these are my latest results. I’m on combo t4/t3. 150 t4 and 15 t3 taken once a day in the morning.
This time there was 11 hrs gap from doses to testing .
13/3/23 Monitor My Health 150mcs Levo plus 15mcgs T3Tested at 7pm 11 hrs after doseTsh <0.01 (0.27-4.2)Ft4 20.1 (12-22)Ft3 5.8 (3.1-6.8)
Are these giving you a better idea than my previous posts where there was a 24hr gap
Thoughts please.
All sound advice from SD, with results like that I'd be inclined to think you are suffering from too much T3 and with high fT4 which is then creating reverse T3 which you possibly aren't clearing and is causing you problems.
Have you tried reducing your T3 a little to see how you feel?
I can’t see where SlOwDragon has said possibly too much T3?
I thought she said combining the two results tgat my results look “perfect”
Where is she saying that?
I meant I agreed with SD’s comments and the suggestion to try a small reduction is my 2 penneth.
You are top end and may have gone past your personal sweet spot which can feel like you are under when actually you are over cooking it
my biggest problem is having a knotted anxious feeling in my tummy which can get to the point that it’s very uncomfortable and almost hurts . It’s like I’ve got a tight band around my waist and above it.
Funnily enough, I only took 10mcgs t3 this morning.
Is it really possible I’ve gone past my sweet spot?
I don’t think the ft4 is worrying is it
I would think you perhaps need to throw yourself at the mercy of your GP with the tummy pain to get that checked out...
It is so tricky to know what is going to be optimal for an individual, I wouldn't be inclined to mess with your T4 as that is in a generally good area and takes weeks to alter, I would be inclined to lower your T3 for a couple of days and you should quite quickly feel if this is a good move or not and quickly revert back if other symptoms arise....
Too much can be as bad as too little
personally as first step I would recommend trying splitting T3 as 3 x 5mcg dose
5mcg waking, 5mcg mid afternoon and 5mcg bedtime
Approx equal 8 hour intervals
Do this for at least 6-8 weeks
Before trying anything else
Only make one change at a time
Other changes to try after that
Splitting Levothyroxine as half dose waking and half dose bedtime
do people of my age 70 actually need the same level of ft4 and ft3 as when younger?
That's a question.... there are so many variables with weight, activity levels, stress etc..... some say they have reduced their dose after menopause so I would guess if you become less active your need would likely be lessened as with calories etc?
Hi Eeyore100 and 130396,
I take 150 mcg Thyroxine and 12.5 mcg Liothyronine. I feel very well.
But for three days I took an extra 6.25 mcg Lio in the morning with the Thyroxine.
I take 12.5 mcg at bedtime.
Three days in I had some obviously over the top adverse symptoms. Heart rate was high, anxiety, etc. Thank goodness T3 has a short half life so I just told myself to hang in there and calm down. I skipped a 12.5 mcg dose and did not take another 6.25 mcg morning dose. All's well. No more experimentation. I've got the sweet spot.
Eeyore100 130396
I'd be inclined to think you are suffering from too much T3 which is then creating reverse T3 which you possibly aren't clearing and is causing you problems.
Reverse T3 is a metabolite of T4, it is not produced by high T3.
Reducing T3 will not lower rT3
In any case, rT3 is inert and only stays around for a few hours before being converted into T2....
It is unlikely to cause ( long term) problems
Sorry....but thought I'd better clarify.
Glad you did! 😅It was a rushed response...
I didn't really explain very well, I was thinking with good levels of T4 and then one hit of T3 mightn't bring about the best results... SD's advice to split the dosing is most sensible
You may find this interesting re rT3
thyroidpatients.ca/2019/11/...
Splitting is a very personal thing! I need 112.5mcg T3-only to function, this I take in a single dose at bedtime, with no problems.
you say you think I could be suffering from too much T3 but then you say not to reduce it so I don’t understand any of it
NO!You are reading the wrong replies.I did not say you could be suffering from too much T3....that was Eeyore100
See my reply to Eeyore100 re rt3
I
you tagged me in the reply to eeyore
The bold text was what Eeyore100 said .....not me.
It's how we emphasise quotes, might have been clearer if I'd used inverted commas.....sorry.
Underneath I have explained why her comment was misleading.
It was meant to also explain rT3 to you
ahhh ok. Thank you.
Wish I’d never posted anything now
No....please keep posting
I learned a lot from posting.
No, don't stop! It's the only way we all learn. Sometimes it takes time to read everything carefully, a few times to understand it all.
well now I don’t know whether to lower both t4 and t3 .
I thought putting my results in 11 hrs after last dose of f3 would give enough inflammation for me to get some advice.
SlowDragon was the only person that combined the two sets of results to ascertain the results based on 24hrs and then the ft3 for 11hrs.
I think the point is not everyone can feel comfortable with an fT3 at 5.8 with top of range at 6.8. My endo experimented with me and I did my own experiments driving fT3 up to 5.6. For some people that's fine but for some peoplel it's too high and causes symptoms.
One thing I got, which I discovered by chance was huge blood glucose swings when the dose of T3 was at 18.25 mcg. It also gave me tinnitus. My blood glucose would rise to over 18 and crash to low 3s. I would start shaking and be extremely hungry. Even my vision was affected so I don't know how low it actually went but for sure it was very low below 3. Tired Thyroid site has information on what excess T3 can do and even though my endocrinologist knew nothing, there is also more information available that too much T3 can screw with blood glucose. It's easy to gain weight when this phenomenon is happening because of intense appetite.
Studies of healthy young people with no thyroid problems show that normal fT3 ranges from between 5.2 and 5.6. If your fT3 is 5.8 12 or so hours after the last dose, how high does it go at its highest? I know, based on repeat testing at different times after the T3 does what my levels were. These days my +12 hr test result is 4.8. For me that's comfortable. For sure a couple hours after taking the 12.5mcg it is probably in the 5s. I take it before bedtime because normal fT3 rises after 10 p.m. and I'm trying to imitate that.
I have a knotted feeling in my tummy almost all the time. Even when my ft3 is at 4.1 25hrs after taking it I still have it.
The 5.8 was after 11hrs gap.
I’m getting nowhere however I take and test it
Hi again 130396
I agree the thread did go off in all directions not all of them helpful
Bottom line...the important question is, " how do you feel?"
If you feel well then do nothing because your labs look very good.
I replied re your tummy ache in your earlier post...
healthunlocked.com/thyroidu...
However, if you have any of the following symptoms, then it might help if you reduce T3 to 10mcg, wait 6 weeks, test again and note any changes in symptoms
nervousness, anxiety and irritability
hyperactivity – you may find it hard to stay still and have a lot of nervous energy
mood swings
difficulty sleeping
feeling tired all the time
sensitivity to heat
muscle weakness
diarrhoea
needing to pee more often than usual
persistent thirst
itchiness
Hope this is a wee bit more helpful.
Take care
So should I try the reduction to 10mcgs and see if it makes a difference to this tummy feeling?
When I was on Levo only for over 28 years I was only on 125mcgs
Worth a try
it’s all experimental as to what to change
Only change one thing at a time and wait 6-8 weeks to assess
personally I would try splitting T3 as 3 doses
or
Try gluten free diet
I did used to split it into 3 doses and it wasn’t any good for me. That’s why I take it all at once now.
As for gluten I don’t eat much food regularly that have gluten in it
The point with gluten is if affected you can’t eat any gluten
Being “almost” gluten free is waste of time
it needs to be absolutely strictly gluten free
Nothing with wheat, barley or rye in
Read all ingredient labels
Latest thyroid function results
My latest test results
Latest blood test results
LATEST BLOOD TEST RESULTS
Latest test results - hypothyroid 
previous test with last dose 24 hours before test
21/2/23
150 Levo 15mcgs T3
TSH <0.3 (0.35-4.94)
Ft4 16.8 (9-19)
Ft3 4.52 (2.6-5.7)
So if we combine the two
Taking TSH and Ft4 results from testing morning and 24 hours before test ……and Ft3 from 12 hours before test
TSH <0.3 (0.35-4.94)
FT4: 16.8 pmol/l (Range 9 - 19)
Ft4 is 78.00% through range
FT3: 5.8 pmol/l (Range 3.1 - 6.8)
Ft3 is 72.97% through range
So these results look “perfect “
How do you feel
Important to test vitamin D, folate, ferritin and B12 at least annually
What vitamin supplements are you currently taking
Is your thyroid disease autoimmune?
hello SlOwDragon
Ft4 was actually 20.8 11hrs after dose not 16.8….
Well I have a knotted feeling in my tummy most days. I’ve gained weight. Constipated. Thinned hair. Rarely feel tired.
Last time I had my B12 tested without supplementing it was 615 top of range 640
Folate was 6.4 before supplementing and over range after supplementing.
Vit D 101
Ft4 was actually 20.8 11hrs after dose not 16.8….
Yes, I realise that
But last dose levothyroxine should be 24 hours before test and ONLY T3 should be 8-12 hours before test
When were iron and ferritin levels last tested
as I only dose once a day I was previously asked to test 12 hrs after dosing with t3 which is what I did.
sorry SlowDragon. I see what you’re saying now!!
Using the ft4 from the 24hr result and using the ft3 from the latest results!! Silly me.
So as far as you’re concerned you think my results from those two are good?
My B12 was 615 top of range 640
Folate before supplementing was 6.4 but went over range after supplementing
Ferritin was 101 I think
Vit D was 125
My RBC has dropped a bit also wbc is now below range
no SlOwDragon
You say my results look perfect but I have terrible constipation and have to take laxatives every day
sorry SlOwDragon . I forgot to say I have a feeling in my tummy like it’s knotted /anxious most days to the point it feels tight and uncomfortable
Are you gluten free? If not, have you tried going GF for a few weeks? That may help
no I’m not gluten free. I have no idea what I can eat that is gluten free.
I’ve been hypo for over 38 years and never had a problem with gluten as far as I’m aware
What kind of things do your normally eat? There are the obvious things you need to think about in terms of buying gluten free substitutes, like bread and pasta (and if you're wanting treats, gluten free cakes and biscuits). Then of course there is the hidden gluten, so that means checking everything, especially stuff you wouldn't necessarily think of like sauces, stock cubes etc.
However, there is also a lot that is naturally gluten free. Meat and fish (assuming you're not veggie like me), dairy, vegetables, fruit.
Don't get me wrong, it is a lot to get your head around to start with, but it does become much easier as you go along. I'm vegetarian, and have been gluten free for coming up 3 years now (I basically eat as if I am coeliac, so don't eat any may contains, am careful with cross contamination when out, our house is completely gluten free etc). We also low carb most of the time, and find it pretty easy to do all of that whilst being gluten free. Eating out takes a lot more organisation, but we don't do it that often, and when we go away I do a LOT of research so we always have a list of places to go.
why after nearly 40 years would I need to go gluten free ?
I was more answering your question as to you saying you had no idea what you'd be able to eat if you are gluten free.
I don't know if your hypothyroidism is caused by Hashimoto's (I may have missed you saying that and haven't looked at any other of your posts), but if it is, it's highly recommended you do a trial of gluten free. I think it's @SlowDragon who often puts up a post about the benefits of trialling gluten free (apologies if that's the wrong person though!).
A lot of people with autoimmune thyroiditis can benefit from a gluten free diet. Having problems with gluten doesn't just manifest itself in having tummy issues, a lot of the symptoms of hypothyroidism overlap with coeliac disease or gluten intolerance such as fatigue, sore joints, brain fog etc. It is also possible to have no symptoms at all, but still be causing damage internally.
It was only a thought. Your symptom sounds rather like mine. It's maybe worth thinking about.
Gluten sensitivity can develop at any time I believe. It happened to my father (diagnosed as coeliac when he was 75) and I am definitely being affected now ( and I'm early 70s)
have you been tested for gluten ?
Are you now gluten free?
I've had 2 negative blood tests.
Before the second one last year, I'd gone gluten free and felt loads better. They agreed to test me again, so I ate a full gluten diet for nearly 6 weeks beforehand. That second test was also negative, but I felt awful eating gluten again.
Since then I've cut out gluten again and have stopped being bloated, no pain, and less tired. Each time I have eaten gluten since, I've felt those symptoms again.
I know the definitive answer would be to have an endoscopy/biopsy, but I don't want to eat gluten again for 6 weeks!
My dad has several blood tests but they were negative. When he 75 he had the endoscopy (it was positive for coeliac), and the consultant rang him to apologise that he hadn't diagnosed him earlier.
has the feeling in your tummy like mine gone then?
what are the symptoms of gluten sensitivity?
You might find my profile interesting
I had zero symptoms of gluten or dairy intolerance….. turned out to react significantly to both
The only way to know is to try it
The GP can do a blood test, but unfortunately these give many false negatives. The definitive answer is from a biopsy. Before either, you need to be eating gluten for at least 4 weeks.
very common to develop gluten intolerance and/or dairy intolerance the longer we are on Levothyroxine
many of us turn out to be gluten and dairy intolerant
Like many I was astonished at transformation cutting gluten out …… and again recently cutting dairy
Gluten in wheat, rye and barley
Get coeliac blood test ideally before cutting gluten out as 3-6 months trial
I tested negative for celiac
so you can immediately trial strictly gluten free
Only 5% of autoimmune thyroid patients test positive for coeliac
But further 81% find gluten free is noticeable or significant improvement or absolutely essential
You don’t need to have any obvious gut symptoms
suggest you spend next fortnight working out what you would eat instead at each meal before taking the plunge
No point being almost gluten free
I’ve looked at the list of gluten foods and I really don’t eat them regularly
There is gluten in all sorts of foods you don't think about. Soups, sauces, dressings, cereals, snacks in packets, sweets and chocolates. Sausages too. You have to read the ingredients list on everything if you want to try it and you can't eat just a bit of it, it all has to go to let the gut heal and see if you have any positive improvements as a result.
I was gluten free for around 18 months at one point. I lost a ton of weight, but probably because I was eating a much healthier diet. I didn't notice other benefits though and I do now eat gluten again. I was not diagnosed with hypothyroidism back then. I found I didn't like or want the gluten free substitutes of bread etc. I just ate different meals. Salads in a Tupperware box for lunch at work instead of a sandwich, that sort of thing.
I don’t think I’m sensitive to gluten as I don’t have the symptoms of it.
You won't know if you don't try. You have symptoms. That's enough. But you do need to be in the right frame of mind to go gluten free, and you don't sound like you are to me. You are fighting all the suggestions of it. I'm not advocating it for you. Just explaining what it entails. I'm glad I tried it and ruled it out. It was one less thing to play at the back of my mind.
what symptoms of it do I have?
Bread, cakes, biscuits, sauces, pasta, pizza etc etc
Wheat is hidden in thousands of products