If adding T3 should T4 be reduced?

[Lavender-Blue]

HI

If adding T3 does it affect T4 levels?

Does T4 need reducing?

Thanks

[SeasideSusie Remembering]

Lavender-Blue

Taking T3 can lower both TSH and FT4.

Does T4 need reducing?

To know whether you need to reduce your dose of Levo depends on what your level is before adding T3. If it's over range or at the top of it's range then reducing Levo before starting T3 is suggested.

[Lavender-Blue in reply to SeasideSusie]

Yes, my T4 is 17 (test A.M before meds when on levo alone).

[Lavender-Blue in reply to Lavender-Blue]

TSH: 7.1 mU/l (Range 0.27 - 4.2) 173.79%

FT4: 17.4 pmol/l (Range 12 - 19) 77.14%

FT3: 2.7 pmol/l (Range 3.1 - 6.8) -10.81%

[SeasideSusie Remembering in reply to Lavender-Blue]

Lavender-Blue

Your TSH is out of sync with your FT4 with those results, normally with a TSH that high your FT4 would be very low. I'm wondering if there has been some assay interference or whether either your TSH result or FT4 result has been skewed in some way. With TSH that high and FT3 that low one would expect your FT4 to be very low and rather than add T3 following those results one would increase dose of Levo to bring TSH down to 1 or below then see where FT4 and FT3 lie before considering adding T3.

Do you take biotin or a B Complex or any supplement containing biotin? If so did you leave it off for 3-7 days before the test?

Did you have water only before the test (some food/drink can interfere with results).

[Lavender-Blue in reply to SeasideSusie]

These results are a pattern, I had a TSH of 2.1 T4 24 and T3 was 3!

Been suggested I sm not converting!

No, I don't take biotin. I do a of juicing though, all vegetables.

I have had a lot of tests, all come back good except iron. On ferrous fumarate x2 per day.

[SlowDragon Administrator in reply to Lavender-Blue]

For good conversion of Ft4 to Ft3 or to use T3 we need OPTIMAL vitamin levels

Please add most recent results and ranges for

Vitamin D

Serum B12

Folate

Ferritin

Iron

How much levothyroxine are you currently taking

Do you always get same brand levothyroxine at each prescription

Do you normally take levothyroxine waking or bedtime

Iron supplements must be minimum 4 hours away from levothyroxine

[jrbarnes in reply to Lavender-Blue]

I had the same pattern as well. My FT4 was often top range and over. My FT3 was usually around 80% and I was functional but my TSH was still over 1 and at times more than 2. Eventually my FT3 dropped to 15%. The specific cause of my elevated TSH was not eating proper amounts of calories and carbs. This has a significant effect on your TSH. The Levo failed to restore my appetite which lead to under eating but I didn't realize this was happening because I ate whatever and whenever I wanted yet I wasn't eating enough. Just by increasing my calories and carbs I brought my FT3 up from 15% to 47% but you see this still isn't enough. I ended up here in the first place because Levo kept me deficient in the amounts of T3 needed and did not restore my metabolism. Pushing my Levo higher and higher only increased the actual amounts of thyroxine in my body and I became over medicated. This state of consistent hypo led to an iron, B12, and folate deficiency which made the hypo and low appetite worse. I had to go on a T4/T3 combo but currently am going T3 only. To correct my iron deficiency I did a little online reading and found that higher doses taken every other day leads to better and faster results. They were right about that. I took Thorne iron bisglycinate 100mg every other day for three months, testing every 4 weeks, and brought my ferritin and iron serum back up to a level where I could function. Since going T3 only my cycles are not heavy anymore which I think will have positive results on my iron.

[Lavender-Blue]

I take Vitamin D 5000 (soft gels by Dr's bedt, I think advised by SeasideSusie on here).

I will have to locate the printout for other tests).

I came off levothyroxine about 5 years ago due to similarities in suffering. At that time only TSH and T4 were tested. I was uneducated on the importance of T3 and even unaware of it!

[SeasideSusie Remembering in reply to Lavender-Blue]

Exactly what thyroid meds are you taking?

Your post 6 months ago showed that you were taking NDT.

You mention above that

Yes, my T4 is 17 (test A.M before meds when on levo alone).

Then

TSH: 7.1 mU/l (Range 0.27 - 4.2) 173.79%

FT4: 17.4 pmol/l (Range 12 - 19) 77.14%

FT3: 2.7 pmol/l (Range 3.1 - 6.8) -10.81%

What thyroid meds and dose gave these results and are they your current results ?

[Lavender-Blue in reply to SeasideSusie]

I am taking levothyroxine (again) now! Dose is 100mcg they are recent results.

I am just wanting to know if levothyroxine needs reducing if adding T3.

Does T3 influence T4 levels; either up or down?

[SeasideSusie Remembering in reply to Lavender-Blue]

Lavender-Blue

I am just wanting to know if levothyroxine needs reducing if adding T3.

Does T3 influence T4 levels; either up or down?

I answered those questions in my first reply. If FT4 is top of range/over range then a reduction in Levo is suggested before adding T3.

Adding T3 tends to lower FT4 level.

But as I said, your TSH level does not sit correctly with your FT4 level so it would seem that one of them is incorrect. Your TSH level would be about right with your current FT3 level, but one wouldn't expect to see FT4 77% through range with a TSH of 7.1 so if those were my results I'd be repeating the test with a different lab to try and get an accurate picture.

[McPammy]

when I introduced T3 my levothyroxine dose was not changed. My T4 was near the top of the range but my T3 was very low like yours. Both very similar to your results. My TSH was high too. My private only endocrinologist suggested to not lower the levothyroxine and we introduced 5mcg of liothyronine T3 twice a day 8 hrs apart. I also decided to split my levo dose to twice a day. I’m a poor converter with only converting 8% of T4 levo to the most important hormone T3. Virtually from day one of taking liothyronine T3 combined with levothyroxine T4 I felt a huge improvement. I could barely walk without T3. Now I go the gym and walk briskly virtually every day. My friends and family cannot believe the positive change in me. I feel great and younger and healthier.

I also addressed my low vitamins B12 and ferritin. I’m a vegetarian and didnt have enough of these vital vitamins. All sorted now with help from GP by getting regular B12 injections and ferris fumerate 210mcg on repeat prescription. My folate and Vit D however are good naturally. Be mindful of your diet. I now eat lots more fruit and veg.

I have now lowered my T4 levo dose by 10% 3 years on. I can do this easily as I take liquid levothyroxine normally but there is a stock out situation in pharmacies just now I reduced the Levo slightly to keep my TSH just about in range I feel a bit better and with keeping my TSH just about in range keeps my Endocrinologist very happy but most importantly I feel very well and energised every day

Hope this helps you.