I'm a bit puzzled with my latest results as my FT3 is now at the top of range and i'm feeling a bit rough. Usually my TSH is reflective, but it seems to have gone higher...
TSH - 2.03 (0.35-5.5)
FT3 - 6.63 (3.1-6.8)
FT4 - 20.9 (11.9 - 21.6)
I seem to be on my lowest dose of levo this year, yet my FT3 is at it's highest but not reflected on my TSH.
I'm not sure whether to drop my daily T3 dose of 12.5mg or to drop my weekly levo from 875mg to 850mg?
If my TSH had been lower, i'd have just automatically reduced my levo I think..
Any thoughts?
P.S. all vitamins good
RAI back in 2020.
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Thyroidsam
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First, I'd drop the levo - ignore the TSH, it's a very poor indicator of thyroid status. And then, after a while, you may find you need to reduce the T3. But that FT4 is just too high.
I think probably more, but I wouldn't like to say for certain. You could start with 25 mcg a week, though, and retest in six weeks to see what's happened and if you need to reduce further.
I had radioactive iodine treatment back in 2020, but I don’t think at the time it was confirmed as being from Graves. Likewise, I didn’t really know much at the time, but looking back, the communication and treatment plan could have been better…
Yes, it probably could have! They don't like handing out too much information, do they. However, if your thyroid was destroyed by RAI, it won't have any impact on the present situation.
Well, that's a problem with ranges. Ranges are not recommendations about what level your results should be, they just tell you what is generally found in an average sample of the population. How many members of that sample actually have thyroid problems is never determined. But what we do know is that when the FT4 is continually high in range, it not only affects conversion but also puts you at risk of other health problems like heart problems and cancer. It is the range that is at fault.
Hey, yes I always follow the testing advice, I usually take my T3 between 8-12 hours the night before my blood test.
As you can see from my results, i've actually been reducing my levo amount over the past year. I was a consistent gym-goer as well.
So from April 24 I had reduced my levo then added a little bit more back in for 3 months, which I then dropped in July. However, from July onwards i've been on the same amount but have started feeling worse, hence the Oct blood test.
Based on previous results I was puzzled as my TSH wasn't reflecting my FT3 level which seems to be at the highest it has been (and on the lowest dose).
I'm not self medicating as such, I now have a 6-9 month review with an endo who back in Sept was happy with my results from 2nd Sept.
Up until the March blood test, I was always feeling a bit hot etc. so reduced down to the 125mg levo a day from then. Looking back, i'd only added in a bit of extra levo in April because my TSH was 2.6 and FT4 17.5 (so thought I needed to have that a little higher).
Don't worry about TSH, science proves it is not a reliable marker after treatment despite what medics opine. It is a cheap way of monitoring, The important labs are FT3 followed by FT4....see link below
Thyroid antibodies do not suggest Hashi's
Who suggested T3 and why?
Your FT3 is consistently high which suggests overmedication
Are you still on 125 mcg levo ( mcg not mg) and 12.5mcg T3
Did you established your T4 to T3 conversion status before adding T3?
Sorry, but by relying on TSH, particularly after adding T3, I sense there is an element of guess work in your dosing protocol
No need to test rT3...it is the product of excess unconverted T4 and is the metabolically inactive form of T3. An rT3 test tells you nothing other than it's high or low but there are many reasons for that ...but only one is related to thyroid function.
Overheating suggests overmedication!
Your 09/24 labs still look a bit high ....but could be ok for you. We are all different so symptoms are vitally important
What symptoms do you have?
Your 10/24 test looks more settled but still a tad high
It takes 6/8 weeks for a new dose to settle so I'd suggest frequent dose changes are not helpful.
You need to decide on a dose and that should be constant for at least 6/8 weeks.before testing...I see you have increased the gap to 2 months which is better
Based on that last test I'd be inclined to leave the T4 but drop the T3 to 10mcg daily, wait 6/8 weeks then re-test. You may need to drop the T4 after the next test....it's still a work in progress!
We only adjust one hormone at a time so that we know what is affecting what.
That dose must be consistant!
The results will point to any further necessary hormone adjustments.....based on the Frees, not the TSH!
Hey, I started T3 back in 2022 as after my RAI treatment (in 2020) my FT4 level was well over range on levo alone,and my FT3 bottom of the range. Felt absolutely awful and couldn't get anywhere with the NHS endo at the time.
I then went to a private endo who was happy enough with me using T3 and was willing to prescribe it to me - but I was already sourcing it myself by that point.
Have you considered reverse T3 test? It would tell you if your T3 is being blocked. I know that there is lab "proof" that reverse T3 does not block free T3. Maybe the mechanism between free T3 and reverse T3 is different than the "blocking" I refer to. However, in real life lowering T4 medication like NP thyroid and raising T3 medication worked for me. You have a lot of hormones floating around reflected in your labs. But, if T3 is not being absorbed it will not work for you. In the end, how you feel is an indicator of your status too.
That was what was puzzling me, why my T3 appeared to be at top of range, but my TSH not reflecting it.
Your TSH level has nothing to do with how much hormone is getting into the cells. The pituitary assesses what's in the blood, not what's in the cells - it has no way of knowing that.
That said, it could very well be that you are having problems getting T3 into the cells. But that has nothing to do with the TSH, nor rT3. Yes, your rT3 is going to be high, because your FT4 is too high. But rT3 does not block T3 receptors, it has its own receptors. rT3 is inert and only stays in the system for a couple of hours before being converted to T2. It is not a problem whatever the cause.
However, if you do have some level of resistance to thyroid hormone, and your T3 is not getting into the cells, the thing to do is to take it all in one go to flood the receptors. And you may need to increase your dose. I have that problem and I take 75 mcg daily, all in one go in the morning.
But forget the TSH. It is irrelevant. And certainly not something to dose by.
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