to 20.58) 95%.

Vit D 75.

Ferritin 141 (30 to 400) 30%.

B12 Active 116 (37.5 to 150) 70%.

Thyroglobulin Antibodies 11 (<115).

Thyroid Peroxidase Antibodies <9 (<34).

Still symptomatic slow heart rate, low core temp and constipation.

Bloods 9th August

Thyroid specialist increased Levothyroxine to 137.5 mcg daily and increased consumption of Ferritin based foods, blood results Monitor my Health 9th August.

TSH 0.05 (0.27 to 4.2).

FT4 20.4 (12 to 22) 84%.

FT3 5 (3.1 to 6.8) 51%.

Symptoms same as previous.

Bloods 19th October

Thyroid specialist considered that the reduction of FT3 was likely due to Reverse T3 and gave me a trial of T3, starting a split dose of 5 mcg leading up to 7.5 mcg after a couple of weeks. Also reverting back to 125mcg of Levo. I have been on the T3 and T4 for 7 weeks, bloods Monitor my Health 19th October.

TSH 0.03 (0.27 to 4.2).

FT4 15.6 (12 to 22) 36%.

FT3 4.8 (3.1 to 6.8) 46%.

Symptoms: slow heart rate, still slow but slight increase, core temp still low but slight increase, constipation, very fatigued and tinnitus worsened, heartbeat in head, headaches, feeling slightly dizzy for split seconds .

My question is, it it usual for bloods and symptoms to initially worsen when T3 is included?

Thanks for taking the time to read, any thoughts appreciated.

[arTistapple]

I am surprised no-one has got back to you yet. Someone far more experienced than me will hopefully be along soon. Can I just ask one question re: dates 19/10 you imply you were not on T3 on that date but then you say you have been on T3 + T4 for seven weeks. It’s not always necessary that starting T3 means a reduction of T4. Your T4 has been dropped. This could be your problem. However the dates are confusing. Can you look at them again? And in the meantime I hope someone truly experienced answers soon.

[Ste1 in reply to arTistapple]

Thank you for your reply arTistapple. The comments were meant to indicate the situation up until the blood results. For example: "Thyroid specialist considered that the reduction of FT3 was likely due to Reverse T3 and gave me a trial of T3, starting a split dose of 5 mcg leading up to 7.5 mcg after a couple of weeks. Also reverting back to 125mcg of Levo. I have been on the T3 and T4 for 7 weeks, bloods Monitor my Health 19th October" This was what I was taking up until these bloods on the 19th Oct.

With regards to the decrease to 125 of Levo, previously when I was on this amount my blood scores were much higher see 15th June.

Thanks again.

[arTistapple in reply to Ste1]

I am on shaky ground here and I can’t understand why no-one else has got back to you. I wonder if there has been some blip in the system somehow? It does happen from time to time. I don’t like to leave you high and dry. Maybe you should re-post drawing attention to it again. A quick look on the forum will allow you to check which administrator you might be familiar with and refer to them in your post by name.

[Ste1 in reply to arTistapple]

Yeah might re-post, thanks for the suggestion 👍. Am seeing Specialist on Thursday anyhow and hopefully she will know what's goin on.

[arTistapple]

However no doubt your intention by posting was to get info BEFORE your endo appointment. Get re-posted.

[Ste1]

Took your advice arTistapple, slightly amended and re-posted. Many thanks again for your help and advice.

[terebol]

Im too am surprised no one has responded to you. Looking @latest lab #s, the TSH (useless in treating) &Ft4 look in range. TSH will be suppressed when you are treated optimally. Your FT3 is low. From the 2 groups I read, it is suggested that FT3 be in the upper quarter of the range. I tried the synthetic route for 14mos. after Nature-throid was pulled (in US); It never worked for me despite my lab #s looking good. I switched over to NP thyroid. When you increase liothyronine, you should feel the increase in 4-5days (my experience). And, maybe synthetics won't work for you.

[Ste1 in reply to terebol]

Terebol, many thanks for your comments, much appreciated.

[terebol]

[Noelnoel]

Bloods 15th JuneMy bloods results Medichecks 15th June, 125 mcg Levothyroxine daily.TSH 0.04 (0.27 to 4.2)FT4 18.9 (12 to 22) 69% through range.FT3 5.76 (3.1 to 6.8) 72%.

For many this would be an enviable set of numbers but it’s interesting how different we all are in terms of where our optimal is

Because those numbers are so, so close to perfection (for many, not all and certainly not for me, my FT4 is low), a smaller increase might just have nudged you into your optimal but importantly, also waiting a bit longer before increasing could’ve given things the time needed for you personally to feel the full effects. Mostly, the 6-8 weeks advised on here is enough but for some of us the process is a bit slower. Sorry

Bear in mind that even when labs SEEM optimal or indeed ARE optimal for a particular individual, it can still take a long time for certain symptoms to resolve. Often this is related to how long a person has been hypo and again bear in mind a lot of us have been hypo long before diagnosis. I believe my Hashi’s began 15 years before diagnosis. I was diagnosed 5-6 years ago and only now are my core temp and pulse looking good but my scalloped tongue is still scalloped and the weight loss is slow, slow, slow

I’m not qualified to comment so all of this can only be speculation on my part but I felt compelled to speak because you look so close to being there, in terms of numbers at least. What I absolutely do know though is that with low and slow we’re less likely to miss that point where a particular dose is OUR perfect and I know this because although my perception in the past was of doing exactly that (low and slow), I was so keen to get things moving that on several occasions I positively galloped past my perfect/optimal and paid the price of adding years to the process

Apologies for the shouty capitals but my bold/italic function has stopped working

[Ste1 in reply to Noelnoel]

Many thanks Noelnoel for your observations and comments. Interesting and worthy of considering giving more time beyond the 6 to 8 weeks to achieve what seem that elusive goal. Will defo mention to my Thyroid Specialist. Thanks again.