results help please

[Liothyronine3]

hi should I take less levothyroxine to bring it within range ? My gp practice always puts satisfactory no follow up but I’m taking 110 mc levothyroxine and 10 mc liothyronine and I can’t get my endocrinologist appointment fir a couple of months thank you in advance 🤞I’m 56 female on hrt 75mc 2 x a week also

[greygoose]

No, you shouldn't. It wouldn't work, anyway. Your TSH is low because you are taking T3. That's what T3 does because the pituitary realises that you don't need TSH anymore.

FT4: 16.2 pmol/l (Range 11 - 23) 43.33%

Your FT4 is possiibly too low, anyway. You could need an increase, not a decrease.

[Liothyronine3 in reply to greygoose]

I’m so confused with it all .. I know I feel better having the t3 as I was constantly tired and fat on only the levothyroxine even when in range . I was on 125mcg of but having headaches so reduced it to 110 and felt fine but when I saw result was out of range thought I must be taking too much levothyroxine still as its at hyper end on results ? Thank you for your reply

[helvella Administrator in reply to Liothyronine3]

They are reference ranges, not prison walls.

Your TSH is a tiny bit below the bottom.

But if you were being looked at because, while not diagnosed, someone thinks you could have a thyroid issue, they'd be perfectly happy to see your TSH rise to 10 - that is, more than double the top of the range - before lifting a finger to do anything.

There is a tendency for doctors to have inconsistent views on being out of range - across many different tests. Shoulder shrugging being quite common - whether as "so what?" or "don't know what to do".

[Liothyronine3 in reply to helvella]

I felt fine in the 110 of Levo so thinking I might stick to that for a while longer .. my endocrinologist put me on T3 as I wasn’t converting T4 properly

[DippyDame in reply to Liothyronine3]

hyper end on results.... No!

If you are HYPOthyroid it is (almost) physically imposible to become HYPERthyroid.

You can be overmedicated causing high hormone levels

OR...

if you have Hashimoto's you can experience transient hyper swings when the dying thyroid dumps extra hormones in the serum. This does not make one hyperthyroid, it just gives that impression.

So "hyper end" does not exist!

[pennyannie]

Hello again ;

without a T3 and T4 result and reading - drawn at the same time - everything is but a guess.

How are your core strength vitamins and minerals as no thyroid hormone replacement works optimally until your ferritin, folate, B12 and vitamin D are up and maintained at optimal levels - which we can advise on - should you some current results to hand.

[Liothyronine3 in reply to pennyannie]

Hi T3 & 4 results are at the top of this post .. everything else is fine it was just those results I was concerned about :/

[pennyannie in reply to Liothyronine3]

I'm sorry - I can only see a TSH and T4 result - can you just type the T3 reading / range in for me please ?

[SlowDragon Administrator]

please add Ft3 result and ranges

Was test done 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

It’s also extremely important to regularly test and maintain GOOD vitamin D, folate, ferritin and B12

What vitamin supplements are you taking

When were vitamin levels last tested

Please add results

Is your hypothyroidism autoimmune?

[DippyDame]

How was your poor T4 to T3 conversion established?

If conversion is poor your FT4 would normally be much higher in range because it was remaining unconverted

To confirm poor conversion we need to test both FT4 and FT3 at the same time.....high FT4 with low FT3 = poor conversion.

However...

Your FT4 above is low at 43.33% through the ref range indicating undermedication, not poor conversion, You need more Levo and unlikely T3!

We aim for both Frees to be roughly 75% through their respective ref ranges.

How you feel is a major part of diagnosis and how the dose was monitored before lab tests!

If you feel well on 110mcg levo then so be it....we are all different and don't always conform to lists of numbers.

Unlike machinery coming off a production line we are humans and cannot be designed to a set point (so we have reference ranges as a guide, not as an instruction)....because we are all different!! Medics seem to overlook this....it can make their life difficult if their thyroid knowledge is poor!!!.