first blood results after adding t3 advice please.

[Racheeeel78]

Hello 👋

I have been on t3 for 2 months through a private endo.

I was originally on 100mg of levo and my tSh and t4 were optional but was still symptomatic.

endo tested t3 and it was 3.4 so I started on 10mg of t3 & 75mcg of levo.

I feel good- main difference being im no longer showering my feet at 3am to warm them up and am feeling good on my 11 hour shifts again- and massive sleep improvement.

no weight loss though.

Lastest bloods are

t4 12 (was 22)

T3 5.4 (was 3.4)

endo said to add 10mg t3 in afternoon.

Do you think that will send me over active?

He said top end of range is 8 but I read everywhere us 6.8?

should I be worried about my decrease in t4?

also my ferritin has dropped from 52 to 15 could this be the t3?

(I did test 27 hours after both tablets as I take together- my appointment was 2 hour late)

No biotin.

thanks so much for your welcome advice

[Jaydee1507 Administrator]

We would really need the ranges for both tests to make any assessment.

Was your previous test done at the same lab as the current test? Just wondering about the large difference. They may well have a different range and be difficult to compare.

If you left 24 hours after your last dose of T3 before the test then what you are looking at is whats called a false low. Your FT3 would have been higher with a shorter dose spacing. You might be better retesting with the recommended timings of 24hrs for Levo & 8-12hours for T3. 2 hours late with a private Endo seems a bit rich!

Even if you take T3 in one dose, the day before the test split it into 2 and take second dose 8-12 hours before test is due.

We could ask radd about ferritin dropping so low when starting T3.

What are you other vitamin levels like?

[Racheeeel78 in reply to Jaydee1507]

Hi Jaydee,

Thanks for reply - I’ve attached my initial results from 2 months before taking t3

Todays results were via the phone and was told the above (t4 12 and t3 5.4). He will send them to my GP next week- is definitely sane lab as at same hospital. Apologies my t4 was 20 before t3 added and levo reduced by 25mcg.

Late- London transport and then I let two ladies go before me as they were older.

My vit D is top range at 150 has been for years.

B12 is 644

Thank you

First results pre T3

[Racheeeel78 in reply to Jaydee1507]

also if false low should I increase dose? I won’t see endo again for 8 weeks to re test and GP won’t test t3. He said t3 short lived so to add 10mg at lunch ( I take my first 5:45 am with levo. Would taking more t3 increase t4?

Thank you

[Jaydee1507 Administrator in reply to Racheeeel78]

Your FT4 has dropped a lot.

If the lab ranges are the same as previous test then these are the %'s.

Free T4 (fT4) 12 pmol/L (10.8 - 25.5) 8.2%

Free T3 (fT3) 5.4 pmol/L (3.1 - 6.8) 62.2%

You can add a bit on to the FT3 too as you left 27 hours after T4 & T3.

I would be concerned that an extra 10mcgs T3 could take you over the top and your FT4 according to these numbers is very low. I do wonder if you heard him right and might be better for you to see the numbers in writing.

No ferritin or folate result.

FT3 peak blood test

[Racheeeel78 in reply to Jaydee1507]

Thanks so much for reply.

I’ll hold off from adding the extra t3 until I see those results in writing.

My ferritin was done by GP early this year and again last week by endo. My TRBC was low too ( I have serious endometriosis & had two surgeries last year) but concerned to see such a drop in last few month.

His receptionist will email the blood test results to me this week so I’ll report back when I have in writing.

Thank you so much!

[Racheeeel78 in reply to Jaydee1507]

Hi Jaydee,

My results have been sent- the range for t3 is up to 8. Do you think best to add the extra t3, add extra levo or leave as is as TSH so low?

Thank you

Results

[radd in reply to Jaydee1507]

Racheeeel78

A drop in ferritin after introducing T3 signifies iron metabolising is changing (which is good).  Paradoxically the larger the iron deficiency the more mechanisims the body might put in place in order to prevent toxicity, a sort of misplaced safety mechanism that prevents members from easily raising iron levels. 

T3 will have increased metabolism that increases (kick starts) the whole erythropoiesis production/processes, ie RBC's, bone marrow, haemoglobin, from  iron absorption to transport to storage. This uses up a lot of energy and possibly already low iron reserves. You might have to supplement for a while if you aren’t already until iron levels normalise. 

Additionally, if you have Hashi low grade body inflammation (thyroid antibodies) change iron mechanisms by producing substances negatively influencing the development/storage/transport of iron. T3 will optimise thyroid hormones and help calm the whole autoimmune response and allow iron to be utilised better. 

[radd in reply to radd]

Christ-Crain M, Meier C, Huber P, et al. Effect of restoration of euthyroidism on peripheral blood cells and erythropoietin in women with subclinical hypothyroidism. Hormones (Athens) 2003; 2: 237-242.

Thyroxine administration has been reported to increase erythropoietin levels and improve erythropoiesis. This leads to increased requirement of iron and may culminate in manifestations of iron deficiency.

.

Erdogan M, Kosenli A, Sencer G and Kulaksizoglu M. Characteristics of anemia in subclinical and overt hypothyroid patients.Endocr J 2012; 59: 213-220.

Lack of stimulation of erythroid colony development by thyroid hormones in hypothyroidism, reduction in oxygen distribution to tissues and diminution of erythropoietin level in deficiency of thyroid hormones leads to anemia and the constituent effect on iron metabolism  Thus, the condition becomes a vicious cycle as iron deficiency may both be a cause and an effect of hypothyroidism.

[Racheeeel78 in reply to radd]

Hi Radd,

Thank you so much - I was worried as was such a steep drop in a short space if time as I was already supplementing to combat hair loss. I will carry on supplementing and hopefully will all even out soon. Thanks for sending the sources too - so appreciated!

[FancyPants54]

Even if your results are correct when you see them in writing, with such a drastic drop in FT4, I'd be tempted to increase my Levo by 25mcg again and keep the T3 as it is. As you are looking at a false low for this current FT3 result due to timing, an extra 10mcg of T3 could make you feel worse. It's such a fine balance and you feel quite good by the sound of it. Don't rock the boat, but do try to increase your FT4 (and iron!).

[Racheeeel78 in reply to FancyPants54]

Hi Fancypants54,

Thanks for reply. I will wait until I see the lab results in writing and If they are correct I will do as you advice- I’ve been overactive before as Dr started me off on 125mcg when diagnosed as was awful - couldn’t even climb stairs without wheezing. I think it’s best to do that and see what bloods say in 8 weeks, rather than potentially over medicating the t3 and under medicating the t4 - especially if already a false low.

Thank you 😊