Need advice about T3 levels: Hi, I have had some... - Thyroid UK

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Need advice about T3 levels

soupfiend profile image
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Hi, I have had some tests recently which included thyroid levels and my free T3 levels are 3.1 which appears to me, to be right on the borderline of normal. The free T4 and the TSH are fine by the look of them.

Im just wondering if that T3 level is a bit low. I dont have any symptoms I would describe as problematic except for feeling cold all the time, very cold hands and feet but then I have lost an awful lot of weight which apparently can make you feel cold (common thing amongst us losers)

Does anyone have any advice, they were private tests just done for myself as an overall check for my nutrient and mineral levels. Ive never had a test that tested for T3 before so all my previous tests either with GP or some bloods I had done privately 6 months ago didnt have T3 tested either.

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FallingInReverse profile image
FallingInReverse

Congrats on finally getting your FT3 number!

We need to see the exact range of the test, and also please share the same for the TSH and FT4. Same for the vitamins and minerals you had done.

It is most likely that - yes - that FT3 is low enough to be causing symptoms.

But to get relevant input from the forum please provide results with ranges for them all. We don’t know enough without them .

soupfiend profile image
soupfiend in reply to FallingInReverse

Thanks. Im not sure what you mean 'range for the test'.

There are tons of results, it would take an age to try to type out all the other results, they're all fine, very good (well slightly high cholesterol but the ratio is much improved as I continue to lose weight)

The TSH was 2.2 and my free T4 was 14.5

TiggerMe profile image
TiggerMe in reply to soupfiend

TSH range might be something like 0.27-4.5

fT4 could be 12-22

fT3 often 3.1-6.8

They differ between labs but your fT3 reading is certainly likely to be causing some issues

You can add a photo if you hide any personal details

If you have results for folate, ferritin, B12, Vit D and iron serum they would help as they all need to be optimised so the body can convert fT4 to active fT3

soupfiend profile image
soupfiend in reply to TiggerMe

Thank you. I only got one figure for each result though? Not a range

Im not good with pictures, wouldnt even know how to get it on here

Iron (doesnt say iron serum) is 16.9

ferritin 95.3

folate serum - 22.4

b12 102

vit d 72.2

Im pleased with these results as Im on supplements and I stopped taking them for a month prior to the test so that there werent any false positives as it were.

TiggerMe profile image
TiggerMe in reply to soupfiend

Which Lab/ Company did you use?

So these levels are good if you stopped supplementing a month ago, iron is on the low side though ferritin is good (iron is quite complex there are other things to consider) and Vit D ideally 100-150

soupfiend profile image
soupfiend in reply to TiggerMe

Sorry I keep missing posts, these threads dont seem to be in chronological order!!! Yes Im really pleased, I thought everything would plummet. I used medi checks and had the 'well woman' test I think its called. I will do another in 6 months as I want my cholesterol to continue to improve.

TiggerMe profile image
TiggerMe in reply to soupfiend

Not to worry, it does take a bit of getting used to

So other Hypo symptoms can include high cholesterol, constipation, slow heart rate, low kidney function, digestive issues usually due to low stomach acid, very dry skin, carpel tunnel syndrome, plantar fasciitis... it's a long list

soupfiend profile image
soupfiend in reply to TiggerMe

Well I have a few of those, high cholesterol (down to previously being overweight without doubt), but its improving and my ratio has come down overall from over 6 to 4.6 in the last 18 months. Constipation, yes because of weight loss surgery, low consumption and the iron supplements. Its not present when Im off my supplements. Good kidney function so no issues there. Dry skin, yes peri menopause. Terrible silent acid reflux so I think Im doing ok in the stomach acid arena!!!

TiggerMe profile image
TiggerMe in reply to soupfiend

You might want to try the Burp Test as often people think they have high acid when really it’s low.

Have you tried heme iron? More effective and no stomach issues 🥳

If you feel well then I wouldn’t worry but something to keep an eye on

Of course I should say you don’t get them all it’s just a varied pick and mix 😕

soupfiend profile image
soupfiend in reply to TiggerMe

My supplements are all in one so the iron is within it. I will keep an eye on it I think. I have just looked up the burp test! I wouldnt be able to do it due to the surgery Ive had. Nice Idea though!

Noelnoel profile image
Noelnoel in reply to soupfiend

Did you know that weight gain is one of the most common hypo symptoms. Some of us on here have gained serious amounts of weight owing to being undiagnosed or under treated with thyroid replacement

Also, simply being hypo can cause raised cholesterol. Lots of us with normal weight have raised cholesterol. Even though your levels have fallen since weigh loss you may find that if you remain hypo, cholesterol will never be “normal”

NB Taking a multivitamin isn’t a good idea. The quality of the ingredients are often inferior and therefore less bioavailable, the dosage too low, on top of which the composition is nearly always wrong because they include vitamins or minerals that should never be taken together and if you’re not deficient in all that the multivitamin comprises of, you risk causing problems by upsetting the balance

FallingInReverse profile image
FallingInReverse in reply to soupfiend

Hi - each test has a range.

For example - chances are next to the FT4 result there are a few numbers - such as 9 - 19, or maybe 12 - 22. Or something like that. Similarly, next to your FT3, there will be a range like 3.5 - 6.5 or something like that. TSH probably 0.4 - 4.0. They might also be different - which is why we need to know the ones for your lab tests.

soupfiend profile image
soupfiend in reply to FallingInReverse

Right, I thought these ranges were the standard NHS range which is what I looked up once I got the test, sorry

So my TSH is 2.2 with the range saying .27 to 4.2

T3 is 3.1 with the range saying 3.1 to 6.8

T4 is 14.5 with the range saying 12 to 22

Im a bit slow as its difficult going back and forward on screens!

FallingInReverse profile image
FallingInReverse in reply to soupfiend

Are you on thyroid hormone replacement?

soupfiend profile image
soupfiend in reply to FallingInReverse

No, never had a problem with my thyroid

greygoose profile image
greygoose in reply to soupfiend

But you do have a problem with your thyroid. With a low FT3 like that you are hypothyroid. And your TSH is saying that your thyroid is struggling. And your FT4 is on the low-side, too. Did you have any antibodies tested?

high cholesterol (down to previously being overweight without doubt)

No, cholesterol levels have nothing to do with weight. Your cholesterol is high because your FT3 is so low.

So, despite your TSH being within the unrealistic range, you should be on thyroid hormone replacement. Unfortunately, doctors only tend to look at the TSH and want it over 10 before they will diagnose and treat. But your TSH does not correspond to your low Frees - it should be higher with those low Free levels. So, I think we might be looking at a pituitary problem, here. Keep testing to see what happens. And if your FT3 or 4 go below range - which they possibly will - you should talk to your doctor about it. :)

soupfiend profile image
soupfiend in reply to greygoose

I missed this sorry. My cholesterol is coming down nicely, the overall hasnt changed that much but the good cholesterol has increased and my ratio is now much lower, a huge improvement. My aim is by next year to get it under 4.

greygoose profile image
greygoose in reply to soupfiend

There's no such thing as 'good' and 'bad' cholesterol. That's just an invention of Big Pharma to scare people into taking statins.

If you get your cholesterol under 4 you are putting yourself at a grave risk of a heart attack. I don't think you understand what cholesterol is. It actually protects you from heart attacks, it doesn't cause them. And the lower it goes, the more at risk you are.

If your cholesterol is dropping, one imagines that your FT3 is rising for some reason. But, I repeat, it has nothing to do with your weight.

soupfiend profile image
soupfiend in reply to greygoose

I want my ratio under 4. Not my cholesterol level. I know what cholesterol is but thank you.

Lucy___ profile image
Lucy___

I can only go on my own experiences, but my T3 is constantly 3.1, highest it's been is 3.8.

I was told on here by these guys until they were blue in the face 😬 that my T3 was low enough to cause me symptoms but trying to get a doctor to listen to that was almost impossible. My GP said "T3 isn't treated on the NHS" and shut me down.

Finally I have seen an endocrinologist who said to me that absolutely my T3 is too low and I'm hypothyroid and he wants to treat it.

He can't start treating it until he's gotten my AI under control with steroids (long story) but the upshot is that yes, at 3.1, he is going to treat my low T3.

It might not be the same for everyone, I don't know, like I say I can only go on my experiences but that's whats happened with me.

soupfiend profile image
soupfiend in reply to Lucy___

Yes I doubt my GP would do anything. I dont know what symptoms I would say I have apart from feeling cold. As I said, I only got this result by accident if you like because its just an overall general test for everything that I had done privately and I didnt have a T3 result prior anyway.

Sunflower64 profile image
Sunflower64 in reply to Lucy___

Sorry, what is AI?

soupfiend profile image
soupfiend in reply to Sunflower64

Auto immunity?

Sunflower64 profile image
Sunflower64 in reply to soupfiend

I saw that the OP has Addison`s disease so assume it means adrenal insufficiency…

FancyPants54 profile image
FancyPants54

Hi. That T3 is low. So is your B12 if that is a serum test. It’s good if it was an Active B12 test. It will say on the test result.

You say you don’t know what symptoms you might have if you were hypothyroid. Here is ThyroidUK’s symptoms list. Worth printing, filling out and checking back from time to time.

thyroiduk.org/wp-content/up...

soupfiend profile image
soupfiend in reply to FancyPants54

It says active next to it, sorry I didnt even see that!

soupfiend profile image
soupfiend in reply to FancyPants54

The list is interesting, I have 17 of the symptoms. However I can pin point most of them to peri menopause (I think) or is it low thyroid!!

FancyPants54 profile image
FancyPants54 in reply to soupfiend

Menopause and the preceding years, often bring hypothyroidism. It did for me.

FallingInReverse profile image
FallingInReverse

 soupfiend - Adding this to the bottom, as in a post like this, it does get a little hard to see the embedded replies.

So - important to reiterate that you are not diagnosed, or being treated, for thyroid issues. You are fortunate to have the bloods you just got, and that you've shared them here. And to reiterate - none of this diagnoses you with anything. I am just going to share some numerical/clinical context for how those most familiar with thyroid bloods would look at your results.

Here are some helpful things to consider:

* Being "in range" for blood tests is NOT necessarily "normal" "healthy" "ok." We use the metaphor of shoe sizes here. The "range" for "normal" shoes sizes might be 36 - 42. But if your feet are a 40, and you are wearing a size 36 - that will NOT be ok for you.

The bottom line for you is that your bloods have some ambiguous things in them, to learn more there are other tests you should get, and ultimately you are ridiculously lucky to have the info you have so you can monitor your numbers, your symptoms, and have a very clear picture of how you may or may not need to take action.

Blood tests results - all of them together TSH, Free T4 and Free T3 get us closer to understanding a complete picture of thyroid health. Here's what we see for those:

- A TSH that is 2.2 is ambigious. On it's own, it does not mean you have a thyroid issue. But statistically speaking, 85% of the healthy population is BELOW this value. The most common value is 1.25, with more than half of the healthy population being under 1.25.

This means with a TSH of 2.2, you would have to be in a small 15% of the population to be among those with a TSH that high and not have a underlying thyroid issue.

See this study for the details: web.archive.org/web/2004060...

- Your T4 is only about 25% through range, and your FT3 is 0% through range. Most people on this forum need these numbers to be more like ~60-70% through range for their symptoms to alleviate. Importantly, everyone is different, it's not a hard and fast rule, but among the thousand on this board actively managing their thyroid issues - this is what we experience.

It's true that euthyroid ("healthy" people without a diagnosed thyroid disorder) that are not on hormone replacement are a little different. But that being said - for example - FT3 is the one number that has the most "causal" relationship to symptoms. That is why the above replies all call that out - none of us here would feel OK with a T3 0% through range.

The other critical piece of this is - symptoms. Your bloods should always be evaluated in the context of your symptoms. Being cold is a very common symptom of low thyroid hormones. As I type this, my fingers are ice cold : ) since my thyroid hormones are still slightly sub-optimal. But as you note - your symptoms are very limited and not getting in the way of living life.

What you might do:

You are one step ahead with your current blood tests. TSH, Free T4, and Free T3 are the core three to watch. I would recommend getting these done - maybe every 6 months - a year?

Further, as Tiggerme notes above - the following vitamins/minerals are essential to optimal thyroid function. These: Vit D3, B12, Folate and Ferritin all play a part in how our bodies use thyroid hormones. And also, when your thyroid function is low, our bodies actually have trouble absorbing these. Downward spiral! As noted, your vit/mins do indeed look pretty good! We like to make sure we get these tested at least once a year, and more if we need to supplement to correct anything.

Also - equally and maybe more important - key into how you feel and recognize that some things that you would never imagine are related, might be.

One more idea that might be useful, you might look into getting a set of thyroid antibody tests done:

These for sure:

- TPOab

- TGab

These if you can:

- TRAb

- TSI

Lastly - don't expect any doctor to understand any of the above, and don't expect the NHS to recognize that any of these needs blood tests or treatment. This last point is a very very big rabbit hole, so I'll just leave it at that.

.

I am sure there are things I didn't include, and also I am curious if others on the forum would recommend a different action plan.

Like I said - most doctors would say your bloods are "normal, nothing to see here." Even you say your symptoms are limited and not creating a lot of hardship. You are in an excellent position with your blood results to monitor this and take early action which will save you a lot of heartache later if you actually need to address your thyroid.

Hedgeree profile image
Hedgeree

Hi soupfiend,

Welcome to the forum! 😊

Members here are very knowledgeable of all things thyroid and will offer good guidance to help you.

soupfiend profile image
soupfiend

That is very helpful thank you. The cost of this test was really pricey but given that I have to supplement myself quite heavily after weight loss surgery, I plan to keep an eye on how that is working for me. It was just included that it had thyroid with it, I wasnt specifically looking for thyroid stuff or thinking there is a problem. I see that you can get stand alone thyroid tests too so I could just do these if I wanted to check how things are in a year or so. I admit that dont feel quite as cold when Im doing more activity and thats my plan for this year, to be more active but I have been shocked at just how cold my hands and feet have become after all this weight loss.

Out of interest, are many of you getting blood tests from your GP or having to go private, given I cant imagine GPs would consider my levels for example a 'problem'. How are you managing to get the support needed?

Hedgeree profile image
Hedgeree in reply to soupfiend

Hi soupfiend,

Many forum members have to test privately in order to get full thyroid testing done (TSH, FT4 and FT3) It is rare to have a GP that will test FT3 (the active thyroid hormone) If you read posts on the forum you will see the difficulty that we have in getting tests done; the only time I got FT3 tested was by the endo surgeon after I'd had a partial thyroidectomy.

My GP is one that won't test so I get private tests done. But it's an idea to try and ask them first as you may have a helpful GP? 🤞🏻

FallingInReverse profile image
FallingInReverse in reply to Hedgeree

soupfiend that is why I said you are ridiculously lucky to have the blood tests results you have - especially the FT3!

soupfiend profile image
soupfiend in reply to FallingInReverse

Well they just happened to be in the package I got!

SlowDragon profile image
SlowDragonAdministrator

Which sort of weight loss surgery

nhs.uk/conditions/weight-lo...

Did you have thyroid levels tested BEFORE you had weight loss surgery

Existing hypothyroidism can be made worse by the surgery

palomahealth.com/learn/bari....

And rapid weight loss after surgery can affect thyroid levels

frontiersin.org/journals/en...

soupfiend profile image
soupfiend in reply to SlowDragon

So in October 22 (4 months before surgery, but 3 weeks after starting a vlcd), my results at the GP (after just a check up) were

Serum TSH level 2.7 mIU/L 0.40 - 5.00mIU/L

Serum free T4 level 11 pmol/L 9.00 - 19.00pmol/L

obviously no T3 tested

And in respect of the weight loss, its not been rapid

SlowDragon profile image
SlowDragonAdministrator in reply to soupfiend

So pretty likely hypothyroid

Very low Ft4

Free T4 (fT4) 11 pmol/L (9 - 19) 

Ft4 only 20.0% through range

soupfiend profile image
soupfiend

Thanks to all who have replied, Im finding it really hard to read the thread. So I think to answer some points but not sure if I have missed others.

The supplements I take are specialist bariatric supplements which I am on for life and they are a requirement.

I can see my T4 has gone up in 18 months so Im hoping that is a good thing, or should it be going down

I think when I next test, probably in year, perhaps 6 months if I can afford it I will make sure I get this one again where the T3 is part of the test.

FallingInReverse profile image
FallingInReverse in reply to soupfiend

FT4 going up is good

When you get up/above 75% then you want to come back here and get advice.

But you want to work up to at least 50% through 60-70% through range.

And just track/be aware of symptoms off that hypo list.

Caveat - level targets for those of us on hormone replacement are slightly different, but the above is in the ballpark.

Read all the responses from all of us and set your plan.

And always come back here and ask for updated advice as you get on, and learn more, and things change!

soupfiend profile image
soupfiend in reply to FallingInReverse

Yes thanks. I think I might try to see if I can get a doctors appointment and just voice it. Im sure I will be shut down, but its my fingers, hands, feet, constantly cold, I make myself jump when Im getting dressed or undressed because my hands are so cold putting clothes on!!

However I also know that if Im being honest, Im not eating enough protein according to my eating plan and doing enough activity, I need to build muscle mass, I should concentrate on this really.

How does anyone get treatment though if your levels are seen as 'ok'. ? And are there natural supplements or certain foods which could help perhaps?

FallingInReverse profile image
FallingInReverse in reply to soupfiend

How to get NHS treatment with "ok" levels. Short answer.... with your bloods, you won't. There are NHS guidelines that say something about 2 or 3 high out of range TSH results like 3 months apart or something like that. And even people who have terrible numbers and terrible symptoms have a very difficult time getting the proper blood tests and treatment for thyroid. As for testing - you can always ask, but many people here do indeed test private like a medichecks.

Others here in the UK might have advice on whether there's any use in bringing this up to your GP.

Also - what you can absolutely do "in the meantime" is keep monitoring your D3, B12, Folate and Ferritin. Which as noted above are pretty decent. Those 4 vitamins/minerals play an essential part along the path of our bodies creating and using TSH, T4, T3 etc. Remember also - the people on this forum are majority diagnosed with a thyroid dysfunction. And... therefore our bodies need slightly different things than your body might. One example - I think euthyroid people are OK with a Vit D of 50 (?) (the bottom of the range) but we hypo people target 100.

Re Protein - your other goals for protein will also help thyroid! I didn't know this but just found this explanation of protein and thyroid function:

palomahealth.com/learn/prot...

Regards to being cold - Hands/extremities and our core body gets cold for a lot of reasons - non-thyroid and thryoid alike. When it comes to underactive thryoid causes of cold - it's an inside-out kind of thing. Since thyroid hormones control our "metabolism" - when underactive, our "engine" simply isn't going to run well enough to produce the heat. Metabolism in a thyroid context is NOT JUST eating and digesting and burning calories. It is the way our body creates ENERGY for all our body's processes. It was an interesting a-ha when I realized that we are cold not because it's cold out or any external factors. It's our body's heating/cooling system malfunctioning : )

Delilahmy profile image
Delilahmy

hello Soupfiend … I’ve been on thyroxine for 35 years (a few years of Armour - which was great but had to stop as difficulty in obtaining) I started T3 in June 22 via my endo …. My levels were similar to yours …. And now with my 10 t3 morning and 15t3 evening I now hover around the upper range in results but they haven’t tested me since aug 23 (results not online as done through private endo) . I found T3 Liothyronine extremely beneficial … remained on a t4 dose which reduced from 150 to 100 … and am still work in progress

I also addressed low b12 with injections which helped

And now take vit d with k2

Don’t know if this is helpful - but I feel improved

Good luck

soupfiend profile image
soupfiend in reply to Delilahmy

Thank you, but how did you get treated if these levels are not considered as problematic? And typically I felt really tired and dizzy yesterday, probably psychosomatic because Ive been talking about all this on this thread!! What were your symptoms?

Delilahmy profile image
Delilahmy in reply to soupfiend

I begged my endo because I felt dreadful … had no energy …cognitive function awful … off work (nurse-and retired on ill health as felt so ill) I wanted him to prescribe NDT And our … but this was the best he would do so he trialled it and decided to leave me on it as I felt as if I was improving. I also went gluten free six months ago - a trial also to see if poor absorption might be hindering my recovery. Still doing this as may be beneficial. But it was a battle overall few years to get him to agree

FallingInReverse profile image
FallingInReverse in reply to soupfiend

soupfiend

I dont have any symptoms I would describe as problematic except for feeling cold all the time, very cold and feet

Interesting, right, that you started out saying “I don’t have any symptoms “ and then you realize you have 17 off the list, and now you’re feeling dizzy : )

So.

From experience here’s what I’d recommend.

Keep a symptom tracker. And track your treatment/healthcare actions. For me, it’s a note/doc on my phone where I put the date and the symptom when it occurs to me. And when I change a dosing, you change only one thing at a time and give it weeks or months to isolate the impact.

I DO NOT sit down every day and proactively ask myself what symptoms I feel today.

I basically just wait for a symptom to accost me.

Because you are correct - humans are sometimes very bad at this, in that we are born to find patterns. This helps us learn and be safe… but it also means we need patterns and assign meaning to randomness too.

Example - I have a symptom journal going back 7 years before diagnosis that tracked bad headaches every 4-6 weeks. I had no idea what it was. Ended up being low thyroid, yes, but until I knew that I had started trying to match it to allergy indexes and even barometric pressure. Sometimes there was a match!

Separately, last year my thumb was aching and so I was sure it was thyroid related joint pain and arthritis. As it turns out - it was how I was holding my cellphone to text. NOT thyroid : )

Short answer we all have a comingling of issues and the list of symptoms that are conclusively due to thyroid may also have contributors of other things.

Your weight loss is a variable that will muddy the water.

Even for the best of us, managing your thyroid is a long, slow process. Even for those of us who know exactly what our levels are and should be and how to dose our replacement. It takes a series of months to adjust our treatment and years as we work towards “optimal.”

And like I said - you have information in those bloods that 99% of people do NOT have. That’s a good thing. Low thyroid does indeed CAUSE problems.

So start your journey! Take your time! Detangle your issues. And just stay aware step by step. Observe how you react to changes you make. And realize that the conclusions will come over time and slowly.

soupfiend profile image
soupfiend in reply to FallingInReverse

Well yes I identified 17 issues on the list but I can account for the vast majority of those as issues that I know what they are. Also I was thinking about the list the other day and noticed that it had ADHD on the list this is a ND condition, people are born with it, its not 'caused' by thyroid problems so Im not sure how accurate the list is overall.

However, that aside, Im slightly unsure what point there is tracking it all, firstly I can only really afford these tests once a year (I hope) and secondly if the GP isnt going to do anything about my sorts of levels, Im not sure I see the point unless I get really ill. However, I think I am going to present with the coldness, or do one of those econsult things to see if they will give me an appointment, because its quite difficult to have hands this cold all the time.

FallingInReverse profile image
FallingInReverse in reply to soupfiend

Thought of you with this thread : )

healthunlocked.com/thyroidu...

soupfiend profile image
soupfiend in reply to FallingInReverse

Thanks, Im coming to update the thread hopefully Tuesday, probably with predictable outcomes but I do have a GP appointment on Tuesday, I did an econsult, set out my results, talked about symptoms rather than being 'in range' used some of the information given here and was offered an appointment. Probably will be dismissed but I will let you all know what happens.

soupfiend profile image
soupfiend

Well Im updating with what happened today. He agreed that my levels are sub clinical and referred back to the test I had in November with the NHS and said the something (cant remember what now) was a bit low. He offered for me to have a trial of thyroxine to see what happens but Im wary of this and hadnt realised that if you start taking this, its for life. So we have agreed that he will ask for a test in 6 months and if the levels are still like this and Im still constantly cold, then we'll see again about thyroxine. I hope he follows through if I do need this! He said he can justify it based on something or other (cant remember what now)

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