I have appt booked with endocrinologist re my low T3 level, what should I be pushing for? Advice for best outcome from this consultation.

[Alternatively]

My free T3 level is 4.2 (range 3.1 - 6.8) , T4 is 20.50 (range 12 - 22) and TSH is 0.311 (range 0.27 - 4.20)

Taking 75mg levothyroxine currently

I have made an appointment with an Endocrinologist privately, but he also is an NHS consultant at Ipswich hospital .

I am going there to ask for Medication to optimise my T3 level, because it seems I’m not converting well, but please could you let me know what T3 figure is optimal ? Also which is the best prescription for this? Armour or Liothyronine ? If Lio, then which brand should I specify? What strength is it best to start at? Is it always best to take a split dose am and pm? And should my Levothyroxine dose be reduced or stay the same when starting on Liothyronine or Armour ?

Id like to go into the consultation knowing what I want, and to come away from the consultation with the best possible result/prescription, and so I’m posting today to ask for advice please, ie. what have other forum members got on well with, what’s not easy to obtain from pharmacies, also advice as to what to refuse! (ie. Like Teva), and general advice from those that have been prescribed T3 please?

How to persuade him if he says, No prescription required, you’re within range? (which technically I am).

Thankyou for reading this, all thoughts gratefully received!

[serenfach]

I doubt the Endo will prescribe Amore, but may be pursuaded to "trial" you on Liothyronine. You will have to really do to town on how ill you feel, how tired you get etc. Many here feel that T3 should be in the upper third of the range in order to feel well. And you may need to drop the Levo a bit as your T4 is near the top of the range and there is not a lot of wiggle room to up the T4. If he says you are in range and go away, use the shoe analogy - the adult shoe range is from 3 to 12, so ask him his shoe size and ask him how he would feel walking around all day in size 3. I hope you get the results you need.

[Alternatively in reply to serenfach]

Thanks for your info Serenfach. I love the shoe size analogy!! x

[LilacandMint]

Ask him to test magnesium, vit D3 and calcium. Magnesium is important in converting T4 to T3. Vit D can be low in thyroid patients. Symptoms of low vit D include fatigue and bone/muscle pain. Low vit D can also cause a condition called Hyperparathyroidism. The Parathyroids control calcium and phosphorous in the blood. Low vit D raises the PTH hormone drawing calcium from the bones. Have you had a DEXA scan to look at bone density.

[Alternatively in reply to LilacandMint]

I really appreciate your reply. I have taking vit D, magnesium, vitamin K2, and calcium supplements for years, before thyroid became a problem, because a Dexa scan revealed that I had osteopenia. Recently tested, my Vitamin D was over range, magnesium high in the range, My B12 levels are over range, probably from it being added to an oat milk I drink everyday. I do also drink 500ml cows milk every day and eat yogurt and cheese, but even so, together with taking 600mg calcium citrate daily, my serum calcium was borderline low, so that’s a mystery. I make sure my total calcium intake every day is at least 1200mg, usually more.

The other thing nutrient wise that was not good was a Ferritin level of 36 and Folate was 10. I’m having private iron panel blood test on Wednesday and will take igennus B vitamin supplement after blood test.

Do you take T3 meds? I need to learn as much as I can about adding this to my Levothyroxine before my appointment with the Endocrinologist on 7/5. I’d love to hear of other forum members’ experiences of starting on this, with their hints and tips.