Thyroid T4

[foxglove]

Results from monitor my health T4 =9. said to be low (12-14) normalDoes this matter and if so how can I raise T4?

[PurpleNails Administrator]

please can you add all your results - TSH & FT3

Do you have a diagnosed thyroid condition? What replacement do you take?

Do you have symptoms?

[foxglove in reply to PurpleNails]

hi, TSH 1 .41 (0.27-4.2), FT4 9 (12-22) FT3 4.2 (3.1-6.8)

Diagnosed with under active thyroid, take 1 grain thyroid-s

No symptoms

[DippyDame in reply to foxglove]

You are taking 1 grain (60/65 mcg) of NDT which contains 38mcg T4 + 9mcg T3

When you add T3 the level of FT4 naturally drops...but at 4.9 (12-22) this particularly low suggesting undermedication.

TSH becomes irrelevant after replacement hormones are added....yet medics claim it is the most important lab!

The most important result is FT3 ( the active thyroid hormone) followed by FT4

Your FT3 is only 29.73% through the ref range which is low...we aim to have both Frees roughly approaching 75% through their respective ref ranges. This low FT3 result also suggests undermedication.

How long were you taking 1 grain before this test...should be at least 6 weeks as I'm sure you must know

When did you take the test in relation to last dose of NDT?

Have you checked through this list to eliminate all possible symptoms? There are many!

Suggest you tick off/ make a list of any that resonate.

thyroiduk.org/if-you-are-un...

[foxglove in reply to DippyDame]

Hi thanks , I think you've misread my FT4 is 9 ...not 4.9! don't know if this makes a difference. Been obeying all advice re timing of meds. etc!!!!

[DippyDame in reply to foxglove]

So it is!

Sorry, eyesight!

Clearer spacing might help

Still suggests undermedication though

I was focussing on FT3

Suggest you need an increase

[foxglove in reply to DippyDame]

Thanks, understand re eyesight... (Me too) and the spacing was a tad close...my fault.

I do feel in need of a boost -anything to help this tiredness I feel.

I have some levo- 25mcg, Do you think taking this with the 1 grain thyroid-s might work? I value your thoughts and anyone else who cares to reply!

I've got a feeling I'm going to try anyway. Problem is I'm impatient and realise I will have to wait 6-8 weeks before retest (alas )

[tattybogle in reply to foxglove]

any reason why you are not considering just increasing the NDT dose a bit ?.. to eg 1 and a quarter grains.

[foxglove in reply to tattybogle]

not really, in fact I'm going to add the extra thyroid-s it was just the thought of splitting all the pills that was bugging me!

[foxglove in reply to tattybogle]

Just about to start splitting tablets now!

[DippyDame in reply to foxglove]

just the thought of splitting all the pills that was bugging me!

Hardly the best way to decide on your dose!

Only split the tablets as you need them....not "all"!

[foxglove in reply to DippyDame]

Agree!

[foxglove in reply to DippyDame]

Thanks thinking on I have GP app 7th Mar o will see what she thinks

[DippyDame in reply to foxglove]

Don't apologise! I just need to double check more!!

Would you be open to adding a quarter grain of NDT...that would raise your FT3 better than adding 25mcg levo....and it's T3 you need to raise right now

A quarter grain would add 2.25mcg T3, it may not be enough, but we have to increase very slowly. The extra 9.5mcg T4 will probably make little difference...no matter right now. It's a work in progress!

I fully understand impatience! I learned the hard way and learned quite quickly how important it is to give the body time to adapt to more hormone.

The other point than can cause confusion is that often after an increase we feel better only for symptoms to return later. At this point people start to assume the med isn't working..... not so!

Instead, what has happened is that the body has reacted as "Whoopee, more T3, I needed that"...which lasts until that initial joy wears off and symptoms return... as the body realises it needs still more hormone.

A further increase is then due in 6/8 weeks

It can be a really long, boring ,trying (lonely even) process...it took me over 2 years to find my therapeutic T3 dose. Though I have a complicated form of hypothyroidism.....

It seems a tiny amount but T3 is a powerful hormone.

As I said earlier FT3 is the most important reading.

i'm probably telling you what you already know....if so, sorry!

But....T3 is the active thyroid hormone ....to become active it must reach the nuclei of the cells which for nearly everyone happens naturally. (It didn't for me hence my long drawn out journey!!)

If FT3 is low then there is not sufficient in the serum to reach the cells via T3 receptors....then symptoms occur

Low cellular T3 = poor health.

Exactly when did you last alter your dose?

If more than 6 weeks then I'd suggest you add the extra quarter grain now....and then sit it out for another 6 weeks and test again.

Sorry....it's a bit of a rant but hope it helps!!

[PurpleNails Administrator in reply to foxglove]

Many feel best with FT3 over mid range point, but we are all different - if you feel well with FT3 lower with-in the range that’s fine for you. 

Lots feel fine with under-range or low FT4 provided FT3 is where it needs it to be.  

If you increase thyroid s or introduce levo your could feel over medicated, or your TSH may drop.  

Low TSH is disliked by doctors but many have low TSH when using NDT.  

There is room to increase as FT3 as lower in range & TSH not bottom of range.

What time was test taken?

Was dose taken before test or was there a delay.

Had you adjusted dose at all in the 6 weeks prior to test.   

[foxglove in reply to PurpleNails]

Thanks have followed advice re timing of test and medication