So, I've written before, and I started taking only T3. At about 100-125mcg per day all at once in the morning (bc my principal concern is my immune system. Also energy, etc).
I went to the ER the other day bc of a bad reaction to Paxlovid, I had presumed covid (multiple close contacts, ie, my kids & same sx, but tested neg).
So, they ran multiple panels, not of course a full thyroid panel. But I was surprised, after months at this level, my TSH was 3.63. It had been just above 5 when I switched my regimen, but it is long enough to have reset.
So-- Am I taking enough? Should I be taking some T4 too? (still tired & getting sick all the time. But have a miniscule amount of re-hair (on body) growth).
best, BlueGreen-WordyDoc
Written by
BlueGreenWordyDoc
To view profiles and participate in discussions please or .
if you took the T3 first thing in the morning, and they drew blood at 8 pm, a twelve-hour half life would possibly account for your pituitary begging for more, considering the highly stressed circumstances with a painful lung condition.
I believe regular users of straight T3 will say to not even look at TSH.
Would that the rest of endocrinology world have the same attitude sometimes.
At about 100-125mcg per day all at once in the morning
What do you mean 'about'? Are you taking 100 mcg or 125? You can't chop and change. If T3 is going to do what it's supposed to do, then you have to take the same amount every single day.
But I was surprised, after months at this level, my TSH was 3.63.
No, that's not right. Just three months ago you were posting about being on NDT, and should you change to T3 mono-therapy, so you can't have been on 100/125 mcg for months. And, in any case, if you started on 50 mcg two months ago, you've increase far too quickly. And that could be part of your problem. So, no, not certain that the TSH has had time to catch up.
So-- Am I taking enough? Should I be taking some T4 too?
Only you can tell if you need to take T4, there's no 'should' about it. And the only way you can know is by trying it to see.
Are you taking enough? Now, here's were it gets complicated...
As I'm sure you know, TSH is a pituitary hormone. The pituitary adjusts its output of TSH by the amount of thyroid hormone it senses in the blood. It has no idea how much gets into the cells. So, we effectively have two problems, here:
a) how much T3 is getting into the blood
b) how much T3 is getting into the cells.
Some must be getting into the cells because you've said that you have so re-growth of hair. But, you're still tired - so not enough is getting into the cells. (The immune system has nothing to do with it at this point.)
On the other hand, your pituitary is saying that not enough of your dose is getting into the blood, because on such a high dose, your TSH should be suppressed. So, one has to ask: how do you take your T3? Do you take it on an empty stomach, etc. Just like levo? Are you taking any other medication that might compromise absorption?
Also, what time of day was the blood draw for this test?
So, in answer to your question: am I taking enough? The TSH is not going to give you any answers because the problem has to lie elsewhere. The question is: where?
Bloods should be retested 6-8 weeks after each dose change or brand change in levothyroxine or T3
As greygoose says …..looking like too many changes too quickly
For full Thyroid evaluation you need TSH, FT4 and FT3 tested
Also both TPO and TG thyroid antibodies tested at least once to see if your hypothyroidism is autoimmune
Very important to test vitamin D, folate, ferritin and B12 at least once year minimum
Low vitamin levels are extremely common when hypothyroid, especially with autoimmune thyroid disease
About 90% of primary hypothyroidism is autoimmune thyroid disease, usually diagnosed by high TPO and/or high TG thyroid antibodies
Autoimmune thyroid disease with goitre is Hashimoto’s
Autoimmune thyroid disease without goitre is Ord’s thyroiditis.
Both are autoimmune and generally called Hashimoto’s.
Significant minority of Hashimoto’s patients only have high TG antibodies (thyroglobulin)
20% of autoimmune thyroid patients never have high thyroid antibodies and ultrasound scan of thyroid can get diagnosis
Recommended that all thyroid blood tests early morning, ideally just before 9am, only drink water between waking and test and last dose levothyroxine 24 hours before test
This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip)
T3 ….day before test split T3 as 2 or 3 smaller doses spread through the day, with last dose approximately 8-12 hours before test
Hi, thanks guys. What happened, which I may not have explained well, is that I was initially taking 50mcg of T3 a day with 1 grain of NP thyroid. Then I ran out of the T3, Had blood studies done and had low T3. I felt terrible only on the NP thyroid and my TSH was elevated beyond even their normal ranges, so I switched to 100mcg of T3, probably about the day I heard back from you all. I was recently sick for two weeks--maybe covid, maybe not-- and raised my dose to 125 bc it seemed I needed the extra to account for being sick. So, the test would be measuring 100mcg a day, for about 3 months. The blood draw was at about 10pm. But they didn't check a T3, I was in the ER for other reasons and TSH was just on the standard panel.
Content on HealthUnlocked does not replace the relationship between you and doctors or other healthcare professionals nor the advice you receive from them.
Never delay seeking advice or dialling emergency services because of something that you have read on HealthUnlocked.
Rundown of TSH, T3, T4
High T3 and high TSH?
Will lowering T3 dose raise TSH?
Low TSH with normal T3, T4. 
Increasing TSH with normal T3 levels. 
