Thyroid hormone balance T4/T3

[posthinking01]

I wonder if someone could advise - my thyroid has atrophied so things have changed and I am out of balance ..........again....if I ever got in balance actually.

My T4 is 11 and my T3 is 4.4 - so I need to raise the T4 ?

Any help would be appreciated.

thanks

[PurpleNails Administrator]

Can you add range ? How do you feel? Ideal is where your ideal is. What replacement do you currently take?

[posthinking01 in reply to PurpleNails]

T3

4.4 pmol/L

Range: 2.4 - 6 pmol/L

T4

11.9 pmol/L

Range: 9 - 23 pmol/L

Date:25 Oct 2022 11:38:00

13.6 pmol/L

Range: 9 - 23 pmol/L

Date:12 Jul 2022 10:59:00

I take 90 mcg of T4 liquid which makes it possible to take odd amounts and I take 10 x T3 split into two doses of 5.

Don't feel balanced - but upping my T4 from 80 to 90 has made a difference. Seems as I upped the T3 in July the T4 went down is that possible.

thanks

[PurpleNails Administrator in reply to posthinking01]

FT4: 11.9 pmol/l (Range 9 - 23) 20.71%

FT3: 4.4 pmol/l (Range 2.4 - 6) 55.56%

FT4 is in low side and FT3 just above mid range.

I don’t have any experience of adjusting T4 & T3 - except to make small adjustments of either T4 OR T3 and re-test 6-8 weeks to see how adjustments settles (you likely know this) 

Did you test as recommended? and did you time doses prior to test? How long a gap between doses? 

Would make sense to me increase levo as previously a increase improved things. Your FT4 is lower than the FT3.  Some are not affected by low FT4 and others might suggest it’s your FT3 which requires fractional increase.  

“Seems as I upped the T3 in July the T4 went down is that possible”

Hard to say, what length of time was test after dose adjustment.    I’m sure I read others have said their FT4 rises too as less of the T4 is needed to convert to T3.  I think we each balance out differently.

Increasing T3 can cause the TSH to lower / suppress and this can mean less T4 is produced.  With an atrophied thyroid you’d expect very little is being produced.

[FancyPants54]

Yes increasing T3 will often lower your T4. I would be tempted to increase your T4 by a small amount. Something like cursing a 25mcg tablet in half and increase that each day.

[posthinking01 in reply to FancyPants54]

I have increased my T4 to 90 but no sure I can tolerate any more T3 I feel congested when I take more - I might need more adrenal support as I am adrenally insufficient.

[FancyPants54 in reply to posthinking01]

So just make sure it's a small T4 increase. Less than 25mcg. I do mine in 12.5mcg doses now. Or you could just increase by 2 or 3 x 25mcg tablets a week. Doesn't have to be the same every day, but I prefer it that way for me.

[posthinking01 in reply to FancyPants54]

I have so far taken an extra 10 mcg of T4 and will leave T3 alone until I get to see the endo.

[SlowDragon Administrator in reply to posthinking01]

Do you split your liquid levothyroxine into two or three smaller doses spread through the day?

[posthinking01 in reply to SlowDragon]

I take 70 in morning then add 10's twice

[SlowDragon Administrator in reply to posthinking01]

why not split as 45 waking and 45 mid-late afternoon (or bedtime )

[posthinking01 in reply to SlowDragon]

When I wake in the morning I look dreadful - I can see I need the metabolism needs speeding up - will try that tomorrow but not sure if my body could take it. I am so deficient that I need it when I wake up. Will try and let you know though - thanks.