little worried

[FoxyTed]

Hi everyone and thank you in advance!

my most recent bloods April 24 (after 8 weeks on T4)

TSH 1.89 (0.27-4.2

FT3 3.7 (3.1-6.8

FT4 (16 (12-22

TPA 17.7 (0-34

Thyroglobulin 15.6 (0-115

Vits etc all ok Jan 24

I previously posted my results of Jan 24.

I started 50mg T4 near end of February. Some tiny improvements and blips since. My main symptom that has worsened is my early morning sweats in bed - water lying on my chest and legs, palpitations on wakening just not pleasant. I am on estrogen only patch 75mg but did not change this until I’d see if thyroid was to blame. My T3 is now lower and my wakening & sweats are much worse!

TPA & Thyroglobulin higher - why would this be please?

I am due my apt in 2 weeks but I’m really worried if I have to take T3 mainly because of the posts I read on forums regarding using it and I have had a horrendous 3 years since this all started.

Really grateful for info and any reassurance🌼

[greygoose]

FT3 3.7 (3.1-6.8) 16.22%

FT4 (16 (12-22) 40.00%

Not surprising if you still have symptoms. Your thyroid hormone levels are very low - especially the FT3! And it's T3 that causes symptoms when it's too high or too low.

Both those levels should be more like 70/75% through the range at least.

50 mcg is only a start dose so it's time for an increase of 25 mcg.

I am due my apt in 2 weeks but I’m really worried if I have to take T3 mainly because of the posts I read on forums regarding using it

Maybe too soon to be thinking about taking T3. Get your FT4 up a bit first. But taking T3 is rarely a problem. I don't know what you've read, but I've been taking T3 for about 20 years and I've never had a problem. The past 12+ years on T3 mono-therapy because I can't tolerate T4. So, I think you ought to cross that bridge when - and if - you come to it and not panic in advance about something that may never happen.

[FoxyTed in reply to greygoose]

Thanks GG, I think it’s because my mood fluctuates and when low I tend to worry more and long to feel well again. I have noticed since taking the T4 my T3 has went from 4ish to 3.7, that’s why I was thinking I have a problem. Is it still possible that taking T4 may yet raise my T3? Tk you!!

[greygoose in reply to FoxyTed]

Not unless you get an increase in dose, no. And even with a rise in dose, there's no guarantee that your FT3 will rise enough to make you well. It's a case of trying it to see what happens.

Even at 4 your FT3 was much too low.

[FoxyTed in reply to greygoose]

Thank you GG

[greygoose in reply to FoxyTed]

You're welcome.

[FoxyTed in reply to greygoose]

Yes GG I’m ready for increase for sure and I understand this takes time working all out.

Much appreciated

[TiggerMe in reply to FoxyTed]

You are in the worst phase where your thyroid has detected the additional hormone so is cutting back on production but you aren't on a high enough dose yet to fully replace your needs... hang on in there and get your T4 increased 🤗

[FoxyTed in reply to TiggerMe]

Thank you Tigger much appreciated and 🤞🤞

[Obsdian in reply to greygoose]

Thanks for this post, it answered something I was wondering yesterday regarding t4 and t3.

[SlowDragon Administrator]

you won’t know if you need T3 until on a much higher dose levothyroxine

Ft4 only 40% through range

You’re now ready for next increase in dose to 75mcg

Retest again in another 2-3 months

Which brand of levothyroxine are you currently taking

Guidelines of dose Levo by weight

approx how much do you weigh in kilo

Even if we frequently start on only 50mcg, most people need to increase levothyroxine dose slowly upwards in 25mcg steps (retesting 6-8 weeks after each increase) until eventually on, or near full replacement dose

pathlabs.rlbuht.nhs.uk/tft_...

Guiding Treatment with Thyroxine:

In the majority of patients 50-100 μg thyroxine can be used as the starting dose. Alterations in dose are achieved by using 25-50 μg increments and adequacy of the new dose can be confirmed by repeat measurement of TSH after 2-3 months.

The majority of patients will be clinically euthyroid with a ‘normal’ TSH and having thyroxine replacement in the range 75-150 μg/day (1.6ug/Kg on average).

The recommended approach is to titrate thyroxine therapy against the TSH concentration whilst assessing clinical well-being. The target is a serum TSH within the reference range.

……The primary target of thyroxine replacement therapy is to make the patient feel well and to achieve a serum TSH that is within the reference range. The corresponding FT4 will be within or slightly above its reference range.

The minimum period to achieve stable concentrations after a change in dose of thyroxine is two months and thyroid function tests should not normally be requested before this period has elapsed.

Some people need a bit less than guidelines, some a bit more

Presumably you are taking your levothyroxine in morning

Palpitations start before taking…..and settle after?

Palpitations can be linked to being on INADEQUATE dose levothyroxine

Medics tend to assume they are only present when hyperthyroid

[FoxyTed in reply to SlowDragon]

Thanks Slow, first 8 weeks I was on ELTROXIN by mercury and past week I’m on Levo generic by Mercury as pharm didn’t have enough ELTROXIN brand but same ingreds. Yes I take in Morn and I do think the palps and sweats are low thyroid - only early hours b4 any meds they wake me up.

Much appreciated

[SlowDragon Administrator in reply to FoxyTed]

Eltroxin and Mercury Pharma are absolutely identical

[NanaV54]

I have taken Armour for 20+ years but had sisters that had already discovered that we have a family history of poor conversion. I started out with Synthroid but it wasn't helping anything other than lowering my TSH some. When I told my Dr about my family, he switched me after 6 months. What a difference it made for me. But, I also knew T4 only probably wouldn't work for me. Would your Dr be willing to run TSH with FT4 and FT3. If your FT4 is high, but TSH low normal, it could be an indication of poor conversion. But there are also common deficiencies that can affect your thyroid levels and cause similar symptoms... Vit D, B12, folate, iron/ferritin, magnesium, zinc and selenium. Those should all be eliminated before jumping to T3. The main difference is that T4 is the storage hormone takes about 7 days to fully absorb and begin helping. T3 is the active hormone, converted from T4. It helps regulate body temp, metabolism and affects virtually every system in your body.. heart, lungs, kidneys, bones, etc. and it acts 1-3 hours after taking it. So, you may feel it, in terms of feeling a little hyper and minor hot flashes that passes fairly quickly. Some Drs start is out low, to give you a chance to adjust. Any time you change does, your body will need time to adjust. Talk to your Dr about deficiencies, and see where it takes you.