T3 test times advice

[BiscuitBaby]

Hi FT4: 12.22 pmol/l (Range 8 - 19.1) 38.02%

FT3: 5.3 pmol/l (Range 2.4 - 6) 80.56%

TSH <0.01

I take 100 t4 and 15 t3. I had the above done just before I started hrt. They are going to test again as I have felt a few of my symptoms returning. Slow bowel, sore feet etc. Nothing major but enough to be annoying. I take my t4 early hours of the morning and after much experimenting I take t3 in the morning in one go about 8am. This works well, I get no peaks/troughs etc and it helped massively with palpitations.

My question is around test times. The endo told me to test 2-4 hours after taking it. At that time I was splitting dose. I have never tested that soon. I started testing about 8 hours after 5mcg. I split the day before and set an alarm for middle of the night depending on test time. My hospital wouldn't do early bloods so I guessed a consistent approach was better!

Should I be testing after taking it all at once as I do, if so what time gap do people recommend?

And is 8 hours the right amount of time?

Thanks in advance.

[adin]

I think you should try to increase the levo dose a bit- to 112mcg...

[BiscuitBaby in reply to adin]

Thanks. I was thinking that as a possibility. I will be getting more bloods done in the next couple of weeks.

[SlowDragon Administrator]

Last dose levothyroxine should be 24 hours before test

If you normally take levothyroxine at bedtime/in night ...adjust timings as follows prior to blood test

If testing Monday morning, delay Saturday evening dose levothyroxine until Sunday morning. Delay Sunday evening dose levothyroxine until after blood test on Monday morning. Take Monday evening dose levothyroxine as per normal

if your last dose levothyroxine was only 12 hours before test result is false high ….

And your Ft4 result is likely too low anyway

Many people on levothyroxine plus small dose T3 find they need both Ft4 and Ft3 at least 60-70% through range

[BiscuitBaby in reply to SlowDragon]

HiThanks for replying. I did adjust my levo timings but probably not as much as you've advised. So dose maybe 18/20 hours before.

I did think my t4 was low. I have bloods to be done in the next week or so but the results will have to go to endocrinology. I was going to ask for an increase in t4. My t4 has never been high, even on levo only. Thanks for your advice. Its reassuring that I was thinking the same. Now to get Dr to agree!

[SlowDragon Administrator in reply to BiscuitBaby]

My t4 has never been high, even on levo only.

Ideally you should have been tried on higher dose of levothyroxine BEFORE adding T3

Many thyroid patients, if on adequate dose levothyroxine (usually Ft4 at least 70% through range) and GOOD vitamin levels…..then frequently Ft3 improves and may not need T3 added

[BiscuitBaby in reply to SlowDragon]

I was on 150mcgs t4 before I added t3. Endo reduced t4 when she added t3. My t3 was very low then.

[SlowDragon Administrator in reply to BiscuitBaby]

So how long were you on 150mcg

What were TSH, Ft4 and Ft3

Reducing Levothyroxine by 50mcg virtually guaranteed to be much to big a reduction

Can see on previous posts you have been dealing with a “must keep TSH in range “ endocrinologist

That’s never going to work on T3

Were vitamin levels optimal before adding T3

Looking at previous posts

You have Hashimoto’s

Are you on absolutely strictly gluten free diet and/or dairy free diet

Approximately how much do you weigh in kilo

[BiscuitBaby in reply to SlowDragon]

I was on 150 for maybe 6 months. Possibly longer. I can't really remember. It was few years ago now! I weigh 80kg. I am a bit heavier since I started t3 but I feel better so I am OK with that. I was 76kg.I tried gluten free but I didn't notice any difference. I never see the same endo twice. The first one (private) she was fine. The rest were nhs. The most recent was also fine. He wrote to gp saying tsh was supposed but my frees were normal so it was OK. The endos between them were awful. None of them could even write an accurate account of the appointment!

Yes. All vits are good. Still taking vitamin d, Thorne basic b. I also periodically take Spatone. I know there's not a lot of iron in it but I feel it helps.

I was having a review as just started hrt. I was feeling my back and hips were aching and my sleep wasn't great. I have to say all these are better but a couple of hypo symptoms are back. I want to increase my t4 but the doc has to do it through endo. I just was wondering about my test time whether it should be different now I take it all at once? Thanks

😊

[SlowDragon Administrator in reply to BiscuitBaby]

Common to need dose increase after starting on HRT

[BiscuitBaby in reply to SlowDragon]

Thanks. 😊