I posted my results last week and used slow dragons response to craft my request for a dosage increase of synthroid. She responded that my tsh was so low that I run the risk of becoming hyper if synthroid is increased..she did agree to add t3 in 5mcg and new labs in 8 weeks. I don't really have any questions, but just wanted to post this somewhere that others understood. I am a bit nervous about the t3 but I'm going to give it a go. Any advice aside from starting out slowly with it? Here are my precious results just for reference. Vitamin d was low but I forgot the actual result. I'm taking the d spray.
Free T4 1.24 range: .82-1.77
Folate 12.7 range: 3 and up
TSH 0.549 range: 0.45-4.5
Ferritin 87 range: 15-150
Free T3 2.6 range: 2.-4.4
B12 433 range: 232-1245
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spookyscaryskeletons
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I'm also in the US. I don't like Synthroid because it's the most expensive and has more fillers but it's a good thing they're going to raise it because your FT4 levels are still low. You won't become hyper because your FT4 levels are so low currently. What matters is your FT4 and FT3 levels. The TSH is a tool to help diagnose thyroid disease and Drs should not be focusing on the TSH solely when treating with Levo. A person with thyroid disease on Levo will need higher FT4 levels than a person with a healthy thyroid so obviously your TSH is going to be lower or even suppressed but this isn't the same as being "hyper." Sadly most general physicians are old school or ignorant in this area, especially endocrinologists. I currently see an RN at a functional clinic. Probably want to get FT4 closer to 1.4 and higher just depending on how you feel when adding the T3 to it. These doses should be increased every 6 weeks until they reach that level. Your FT3 levels are really low. I need mine to be closer to 3.8 and higher to feel normal. A lot of people like to split the T3 and take it 2-3 times a day and others take it all at once. To split the 5mcg is a little more challenging but I bought a splitter online. Your ferritin looks good but B12 is on the lower end. I like Metagenics Intrinsi B12. They also make a vitamin D +K. This is an excellent brand. Good luck! see link below on optimal labs
i would take the offer of T3 at this point and try it .
hopefully your Doctor does realise that adding T3 is going to lower your TSH just the same as increasing Levo would (in fact it will probably lower it more than a levo increase would have )
your TSH is currently in range ( just) and your fT4 is only 45% through range ... so her comment that 'increasing Levo risks making you hyperthyroid' is not really correct.
~ Whether you increased Levo or added T3 , either way it risks sending your TSH below the reference range yes , but that is not the same thing as being overmedicated/ "hyper"
you would only be overmedicated if you developed symptoms of overmedication, or, if your fT4 / fT3 were over range. Having a slightly below range TSH does not necessarily mean the patient is overmedicated.... many are not.
But...... while i don't agree with her reasons for saying no to a Levo increase...
...... i do agree with her advice to try adding some T3 at this point, rather than increasing Levo.
......because if you look at your fT3 results since you started taking Levo , you will notice that it was previously quite good and your own production of / conversion to T3, has fallen lower and lower as your TSH has gone lower .. so adding some T3 back to try to rebalance T4/T3 levels seems quite reasonable to me .
April 2022 on 50mcg Levo fT3: 3.97 [2.5 - 3.99] 98% .... TSH 1.42 ..... fT4: 0.79 [0.6 -1.6] 19%
June 2022 on 50mcg Levo fT3: 3.28 [2.5 - 3.99] 52% .. TSH 1.22 .... fT4: 0.89 [0.6 -1.6] 24%
Don't be scared, just give it a try and start slow ...eg. maybe you could try just 2.5mcg once a day for a week, and if no problems , then try 2 x 2.5 (am / pm) ....or if you feel good on just 2.5mcg , you could just stay there.
most of us 'over here' would bite her hand off if she offered us a bit of added T3.... and if you try it out for a while and find you don't like it, you can go back to just Levo and try increasing that instead , no harm done .
it will be interesting to see what she says about TSH / overmedication when adding T3 takes your TSH below range .. (which it inevitably will) .
Thank you! I thought the same thing about tsh. It's really scary when the actual doctor doesn't seem to know what she is talking about. I'm worried that she will just go by the lab results and not how I actually feel. Crossing my fingers and hoping for good results and a good response from my doctor.
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