Raising t3 without raising t4

[Vicky789]

Hi, just after some advice re increasing my t3. On paper my results look good, but I am still so fatigued! (Vitamins, ferretin levels all good as private bloods checked regularly)

I'm also taking HRT, recent test revealed oestrogen raised, (twice highest recommended level) so reducing my intake in case its that.

So I take 125mcg levo and 12.5mcg t3 daily, latest results

Free Thyroxine 22.2 (12-22)

Free T3 4.6 (3.1-6.8)

TSH 0.01 (0.27-4.2)

I also take d3+vit k (4000)

Magnesium

Selenium and zinc

Vit b complex (stopped 2 weeks before)

Advice on raising t3 without raising t4 please.

Thank you in advance

[SeasideSusie Remembering]

Vicky789

Looks to me like you could do with reducing your Levo and adding a bit more T3. Redeuce Levo first, wait a week or two then add in an extra 1/4 tablet of T3. Wait 8 weeks and retest to check levels and see how you feel. Balancing Levo and T3 is like a see saw and we're all different as to where we need the individual hormone levels.

[Vicky789 in reply to SeasideSusie]

Thanks Susie, that sounds like a sensible plan 😎

[DippyDame]

Your T4 to T3 converson is poor....high FT4 with low FT3

Adding T3 will naturally cause the thyroid to produce less T4

This may be of interest...

thyroidpatients.ca/2019/09/...

You could try adding another 6.25mcg T3 ( to your current dose of 125mcgT4 + 12.5mcgT3)....

if that goes ok then after2 weeks you can add a further 6.25mcg ( total 20mcg T3)...

then wait 6/8 weeks on 125mcg T4 + 20mcg and test

The results will point the way forward, post them here.

Are vit D and vit B12 optimal?... helps support conversion....good you are supplementing

The Vit D Council recommend a level of 100-150nmol/L (40-60ng/ml),

We are all different with different needs so trial and error is sometimes required to help find your therapeutic dose.

Good luck!

[Vicky789 in reply to DippyDame]

Thank you, I will need my brain to be working a bit better than today to digest the whole thing......I'll try again tomorrow 😅

[DippyDame in reply to Vicky789]

It will work once you are adequately medicated....I remember having a head like a tin of treacle....it's no fun.

[SeasideSusie Remembering]

Vicky789

Conversion doesn't really come into it when already on a combo of Levo plus T3, you are adding T3 exogenously so you can't tell how you convert now.

If you were taking Levo only with these results

Free Thyroxine 22.2 (12-22)

Free T3 4.6 (3.1-6.8)

we would be saying your conversion is poor because your FT4 is 102% of range with FT3 a mere 40.54% through range. We would be suggesting that you add some T3 but to reduce your dose of Levo first because it's over range. Yes, taking T3 tends to lower FT4 level, but when FT4 is high or over range it's usual to reduce the dose of Levo first to bring the FT4 down a bit before adding T3, see what happens then experiment adjusting dose to find the optimal levels for you.

So you are already taking combination thyroid hormone replacement but for most of us when on combo meds we often are OK with a lower in range FT4 as long as FT3 is in the upper half of it's range, with the caveat that we have to find the levels that are right for us as an individual, what suits me wont necessarily suit you. Hence my suggestion that you reduce your Levo now, you can do it gradually and maybe start with a reduction of 12.5mcg, then wait a week or two before adding an extra 1/4 of a tablet of T3. Thereafter make gradual changes to one or other of the hormones, only one at a time never both together, and wait 8 weeks after the dose change to check levels and how you feel before deciding on the next step.

Also, make sure that your key nutrients are optimal:

Vit D - 100-150nmol/L

B12 - near top of range for Total B12, for Active B12 over 100 is recommended

Folate - at least half way through range

Ferritin - some experts say the optimal ferritin level for thyroid function is 90-110ug/L.

[DippyDame in reply to SeasideSusie]

I think my old brain is back in the treacle tin!

Time to give it a break!!

Thanks Susie

[SeasideSusie Remembering in reply to DippyDame]

Don't worry, I'm actually surprised mine is working at the moment!

[DippyDame in reply to SeasideSusie]

Thank you!

[Vicky789]

I appreciate the advice. Having been unwell on and off since 2017 and chopping and changing antidepressants 2 years, HRT the past year, Clonidine for excessive, and I mean excessive, sweating, and getting over the death of my Mum in August, who i nursed for 2 years whilst Motor Neurone Disease robbed her of the ability to move, talk, swallow and eventually breathe.

Consequently i am sick of not knowing which of the above (or something else which will be overlooked because i am a middle aged woman) is making me feel so bleugh.

I will be going down the more cautious route. I have recently had covid, for the second time, despite 4 covid jabs which leave me ill for a week each time (better than dying obviously), but I'm sure it leaves me mentally slower each time,

[Persevere99 in reply to Vicky789]

sorry to hear about your mum Vicky

All the best

Persevere99

[Vicky789 in reply to Persevere99]

Aww thanks. I don't know how people cope with sudden death, I watched mum deteriorate over 2 years, and she was better off gone in the end, but I still somehow cannot comprehend that she's gone. Well I can, but forever is such a long time.