Confusing result

[Glutenfre]

These are my most recent results. Blood was taken first thing in the morning, fasted and before I took my medication. The lab ranges are also shown above. How can my tsh be so low and my t3 still be so low/not optimal? I'm on 150 levothyroxine. Am I right that I might need some t3? And if so, would I reduce the levo slightly?

Many thanks for your help!

[greygoose]

You would be right, yes. Your TSH is so low because your FT4 is so high, and your FT4 is so high because you're not converting it to T3 very well, and your FT3 is too low.

Probably not necessary to reduce levo. Adding T3 will lower the FT4, anyway.

[Glutenfre in reply to greygoose]

Thank you. Would 25 t3 be a good dose to start?

[SlowDragon Administrator in reply to Glutenfre]

Before considering adding T3 have you tested vitamin D, folate, B12 and ferritin

Can you add most recent results

What vitamin supplements are you taking

Looking at your forum name you are presumably already on gluten free diet

Are you also on dairy free diet

which brand levothyroxine are you taking

Do you always get same brand

Would 25 t3 be a good dose to start?

Definitely NOT

Far too high to start on

Maximum starting dose is 5mcg …..perhaps initially as 2.5mcg twice a day

But if only got 20mcg tablets…5mcg waking

After week or so add second 5mcg dose 10-12 hours after morning dose

Wait 8 weeks at this dose and then retest

[greygoose in reply to Glutenfre]

Absolutely not, no. 5 mcg, with increases of not more than 5 mcg, after two weeks minimum.

[jgelliss in reply to greygoose]

I was going to say the same thing about not lowering the T4. Dr's and some thyroid patients think that when adding T3 one needs to lower the T4. Not necessarily. I do much better without lowering my T4 and adding T3. Thank you GG for Being Spot On .

[Glutenfre]

Oh OK. Yes gluten free but not currently dairy free. My vitamin labs were pretty optimal. I take vitamin d with k, omega 3, magnesium, glutathione and b12. Always the same brand of thyroxine

[SlowDragon Administrator in reply to Glutenfre]

Can you add most recent vitamin results and date last tested

You aren’t taking any vitamin B complex or folate?

Important to test ferritin too

[Glutenfre in reply to SlowDragon]

Vitamins

Vitamins

[SlowDragon Administrator in reply to Glutenfre]

Exactly what B12 supplement are you taking and how long before test did you stop taking it

B12 is low, and especially low considering you have been taking B12

[Glutenfre in reply to SlowDragon]

I started talking this after that result and haven't retested yet

.

[Glutenfre]

Ferritin

.

[SlowDragon Administrator in reply to Glutenfre]

Ferritin is ok,

You don’t want it to drop under 70

Eating iron rich foods like liver or liver pate once a week plus other red meat, pumpkin seeds and dark chocolate, plus daily orange juice or other vitamin C rich drink can help improve iron absorption

List of iron rich foods

dailyiron.net

Links about iron and ferritin

irondisorders.org/too-littl...

davidg170.sg-host.com/wp-co...

Posts discussing why important to do full iron panel test

healthunlocked.com/thyroidu...

Good iron but low ferritin

healthunlocked.com/thyroidu...

healthunlocked.com/thyroidu...

Chicken livers if iron is good, but ferritin low

healthunlocked.com/thyroidu...

Shellfish and Mussels are excellent source of iron

healthline.com/nutrition/he...

Iron deficiency without anaemia

healthunlocked.com/thyroidu...

Ferritin over 100 to alleviate symptoms

healthunlocked.com/thyroidu...

healthunlocked.com/thyroidu...

Great research article discussing similar…..ferritin over 100 often necessary

ncbi.nlm.nih.gov/pmc/articl...

If ferritin drops under 50 get a full iron panel test for anaemia. Never just assume that iron is also low

It’s possible to have low ferritin but high iron

Test early morning, only water to drink between waking and test. Avoid high iron rich dinner night before test

Medichecks iron panel test

medichecks.com/products/iro...

retest full iron panel 3-4 times a year if you start on iron supplement

If taking any iron supplements stop 5-7 days before testing