High TSH, Low FT4 Help Please : I have Hashimotos... - Thyroid UK

Thyroid UK

140,928 members166,050 posts

High TSH, Low FT4 Help Please

butterflynett profile image
11 Replies

I have Hashimotos and just had new labs completed. I've been taking Cytomel for about a year now, as my FT3 was previously an issue (low). Now that it has improved some, my FT4 is low and my TSH at an all time high. There are no endos near me that will take my insurance. Was hoping someone could offer some guidance as to what I should be taking for this situation? I once took Levo, but had terrible side effects from it and saw no improvement. I don't want to resume taking it, so would appreciate alternate suggestions.

TSH: 6

Free T4: 0.8

Free T3: 2.9

T3 Uptake: 22

Glucose 97

Written by
butterflynett profile image
butterflynett
To view profiles and participate in discussions please or .
Read more about...
11 Replies
SeasideSusie profile image
SeasideSusieRemembering

butterflynett

Your FT4 is low because you take T3 only.

You will need to post reference ranges that came with these results so that we can interpret them, ranges vary from lab to lab.

Did you do test as we advise:

* No later than 9am

* Nothing to eat or drink except water before the test

* Day before test split T3 into 2 or 3 doses and take last dose 8-12 hours before the test

* No biotin, B Complex or any supplement containing Biotin for 3-7 days before the test

Have you tested key nutrients Vit D, B12, Folate and Ferritin?

butterflynett profile image
butterflynett in reply toSeasideSusie

Yes to all of the test parameters listed. I didn't take Cytomel for 3 days prior to testing.

SeasideSusie profile image
SeasideSusieRemembering in reply tobutterflynett

butterflynett

As explained, we must have the reference ranges for your tests to be able to interpret them.

I didn't take Cytomel for 3 days prior to testing.

Why would you do that? Your FT3 is showing a very much lower level than would be your normal circulating level. It should be taken up to and including the day before with the last part of the daily dose 8-12 hours before the test. This makes your result meaningless I'm afraid, to get any sense of your levels you will need to retest following the correct timing.

jimh111 profile image
jimh111

How much Cytomel are you taking? Perhaps it is too little although I would try adding i. a little levothyroxine if you can get it. You might be able to tolerate levothyroxine now you are taking Cytomel.

butterflynett profile image
butterflynett

I take 12mcg daily

jimh111 profile image
jimh111

That's not much, you will need some more levothyroxine or liothyronine.

butterflynett profile image
butterflynett in reply tojimh111

What is a typical dosage? That's all my Dr had put me on, but I have read that you get to a point where you should increase it.

jimh111 profile image
jimh111 in reply tobutterflynett

Liothyronine is 3x as potent as levothyroxine. A typical dose for someone with no thyroid function is 125 mcg levothyroxine. You are on the equivalent of 36 mcg.I would try some levothyroxine in addition to your liothyronine first as it will give you steady hormone levels and be closer to what we get from our thyroid.

If that doesn't work then you could increase your liothyronine.

Cricket-mas profile image
Cricket-mas

Talk to your doctor about desiccated natural thyroid medication. You need both T3 andT4 if you are taking supplemental thyroid medication.

I am in the throes of imbalance and having a devil of a time getting right. I feel functional if I take T3 only, but I now have osteoporosis. Because the T4/T3 ratio in my blood is too low, the parathyroid glands have been calling for calcium to slow down the T3. I also react to high calcium foods like cheese and cabbage (hashimotos itch). And the calcium in the blood slows down the body.

After 12 years of cytomel only, 18 yrs of synthroid only, and recent 20 years of liothyronine only, I am now working on aT4+T3 regimen but the TSH continues to be low--0.008. My doctor wants me to reduce the T3, but because of a very adverse reaction I had to a Covid booster, I fear the pain and exhaustion a reduction in T3 would cause at this time, while I am still recovering. (Thyroid and immune system are connected through the pituitary gland.)

T4 only may feel non-productive, T3 only may make you feel good, but you need both. Keep an eye on your calcium levels as that will help you know if you are out of balance.

Hashihope profile image
Hashihope

I can't imagine having high tsh on cytomel. My T4 and TSH are extremely low. I am hoping someone else on here can shed light on this.

butterflynett profile image
butterflynett in reply toHashihope

Yes, I was quite stunned as well and feel defeated quite honestly. Ive begun taking Inositol in hopes of it potentially helping to lower my TSH. I will update later on with the result of this endeavor.

Not what you're looking for?

You may also like...

High Tsh, High Free T4 and low Free T3 - HELP PLEASE

Hi Everyone, I am hoping I can get some advice. I have been on levothyroxine for 6 years. First...
Bubbap profile image

Low TSH, low FT4 and high cortisol. Feeling crap! Help!

Hi everyone I was diagnosed hypothyroid 5 years ago and am currently on levothyroxine 75microgram/3...
raggydolly profile image

Test result help please?: Low TSH and Low T3

Morning all I'm on T3 only (80mcg) and was feeling a bit tired of late and it has been 4 months...
pennyrose profile image

Very low TSH and High T4

Hi, I have a partial list of test results and I really don't know what to make of this. The last...
marvalrus profile image

High TSH, Low FT4

My son increased his levo from 150 - 175 micrograms, and has been taking for the last 14 weeks....

Moderation team

See all
helvella profile image
helvellaAdministrator
Jaydee1507 profile image
Jaydee1507Administrator
PurpleNails profile image
PurpleNailsAdministrator

Content on HealthUnlocked does not replace the relationship between you and doctors or other healthcare professionals nor the advice you receive from them.

Never delay seeking advice or dialling emergency services because of something that you have read on HealthUnlocked.