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[joey82]

Last thyroid function test... 15th December. 150 mcg day.

TSH 1.48 range: 0.27-4.2

FT3 4.6 range: 3.1-6.8

FT4 18.8 range: 12-22

Last May when I was almost symptom free;

100mcg T4 & 20mcg T3 daily;

TSH 0.52 Range 0.27-4.2

FT3 7.4 Range 3.1-6.8

FT4 13.8 Range 12-22

What do you guys think?

[Jaydee1507 Administrator]

Current results:

Free T4 (fT4) 18.8 pmol/L (12 - 22) 68.0%

Free T3 (fT3) 4.6 pmol/L (3.1 - 6.8) 40.5%

May results almost symptom free:

Free T4 (fT4) 13.8 pmol/L (12 - 22) 18.0%

Free T3 (fT3) 7.4 pmol/L (3.1 - 6.8) 116.2%

I think the issue with your T4/T3 combo was your low FT4. Ideally it would be around 60% as would your FT3. It was quite an inbalanced result.

Hopefully you will feel a bit better once you get your FT3 over 50% which could happen with the next dose increase.

[pennyannie]

Hello Joey :

Can you remind me what you were diagnosed with please ?

Was it your choice to stop the T3/T4 medication and take T4 monotherapy ?

Were you initially taking T4 - Levothyroxine only ?

It's such a shame as you say you were almost symptom free - so - how are things now ?

I read this can be a difficult thing to do as the body adjusts itself the longer you are on a T3/T4 combo and with T3 said to be around 4 times more powerful than T4 you may well be struggling on T4 only.

On a T3/T4 combo the TSH will be suppressed and the T3 can also lower T4 levels and t's more about being without symptoms and even though your T3 a little over range this could just be a dosing and timing issue unless you felt unwell - which you didn't.

On T4 monotherapy we generally feel best when the T4 is up in the top quadrant as this should in theory convert o a good level of T3 at around the mid 5's.

Your T4 needs increasing and that in turn should lower your TSH as we generally feel improved when the TSH is down towards the bottom of the range.

P.S. No thyroid hormone replacement works well until ferritin, folate, B12 and vitamin D are up and maintained at optimal levels :

[joey82 in reply to pennyannie]

HI,

Hashimotos. It was a decision me and the private endo took to come off combi T3/T4. My tinnitus was really bad and he thought it may be because my FT3 was really high at the time. Plus I was still heavily symptomatic. Been on T4 only since early November. Initially T4 only with NHS GP. And I felt pretty rubbish. NHS endo was a waste of time.

I have felt quite unwell for 2 weeks now. Light headed, almost dizzy at times. Nausea, lack of energy, tinnitus and normal hypo problems. There has been a small improvement with my dry eyes, tinnitus, morning groggyness. I've had a couple of good weeks here and there which is nice, and the odd day. These small improvements gives me hope I am going in the right direction with T4 and if I keep going I will get there.

I really hope the T4 works. As to go through the whole trial and error with NDT and T3 breaks my heart, as I know that will mean a long time of feeling so unwell.

Really going to concentrate on getting optimum levels and checking for leaky gut over the next few weeks.

Thank you.

[radd]

joey82,

Many/most of us have experienced your symptoms and because they are perpetuated by each other and self sustaining, and all with brain fog it can be tricky to see ahead. 

I think you were previously T3 overmedicated. You advised in a previous post that blood was drawn 12 hours after previous dose that would give a lower than average result but your results was still over range. T3 or NDT can also be tricky to introduce with insufficient adrenal reserve, and/or iron/nutrient deficiencies. Also if we have very elevated thyroid antibodies at the time of introducing new meds.

Our sweet-spots are very narrow and extremely individual regarding levels and ratios of FT4:FT3. I would guess you’ve missed your sweet-spot that is often disguised behind all these symptoms that can lag several weeks/months behind good biochemistry. 

The goal is to establish why Levo isn’t working for you, and when all possibilities have been exhausted, then you think about adding T3 or NDT which is always available but not necessarily through the usual NHS methods. Some of us have private endos/prescriptions and others self source meds from abroad, guided by others members experiences.

You’ve already received great advice regarding testing, etc so I will only mention the tinnitus. Try increasing your magnesium intake. I have read studies showing magnesium deficiencies to be a cause and upping my intake decreased my own tinnitus. However, yours may not respond so well until thyroid meds are sorted.

If I was you I would write down where you are at now, ie meds, test results, symptoms no matter how small and include temps and pulse. And then write a weekly plan whether it be something small like check out some supplement or larger such as investigating an adrenal test (for example). You will receive much good advice from members and it can be overwhelming so pick, choose and bookmark anything of value.

Above all remember how unwell unmanaged hypothyroidism can make us feel physically and mentally, and that everyone behaves badly at some point in their life, and believe you will get better but it can take time. Once we regain a level of wellness and the brain fog clears everything becomes more manageable. Regarding the rages, members have detailed these when FT3 has been excessive levels but also testosterone. All hormones work together and sex hormones become notoriously unbalanced when we are left hypo for too long.

[joey82 in reply to radd]

Thank you Radd. I really appreciate your advice and will take it forward. My blood test is in 3 weeks and I will post my adrenal results on here soon and see what people think. Definitely going to work on my nutrition and vitamin intake, although I am already taking supplements

[Lulu2607 in reply to joey82]

Hi Joey. Just wondering if you have had covid at all? I have hashimotos too and my symptoms have been all over the place recently. In discussion with a specialist (not thyroid) he said having covid (which I've had) can interfere with autoimmune thyroid levels and close monitoring /adjusting of doses might be needed at that time. It may not be relevant to you but I thought I'd mention it. Many people aren't testing for covid now and may not even know they've got it or had it. I might also add that I get tinnitus from time to time and a recent test showed vitamin d deficiency which could be contributing to that. Vitamin d deficiency is hugely common and more so in hashimotos patients. I don't know if you've had that checked lately. I started high dose vit D and feel better in a number of ways. I hope things settle down for you soon.