What do I do next? Is this T3 results low?

[Wrayofsunshine]

Hi all, just had my latest results from Medichecks, TSH is low, T3 and T4 normal. Tests were done 9am following the usual recommended protocol. The comments with the results suggests I'm perhaps over medicated and could be at risk of osteoporosis due to the low TSH. Is that right? They suggest perhaps a lower dose of levo (I'm currently on 75mg). I'm really not keen on the idea of a dose reduction as I felt rubbish in 50mg.

If anything I wondered if the T3 was too low? I don't know what to do next. I'm not feeling too bad energy-wise at the moment although it does fluctuate and my brain is still getting very foggy at times. I'm also getting some symptoms of early menopause so don't know how much of my symptoms are caused by thyroid and how much menopause 🙄.

I just don't really know where to go next. Do I need to reduce my dose? Would some T3 help? If so how do you go about getting your GP to prescribe T3? Any advice would be gratefully received.

[TiggerMe]

TSH 0.14 mIU/L (0.27 - 4.2) -3.3%

Free T4 (fT4) 18.2 pmol/L (12 - 22) 62.0%

Free T3 (fT3) 4 pmol/L (3.1 - 6.8) 24.3%

T4:T3 Ratio 4.550 

Your fT4 isn't very high and your fT3 is low showing poor conversion

You could do with a small increase in your T4 +12.5mcg, is your GP any good or just fixated on TSH? You could show them your results and request a referral to Endocrinology 🤗

How are all your other levels? Ferritin, folate, B12 and Vit D

[Wrayofsunshine in reply to TiggerMe]

Thanks for the advice! I don't know what my GP is like, I've just moved to a new surgery so I'm not sure how they will respond to any question of a dose increase with such low TSH. Vitamins were last checked in September, B12 and D were good, Folate was low but I hadn't taken it for a week or so as I stopped the B vitamin complex before the test due to the Biotin. Ferretin could be higher too so am trying to work on increasing that too. Is there any truth in what medichecks have said about increased risk of osteoporosis with a low tsh?

[TiggerMe in reply to Wrayofsunshine]

Worth sounding them out then... might get a good one 🤞

I wouldn't do anything about ferritin without having a full iron panel done first as you can be high in iron whilst low in ferritin

People that are hyperthyroid are more at risk of bone issues I believe, it isn't so much the low TSH as the high fT3&4.... hence when hypo being overmedicated isn't good but it's about the fT3&4 being kept within range

[Wrayofsunshine]

That's good to know. I didn't think low TSH should be a problem if T4 and T3 are in range. Ferritin I'm trying to raise through diet not supplements, its going up slowly but each time I test a little bit better! Will make an appointment with the GP and see what she's like. Very grateful for the advice Eeyore!

[SlowDragon Administrator in reply to Wrayofsunshine]

Retest again in another 8 weeks including vitamins

In the week before test when you stop vitamin B complex, you might want to consider taking a separate folate supplement (eg Jarrow methyl folate 400mcg) and continue separate B12

If not already on gluten free diet

As you have Hashimoto’s have you had coeliac blood test, get tasted via GP (or buy kit on line)

Only 5% of Hashimoto’s patients test positive for coeliac but a further 81% of Hashimoto’s patients who try gluten free diet find noticeable or significant improvement or find it’s essential

Also consider trialing dairy free in few months time