Low T4 still. : My FT4 result continues to be... - Thyroid UK

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Low T4 still.

Fifteen profile image
28 Replies

My FT4 result continues to be quite low, I would welcome advice on my medication. SlowDragon, I think you have commented in the past. I would value your opinion now. I have been unsure what to do as there seem to be many warnings about atrial fibulation.

FT4 14.6 pmol/L (9.0 - 23.0)

FT3 5.4 pmol/L (2.4 - 6.0)

TSH <0.01 mU/L (0.3 - 4.2)

Interestingly, the laboratory now states that my TSH result is Satisfactory and No Further Action.

The tests were done at 8:30am and I followed the guidelines. My vitamins results are all satisfactory.

I take 125mcg of levothyroxine in the morning; 10mcg of Thybon20Henning in the morning and 10mcg mid-afternoon. This has been my protocol for some years.

My mood is low at all times and my immune system is not good - I am on the 9th day of my third Covid infection.

Many thanks for any thoughts or suggestions.

I wish everyone a Happy New Year.

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Fifteen profile image
Fifteen
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28 Replies
Buddy195 profile image
Buddy195Administrator

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SlowDragon

Personally, I would add 12.5mcg Levothyroxine (I find a pill cutter useful for this) as I’m a fan of adjusting medication slowly. As your FT4 is fairly low in the range, you could then look to another 12.5mcg if your symptoms are not alleviated.

Fifteen profile image
Fifteen in reply toBuddy195

Thanks for the tip and your suggestion. I had been thinking that may be a worthwhile way to try it out - I just don't know if it is safe to do that with a fairly high T3.

TiggerMe profile image
TiggerMeAmbassador in reply toFifteen

I agree with Buddy with results like that I'd be aiming to get your fT4 above 50%... 12.5mcg might make all the difference 🤗

Free T4 (fT4) 14.6 pmol/L (9 - 23) 40.0%

Free T3 (fT3) 5.4 pmol/L (2.4 - 6) 83.3%

Buddy195 profile image
Buddy195Administrator in reply toFifteen

We all have different sweet spots where we feel well. For me, it’s mid range FT4 and FT3 near top of the range.

Fifteen profile image
Fifteen in reply toBuddy195

Thanks. I will try it - if my GP will give me a prescription for more leovothyroxine. He's nice but very nervous about thyroid treatment.

TiggerMe profile image
TiggerMeAmbassador in reply toFifteen

I wouldn't stress too much about getting him on side, if you get your scripts filled quickly or perhaps request an early one due to a holiday you can gain enough wiggle room to fine tune without exasperating yourself trying to make him understand... I also find asking for 2 months worth at a time is a lot less faff all round 🤗

Kalicocat profile image
Kalicocat

You are taking too much T3 based on your non-detectable TSH and low T4. If you were to reduce your T3 and increase your T4 you may find your body will want to hold on to more T4. If you have warning signs of AFIB then you DEFINITELY need to reduce your T3.

TiggerMe profile image
TiggerMeAmbassador in reply toKalicocat

At just over 80% fT3 this is a comfortable place for many but low fT4 when starting T3 often makes people feel unwell again after the initial lift from adding T3... it may well be that once the fT4 level has come up a little a slight reduction in T3 could be trialled.

Non detectable TSH is the norm for most of us who take T3 & 4 which is why everyone needs to base their dosing on fT3 & fT4 results which is far more reliable

Fifteen profile image
Fifteen in reply toTiggerMe

Thanks. I am not at all worried about the very low TSH. It always dips to negligible levels when you take T3 and mine certainly did. An endocrinologist explained this to me years ago when he first prescribed liothyronine. That's what I was wondering about - if or when I should lower my T3 medication. It seems I need to give the extra T4 time to work. Do you know how long it usually takes?

TiggerMe profile image
TiggerMeAmbassador in reply toFifteen

For me it generally takes a good 4 weeks for an increase to kick in and at least another couple to settle... perhaps a little longer with the added battle with covid?

I've not done battle with it myself but many have said it takes a good few weeks to shake off

Are you of HRT age? I'd be tempted to boost oestrogen levels to aid the immune system, I had no idea the female immune system runs on it!

Angie33 profile image
Angie33 in reply toTiggerMe

Interesting!i didn’t realise oestrogen did the immune system.

My immune system is constantly so low, in my blood tests, since l’ve had an under active thyroid. I am on the keto diet and good quality supplements and still l pick up whatever virus is out there. Still on very low energy a month after covid. Sleeping 12 hrs a day. New bloods due next week as my T4 is still below range. T3 higher end of normal and TSH 0.001

Hoping to increase my T4 to get it in range so l return to work as l have had so little energy these past 3 years due to thyroid. Feel l’m watching my life go by.

TiggerMe profile image
TiggerMeAmbassador in reply toAngie33

Have you looked into your sex hormone levels?

Angie33 profile image
Angie33 in reply toTiggerMe

Last year my endocrinologist said they are fine now. I’m on evorel 75 patches. Admittedly she wanted me on 100 but GP said that is too high. My hair is getting thinner too 🙁 l am going for a thorough blood test again soon! Thank you for replying!

Fifteen profile image
Fifteen in reply toTiggerMe

Not yet. Thanks

Fifteen profile image
Fifteen in reply toTiggerMe

Not yet. Thanks

Kalicocat profile image
Kalicocat in reply toFifteen

My TSH (edited because I mistakenly said T3) is smack dab in the low end of the normal range - 1.2 to 1.5 which it was before hashimoto's and I take 5.5mcg T3 every morning.

Fifteen profile image
Fifteen in reply toKalicocat

Are you thinking of increasing your dose? I take 10 mcg of T3 twice a day. That keeps me at about 83%.

Kalicocat profile image
Kalicocat in reply toFifteen

No, I want my TSH in the normal range. I feel like I don't have thyroid disease at all now. I think it is not good for anyone's health for TSH to be suppressed. I started off with 10mcg T3 per day which was WAY too much. My TSH is now exactly where it was before my thyroid bit the dust. I believe that is the most anyone should shoot for, not T3 in the highest end of the range - high T3 is not good and risky for a lot of different health problems. You likely go over range every time you take your dose.

Kalicocat profile image
Kalicocat in reply toTiggerMe

My TSH (edited because I mistakenly said T3) is smack dab in the low end of the normal range - 1.2 to 1.5 which it was before hashimoto's and I take 5.5mcg T3 every morning.

TiggerMe profile image
TiggerMeAmbassador in reply toKalicocat

If you feel well then that is great but generally people on T3 need to treat until symptoms are resolved, often finding that RHR, temp and BP rather than blood results are more accurate, as it's all about getting enough T3 into the cells.... fT3 in the blood isn't effective until absorbed by the cells

Often the people that have had a thyroidectomy need their blood levels slightly higher than before to be effective

Fifteen profile image
Fifteen

The breast cancer I had was oestrogen related, so I won't be doing anything to boost it. Women's bodies are very complex, aren't they. Thanks for the thought, though.

TiggerMe profile image
TiggerMeAmbassador in reply toFifteen

Ah, sorry to hear that... I think the newer transdermal body identical range are safe in this respect

Lottyplum profile image
Lottyplum in reply toFifteen

I don't want to butt in about the extra issues you're having due to COVID (and I've never had it or the jab) but I learned from drs in USA that optimal levels of D3, Zinc+Quercitin are excellent in boosting your immune system+ also aiding your fight against COVID+variants. I understand zinc prevents the replication of any virus in yr cells but you need quercitin to get the zinc in yr cells. The D3 (with K2) has also been found to boost your immune system. Hope this helps.

Angie33 profile image
Angie33 in reply toLottyplum

Thank you for sharing! I will look at my zinc levels. Not heard of quercitin!

Lottyplum profile image
Lottyplum in reply toAngie33

You can find Quercitin in veg, including onions. I take my Quercitin in tablet form.

Fifteen profile image
Fifteen

Thanks for this. You make a good point. I am usually very diligent in taking my vitamins but had been less so in the last few weeks. I don't retain Vit D so am now back to my 5,000iu a day.

I have heard contrary opinions about Quercitin - some opinions are very negative. I had not heard about its positive interaction with zinc. My zinc capsules contain bio-selenium.

Lottyplum profile image
Lottyplum in reply toFifteen

Info came from an American doctor - Quercitin is the gun+zinc is the bullet. You need both. He had an elderly population on his books+this was part of his protocol to keep them healthy!

Fifteen profile image
Fifteen in reply toLottyplum

Thanks.

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