I read that it isn't advisable to take thyroxine with suppressed TSH and T4!

[Angie33]

Hi,

I'm wondering if anyone is taking thyroxine with a suppressed T4 (6.6 range 08-19.1) and TSH 0.01

I read on google, it's not advisable if levels above, are suppressed or you have adrenal fatigue, which I have suffered from in the past.

My main medication is 40 mcg of T3 which makes a big difference to my quality of life.

However, I am still suffering with low energy. So much so, I can't work full time or at least exercise, as a result of not working. My social life is ad hoc. I am normally a very active sociable person.

I was advised by a holistic GP that I should still aim to get my T4 in range despite my thyroid not converting T4 to T3 very well.

I have been trying to get my head around meds and doses for 3 years now I feel a pain when I speak to professionals, and end up apologising as left feeling I am making a fuss. I just want a 'normal' quality of life to at least work full time.

Does anyone take T3 and Metavive? I took this in the past but since they changed the ingredients of metavive, I am not convinced it does anything for me these days. Unsure..

Thanks in advance! x

[ironchica]

Hi Angie33, I’m not an expert on this but I also take T3 and T4 and I don’t convert well either. greygoose gave me some wonderful advice on this as my GP was trying to get me to get my TSH in range, but with T3 it will be suppressed anyway.

I would recommend reading Greygoose’s profile journey so you can see how T3 impacts this. It’s very enlightening and I found it very helpful.

I did increase my T4 a few weeks ago as a result of my T4 being low in the range, with low TSH, but I’m waiting to see if it makes a difference or whether I should go back to where I was before and up my T3 instead.

I did this for a few days and I had lots more energy, so I’m wondering if that’s the way to go. It’s such a balancing act all this, and optimal vitamins and trace minerals will also make a difference.

Not sure this is all that helpful, but hopefully others will be able to give more advice. Good luck!

[Angie33 in reply to ironchica]

Hi Ironachica, thank you so much for your very helpful reply! I will read Greygoose's post as requested. I know T3 works well for me, however, I am wondering whether to persevere with T4 or just up my T3 as well, as my body still feels like a heavy weight daily. I would be interested to hear how you get on with your results! I get my next bloods taken next week from medichecks.

[greygoose]

Could you provide a link to where you read that, please, because it doesn't make any sense. I can only assume they said that because they think a suppressed TSH always means you're hyper - which, of course, it doesn't. You have to take the FT4 and FT3 into consideration as well as the TSH before taking anything.

[Angie33 in reply to greygoose]

Hi Greygoose, thank you very much for replying. I've been wiped out past few days so only logging on now. I annoyingly can't find the website which advised against thyroxine if your T4 and TSH are suppressed. I can only find the links where it advises thyroxine is not advisable if you have adrenal issues. I have made another appointment with my endo, after a 13 month break from her, as she won't allow me to increase my meds with my TSH being so low 0.01. If I don't increase my meds I have no quality of life.

I read all sorts of contradicting advice about TSH. Some say ignore it others say it's important to ensure it is not suppressed as this effects your bone density and heart. No wonder I am exhausted.

I think I need to persevere on T3, see what my next bloods say and take it from there re introducing more thyroxine or ignoring my T4 and up my T3. One holistic GP said although my body struggles to convert T4 to T3 I should still give my body T4 and let it do what it can.

[greygoose in reply to Angie33]

I can only find the links where it advises thyroxine is not advisable if you have adrenal issues.

And not everybody agrees on that, either! However, like most things thyroid, it depends on the person. Some people find that when they begin thyroid hormone replacement, and their T3 starts to rise, so does their cortisol. But, others need to raise the cortisol first. We're all different.

she won't allow me to increase my meds with my TSH being so low 0.01.

This is the problem with endos: they know nothing about thyroid. For the most part they are diabetes specialist with some weird ideas about thyroid. Not always a good idea to consult them, they can make things worse!

I read all sorts of contradicting advice about TSH. Some say ignore it others say it's important to ensure it is not suppressed as this effects your bone density and heart.

TSH has nothing to do with hearts or bones. This idea is a misunderstanding of Graves' Disease. With Graves', the TSH is suppressed and FT4/FT3 are very high, and hearts and bones are affected. But it's the high T3 that affects them, not the low TSH. However, our brilliant medics do not understand that a suppressed TSH on thyroid hormone replacement is not the same thing as a TSH suppressed due to Graves'. I very much doubt your FT3 is high enough to have a negatvie effect on your heart or bones, however low levels of T3 are just as bad.

If your TSH is low it's because the pituitary has decided that you don't need it anymore - and you don't, because you're on thyroid hormone replacement.

One holistic GP said although my body struggles to convert T4 to T3 I should still give my body T4 and let it do what it can.

Well, he's right and he's wrong. Some people do need good levels of FT4 even when taking T3. However, other people are better off without any T4 at all. Treatments should be adapted to the person, not dogmatic theories. And you have to find out what suits you best by trial and error.

[Angie33 in reply to greygoose]

Thank you so much for explaining this is so much depth. You are a godsend! You really know your stuff and you make perfect sense. I am due to give bloods tomorrow for an updated Medichecks check up. The most thorough one they have.

If you don’t mind, l’d love to run my latest results by you. Probably in 1-2 weeks’.

I am currently exhausted daily and functioning with brain fog.

Thanks again!!

Angela

[greygoose in reply to Angie33]

No problem.

[Noelnoel]

since they changed the ingredients of metavive, I am not convinced it does anything for me these days

It certainly does something for me. My FT3 is now top of the ref range and FT4 is creeping up slowly

Reading your post again I’m not sure what you’re asking but if you post the most recent thyroid panel, someone more knowledgeable may come along with suggestions but I don’t recommend just adding Metavive at this point

Post:

FT4

FT3

TSH

To include ref ranges

[Angie33 in reply to Noelnoel]

Hi Noelnoel, thank you so much for your reply. Much appreciated. I was initially enquiring if anyone had been advised, to avoid thyroxine if T4 and TSH levels were suppressed. I then diverted, apologies for the confusion, to enquire if anyone else was taking T3 with thyroxine or metavive, to hear how others were getting on. That's great metavive is working well for you along with T3! That is encouraging!

[Noelnoel in reply to Angie33]

Hi!

You’re welcome. I don’t take T3 though, just Metavive

[Angie33 in reply to Noelnoel]

That’s great metavive is working for you!

Do you mind me asking how much you take daily? I appreciate it varies from person to person. I’m just curious as l was latterly on 320mcg and l was still struggling with my energy. I decided to change meds as l thought this was already a high does, despite my levels being within range.

Thanks Angela

[Noelnoel in reply to Angie33]

I eventually decided to combine both types, porcine and bovine because the porcine alone takes my FT 3 right up but leaves my FT4 trailing behind. I’m now on

Bovine x 200

Porcine x 120

I believe reaching bovine x 240 - 280 will see me about right but as ever with thyroid replacement, I won’t know till I’ve been on that dose for a while

[Angie33 in reply to Noelnoel]

Oh that's interesting! I was told 320 mcg was a high dose of metavive, despite still being within the normal range and lacking energy. I therefore, reverted back to T3. I am still trying to find the right dose and decided whether to up my T3 again or up my thyroxine too (currently only 25mg) I will see how I get on but I may try metavive and bovine too if my energy levels don't increase. Everyday is a struggle just now.

Thank you again for sharing your dose. I feel 320 mcg wasn't too high after all!

[Noelnoel]

We need what we need. It’s the same with all thyroid replacement, whether that be glandulars, NDT, levo or lio

Try not to chop and change too much and try not to add Metavive to your levo and lio mix. That will just complicate things for you. Give what you’re currently doing a decent length of time for it to show its colours before you change anything else

[Angie33]

Thanks Noel! I wouldn't add metative to the mix. The metavive would replace the 25mg of Thyroxine. I've been on this dose for over 2 months now. I'll see what my bloods say in a weeks' time. Thank you again for taking the time to reply. I really appreciate it.