Please could I have help interpreting my new results after 6 weeks adding T3 to my Levo?

[Oakwood4321]

I’ve had my appointment with the nhs Endo and she has agreed to prescribe T3 again due to my heart checks all being fine.

she thought my tight chest last year when on T3 was due to my Levo dose being too high.

she has prescribed 2 x 5 mcg T3 daily (1 dose morning & 1 dose afternoon).

She said to reduce my Levo to 25mcg and to do this all at the same time.

(I had been on 87.5 mcg Levo until 6 weeks ago when I reduced to 75 mcg and added 5 mcg t3). I didn’t mention this to her.

May nhs results were:-

Free t4 22.7 (11-22)

Free t3 3.3 (3.1 - 6.8)

tsh 2.00 (0.27 - 4.2)

August Medichecks results are:-

Free t4 17.8 (12-22)

Free t3 4.1 (3.1 - 6.8)

tsh 2.52 (0.27 -4.2)

Thyroglobulin antibodies 93.6 (0-115)

Thy. Peroxidase antibodies >9 (0.34)

I can see that my FT3 has improved.

My tsh has increased but I think I read that most people feel better with a tsh of 1 or under, so this is probably worse.

I’d like to increase my t3 from 5 to 10 mcgs but not sure if I should change the Levo to a lower dose at the same time.

maybe I should reduce to Levo first then add the other 5 of t3.

I haven’t felt much better but it’s only 6 weeks on t3. I have noticed that I’m not so tired in the afternoon. A real change for the better is that once a take my meds about 4.30 a.m (when my cat wakes me 😩) , I could never get back to sleep but since the t3 dose I go back into a really deep sleep for about 3 hours which is amazing. Maybe that’s why I’m not so tired in the afternoon/evening.

Do my results shed any light on next steps please?

thank you 😊

[greygoose]

Well, I would say that now is the time to add in the other 5 mcg T3. But, if I were you, I would not reduce my levo any further. Your FT4 is only around mid-range. And I think the endos idea of reducing it to 25 mcg was rediculous, given that the FT4 will drop a little anyway when you start T3. So, I'd leave that alone and see how you get on.

[Oakwood4321 in reply to greygoose]

Hi Greygoose, thanks for replying. The Endo seems to just prescribe doses to me without referring to b/t. When she initially agreed a trail of t3 last year I asked shall I get b/t done and she said the ones I’d had months before were ok. 🤔 At the moment she thinks I’m on 87.5 (which I was for years until I made my own reduction 6 weeks ago), she wanted me to lower from 87.5 to 25 in one go and take 2 x 5mcg doses of t3. Thanks to what I’ve learned on here I knew not to. I did ask her shall I reduce Levo slowly but she said no just start next day with 25 mcg.

I’m going to take another 5mcg from today and keep Levo at 75mcg then retest is 6-8 weeks.

I feel I’ve absorbed a bit more understanding of how to interpret and what to aim for with results from your reply. The FT3 and FT4 need to be higher in the range ?

🙏🏽

[greygoose in reply to Oakwood4321]

Well, I would say the FT3 certainly needs to be higher, it's not even mid-range. But, the FT4 is not so clear cut. It's a very individual thing. Some people need it high in the range, others - like me - don't need it at all. And others somewhere in between. This is something doctors just have no understanding of, how we are all different. So, once you've got your FT3 to a decent level, if you feel ok, then all is well. But if you don't, you might need to fine-tune your FT4. But, you're not there yet. Concentrate on the FT3 for the moment.

[Oakwood4321 in reply to greygoose]

Thanks Greygoose, that helps. In actual fact I feel like I’m absorbing the information more than before.

I’ll keep a diary of how I’m feeling.

I’m grateful that nhs are prescribing the t3 for me.

😊

[greygoose in reply to Oakwood4321]

Yes, that is something to be grateful for. But not a lot of help if they don't prescribe enough.

[Oakwood4321 in reply to greygoose]

…..or refer to my blood tests when I go 🙃

[McPammy]

I wouldn’t reduce the levothyroxine T4 but I’d definitely add a further 5mcg T3 about 3pm now. That should help and reduce your TSH a little too. My TSH hovers around 1.00. My T3 is normally around 5.6(3.7-6.0) that’s ‘with’ taking T3 2hrs before test. And T4 is usually around 10(7.5-14.0) that’s ‘without’ taking levo before my test. Most importantly I feel pretty good. I don’t change my regimen around blood draws which I get by my NHS GP at 9am every three months without fail. I like to know how high or low my levels can be if I haven’t taken my T3 before a blood draw it’s normally around 4.5(3.7-6.0) Before starting T3 my level was only 3.9 and T4 was 14 I was only converting 8%

[Oakwood4321 in reply to McPammy]

Hi McPammy, thanks for replying. I read through your profile and can identify with the long difficult journey you’ve had regarding this condition. It’s really good to hear you feel pretty good now.

I was wondering last night whether to take the 75 Levo and 10 mcg t3 all at same time on waking but decided to take 5 mcgs t3 later in day. Wasn’t quite sure when to do it so your message helped. I’ll take around 3 pm as that works well leaving time after lunch and not too near dinner - plus stops me snacking

It was helpful seeing your feedback on the different brands of t3 you’ve had and how you’ve felt on them. I’ve started a diary and will monitor how I get along. 😊

[McPammy in reply to Oakwood4321]

Thank you. I’ve just got off the phone from my private only endocrinologists annual consultation. He is extremely pleased with my blood results and actually said they are ‘bloody great’ and impressed that I can exercise and have a full life. He was the one that told me to split my T3 doses 8hrs apart. I also decided to split my levothyroxine dose too. I was having trouble a couple of hours after my full levo dose. Splitting it really helped. I don’t seem to get any symptoms of Hashimoto’s as long as I get my medicine regularly and keep to my regimen. I find my body likes routine with thyroid hormones. I truly hope you find you sweet spot soon. It took me a little while but once found I haven’t altered anything. My only issue is consistency with supply of liquid levothyroxine that I’m prescribed. Currently that’s all fine now. Hope it goes well for you.

[Oakwood4321 in reply to McPammy]

That must be so rewarding hearing his feedback, and also actually having feedback that matches how you’re feeling. Those awful years of being told everything is in range but feeling dreadful are hopefully behind us now thanks to learning through here that we have other options.

I’m grateful to you for sharing his recommendations on your dosing times. I’m going to split my Levo & take half at 3 when I take the t3.

thanks for sharing your news, gives me hope 😊

[McPammy in reply to Oakwood4321]

We can only try options to see if they help. My regimen is:

T3 5mcg at 7am. Thybon

T4 34mcg at noon. Liquid

T3 5mcg at 3pm Thybon

T4 34mcg at 4.30pm. Liquid

I also get b12 injections quarterly and take ferris fumerate 210mcg every other day. I’m a vegetarian for over 35years not sure if that’s why my b12 and ferritin has been low as my partner also is a vegetarian and their bloods are good without supplements. Mine could be absorption issues.

[Oakwood4321 in reply to McPammy]

Hi McPammy

Apologies for my late reply. I’m like you with keeping to the meds routine that I’m on. I hope this next step now with the t3 will give me more brain power to absorb information to keep learning about this thyroid journey.

Thanks for your support 😊