T3 continues to drop

[aptucxet]

I was diagnosed with hypo and hashimoto's about a year ago. I was started on 25 mcgs of Levo.......gradually increased to the present 75 mcgs. My T3 continues to drop, and is now just a bit below the range. I am wondering if perhaps I am not converting T4 to T3 and should therefore be taking T3 along with the T4. My TSH is now at 1.1 (.45 - 4.5) Thank you for your thoughts.

[SeasideSusie Remembering]

aptucxet

For us to be able to respond meaningfully, please add your results plus their reference ranges for all tests done, not just TSH.

Also, please confirm when you took your last dose of Levo before the test, it should be 24 hours before blood draw and test should be done ideally no later than 9am before eating or drinking anything but water, and leaving off biotin or B Complex for 3-7 days before test.

[aptucxet in reply to SeasideSusie]

Susie.........results of the March 29th blood tests

Tsh 1.1 (.45 - 4.5)

T4 1.54 (.82 - 1.77)

T3 1.9 (2 - 4.4)

Blood drawn at 8 30 a m ...........more than 24 hrs after last dose of 75 mcgs levo ........and 4 days after biotin........all of my vit D and B12 tests are in good shape. I believe previous blood test results have been posted earlier. Thank you very much........with the current T3 being below range, I am concerned if I am converting T4 to T3

[Charlie-Farley in reply to aptucxet]

Hi aptucxet

Can you tell us your weight? This was the NICE guideline that was ignored in my case (and seemingly many others) and I was left under medicated for a long time. TSH may go below range but not a problem compared to the issues with being under medicated.

Dosing by weight guideline is 1.6ug per Kg. But once again this is a guide.

[aptucxet in reply to Charlie-Farley]

My weight is 145 pounds .......5 feet 10 inches tall.....definitely not overweight.

[Charlie-Farley in reply to aptucxet]

Hi Aptuxcet you certainly arn't! 🤗

Wish I could say the same, but with dosing by weight it's kind of the bigger the car, the bigger the tank, the more fuel required - you get my drift. I'm 15 stone - I don't like to think about it in pounds as it is such a big number 😂. I calculated a guideline dose for myself of 150ug and found (luckily this was optimal).

There's room for another dose increase 😉

Once this avenue has exhausted then look at conversion. It's a case of working through the variables. SlowDragon and Seasidesusie give good advice (they gave me good advice too along with some other amazing forum members).

[aptucxet in reply to Charlie-Farley]

Slow Dragon recommends increasing the Levo and re checking again in 6 to 8 weeks.......perhaps if my T3 is still under range, I might add T3 to the mix

[Charlie-Farley in reply to aptucxet]

A sensible and logical route forward.

And you already have plan B. 🤗 I'm on an even keel now and a million miles from the depths of despair I was experiencing grossly under medicated and mismanaged, but there is always a chance things have to be tweaked going forward - we are not steady state objects, but organisms in a constant state of flux - perhaps this is something we become more aware of through this journey.

[SeasideSusie Remembering in reply to aptucxet]

aptucxet

Blood drawn at 8 30 a m ...........more than 24 hrs after last dose of 75 mcgs levo

Do you know exactly how long before the test you took your Levo? It's best to leave a gap of 24 hours, this ensures we don't get a false low FT4 by leaving longer than 24 hours (or a false high FT4 by taking Levo before test).

I'm surprised your TSH is over 1 considering that your FT4 is quite high in it's range, could anything have affected TSH result such as eating breakfast, having coffee, tea, or other caffeine containing drink?

[aptucxet in reply to SeasideSusie]

It was about 26 hours after the last Levo dose..........and a 14 hour fast prior to the blood draw.

[SeasideSusie Remembering in reply to aptucxet]

OK, that's not too bad then.

I take it the T3 test is a Total T3 rather than Free T3? It's the free T3 that's available for the cells to use and that's the more useful test to tell us about conversion.

[aptucxet in reply to SeasideSusie]

Yes, the test shows free T3

[SlowDragon Administrator]

Request increase in Levothyroxine first

Initially to 87.5mcg daily

Retest in 6-8 weeks

[aptucxet in reply to SlowDragon]

Thank you.....so it is best to try an increase in the Levo.........before considering adding a T3 prescription.

[SlowDragon Administrator in reply to aptucxet]

yes….. always

Levothyroxine is much easier to manage

If it doesn’t improve FT3, or you can’t tolerate increase ….. then trial of adding T3

[aptucxet in reply to SlowDragon]

Thanks very much.. I am now better informed when I see my doctor in 2 weeks.

[silverbelle51]

How is your selenium levels , if you are low you may not be converting . A supplement that can be purchased over the counter could be the answer!

[aptucxet in reply to silverbelle51]

I'm sorry, I missed your post earlier.......I do take a selenium complex supplement.........thank you for asking 👍