Hi, annual draw came back with this.
GP is freaking out but I'll try appease them when I get to having t deal with that.
Background is Hashimoto's, now on 42mcg T3 and 25mcg T4 pd. I skipped all meds for 24hrs a hard of this draw. Does this look relatively common /uncommon to you? Am I overdosing T3?
I feel well!
Thank you,
Why would you be overdosing on T3, the blood test result is around half way through the range. The GP is probably getting in a tizzy over the below range T4, the pro hormone which is relatively benign. If you feel well you need to fight your corner and stick on this dose.
Hiya, I'm thinking possibly because I skipped 24hrs for the draw. Therefore maybe my TSH would be in the negative range if they had just tested me on an average day. Probably? But I don't know. I've NEVER felt hyper.
I know what you mean, as it's just numbers. I don't feel overdosed at all. And yep, I'm going to have to explain why T4 is suppressed 😐 because my GP doesn't understand how T3 works.
Normally the advice is last dose of T3 8 -12 hours before a test, Levo is 24. TSH unlikely to be affected as that changes very slowly, especially when taking T3. Its likely your FT4 is accurate if you left 24 hours after Levo, but FT3 is artificially low as you left too long after taking last dose before testing.
Your GP is likely confused as your very low TSH isnt reflecting your very low FT4. Normally GP's are used to seeing very low TSH with high FT4, ie hyperthyroidism. The pertinent question is how you feel?
Hi, thank you for your response.
Tbh, I feel fine, good - much better than I have before. But I'm frustrated by the low iron and B12, as I was hoping for these to be a bit better now that my digestion is better following the start of T3. I'm also an avid meat eater.
Clearly I need to look at these minerals again. And try something different. Perhaps it is these being low that is causing the thyroid hormones jot to work as well as they should (as others have suggested).
A bit gutted!
T3 has a short half life. If you want to see your stable blood level you need to split your dose the day before test, into 3 portions and delay the last dose to allow 8-12hrs before the test.
What you are seeing in these results is too longer gap and a false low.
So we cant tell anything with these test results other than your FT4 is far too low and likely you need less T3 and alot more Levo.
What are your latest vitamin results and what supplements do you take?
Hiya, I split my T3 into three doses normally, but waited 24 hrs for this draw. Clearly, if I'd waited 12 hrs, my TSH would be in the negative. Hm. You think I need more T4? Interested to know more on this (I'm homozygous for Dio1 and Dio2 BTW, which why I ended up on T3 in the first place).
I'm not taking many supplements atm, just vitD and iron - although as you'll see my iron still needs work and is low.
Will share recent labs, all take the same take as these thyroid labs below.
(Apologies writing from my phone and struggling to attach images).
Thank you in advance!
If your TSH is suppressed or almost then it can take many months if it ever returns to normal or anywhere approaching that. No point delaying dose by 24hrs.
Be sure to take iron 4hrs away from Levo & T3, it affects absorption.
Your results and dose are very unbalanced. Are you meant to be on combination therapy or T3 only?
I dont see any vitamin results just full blood count.
Most people need a B complex.
Hi again, I'm on combined therapy (see my first post in this thread), yeah I agree they seem unbalanced.
I didn't realise that tsh took so long to respond, it thought it would shift more quickly than taht, OK good to know.
I have posted some more results below. Vits not tested, just iron and b 12.
Honestly in T3 your TSH eill be sypressed un less it's a very low dose of T3. Some people do need to take their T3 in one go to get it into their systems. Generic graphs can only ever be a guide. I'm Sure to have come to having T3 as your main hormone that you are taking, you've arrived at this because you tried the other options before.
For some people who are T3 only they can take a small amount of T4 as well. Glad you can too. I know Paul Robinson is now able to take a bit of T4.
As for thyroid blood tests do look Paul Robinson up. He and his GP found that treating via blood tests does not work well for T3 only treatments. And he found he was swinging from one dose to another. Might be worth a read. He's written several books and also has a Facebook group too.
Your GP will freak out with these results because he is trained in simple hypothyroidism that responds well to levothyroxine. Unfortunately 20% dont and then the fun begins!! As I expect you know.....
Labs
Labs
Its really essential to raise lower than optimal levels so that thyroid hormone will work well.
B12 is too low, folate could be higher. Suggest you start a good methyl B complex to balance all the B vitamins and raise your levels more.
B complex suggestions: Slightly cheaper options with inactive B6:
amazon.co.uk/Liposomal-Soft...
Contains B6 as P5P an active form:
bigvits.co.uk/thorne-resear...
healf.com/products/basic-b-...
Explanation about the different forms of B6:
helvella.blogspot.com/p/hel...
B complex comparison spreadsheet:
healthunlocked.com/thyroidu...
Thank you, I have some iron bisglycinate I'll get back on, as well as some B vits. Can I ask, is it OK to take them together (away from food and calcium Re. the iron)?
Heme iron is far more effective, this product is one that many members use and do well with.
threearrowsnutra.com/en-uk/...
Iron needs to be taken on its own, 4 hrs away from anything else. Take it with vit C or orange juice to help absorption.
Why are you taking calcium? Its not recommended unless prescribed having been proven to be low.
Hi, no sorry, I wasn't clear, I'm not taking calcium. What I meant was, I avoid dairy (calcium foods) etc too when taking iron tabs.
And yes, I might try heme iron next. I'm running out of options having tried so many others before, but levels not being low enough for GPs to consider it to be in any way an issue. 😞
Considering how much T3 you're taking, your FT3 is very low - yes, I know you left too long before the last dose and the blood draw, but even so, had it been only 12 hours I doubt the FT3 result would correspond with your dose. Do you take it on it's own, well away from food and other medication/supplements? And never mind it's half-life. That's a total red-herring and irrelevant if you're taking the same dose every day, you'll more than likely always have the same amount in your blood.
Your FT4 is low, but that's not necessarily a problem. It's possible you don't even need it at all. But then again, that doesn't necessarily have anything to do with how well you convert it.
Your TSH is low because you're taking all that T3. It couldn't be otherwise. But in any case, TSH level has nothing to do with when you took your last dose, it has more to do with the time of day of the blood draw: highest before 9 am then dropping sharply to its lowest around midday, then slowly rising again.
I expect your doctor is freaking out because of that low TSH - he probably thinks you're going to drop dead of a heart attack at any minute. They just cannot get it into their heads that TSh has nothing to do with hearts - or bones - and that taking T3 will suppress it. And for a very good reason: because the pituitary realises that you don't need it anymore. You don't have to stimulate your thyroid to make thyroid hormone - which is what it's mainly for - and you don't have to do any conversion because you're taking a lot of T3. Why would you need TSH? 
Hi, thanks for your comment, I split the T3 into 3 doses a day. The first (largest) is early am and away from food the other two, less so. My habit is tea drinking, and often have a cuppa close to a pm dose. I don't take supplements at the same time at all could tea be the problem?
Do you mean you think my T3 would still be too LOW if I'd waited 12 hrs or too high? Or simply that it would still be 'off'? I'm preparing myself for the pointless TSH pituitary hormone conversation, thank you for the reassurance in that regard.
I didn't think my T3 dose is really all that big, and certainly never feel hyper on it. I've never tried T3 only, just because my Endo was keen to keep me on a teeny 25mcg dose. At this point, I'm looking unstable anyway so wondering what to do or try next. (To confirm, I don't feel unstable tho!)
Thanks!
I didn't mean either. I meant that considering your dose, your FT3 would still be lower than expected even if the had only left 12 hours. Whether or not that would be too high or too low for you is not for me too judge. I'm just saying that your level does not correspond to your dose, so one has to suspect an absorption problem. Could be the tea, I don't know. But considering that on average people rarely take more than 15 mcg, when also taking levo, yours is a high dose.
But, if you feel well on that dose, why change anything. And if you are being treated by an endo, it's not up tp your gp to change anything, either! Don't let him meddle!
New Labs 
New Labs and still no FT3:
new labs / thyroid/ vitamins
Roseway labs 
Help new labs. 
