T3 and T4 results

[Tjqui00]

my doctor has been getting me to reduce my thyroxine now for years based on my suppressed tsh result. My t4 and t3 had gone just above range so I agreed to reduce from 100 mcg every day to 100 mcg for 2 days and then 75 on the 3rd day. They wanted me to go to 75 every day and have stopped me getting 100 mcgs but I managed to get them as a one off. I’ve just had my results in and tsh is still suppressed but t3 has gone from 6.6 to 5 when the range is 3.8-6.6. I don’t think my t3 has ever been as low as 5. If I had done what they wanted and been on 75 every day, then my t3 would have probably been bottom of the range. My t4 is 16.5 (range 8-18) and was 18.1 May 2024.

Do you think I should stay on 100 for 2 days and 75 on third day or ask to go back to 100? Don’t think they’ll agree anyway. I want to at least be able to get 100 mcgs again.

[SlowDragon Ambassador]

How do you feel

What symptoms

Weight stable?

Just testing Ft4 and Ft3 doesn’t tell whole story

Looking at previous posts You

You have Hashimoto’s

are you on gluten free and/or dairy free diet

What brand Levo are you taking

Do you always get same brand

Just testing Ft4 and Ft3 doesn’t tell whole story

Essential to test and maintain GOOD vitamin levels

Low vitamin levels tend to lower TSH

Ferritin was on low side 7 months ago

Have you retested vitamin levels since then

[Tjqui00 in reply to SlowDragon]

I’m on levothyroxine and always take the same brand. My tsh has been suppressed over 10 years, no matter what dose I’m on. I have gained a few pounds when I don’t usually and feel more tired.

No I haven’t gone gluten or dairy free. Haven’t had my vitamins tested for a while but last time I did, my vitamin b12 had gone up quite a bit after taking vitamins. Vitamin d was 90 I think. I haven’t been taking vitamins as often lately.

[SlowDragon Ambassador]

was last test early morning, and last dose levothyroxine 24 hours before test

Ensure last dose day before is 75mcg (not 100mcg)

Free T4 (fT4) 16.5 pmol/L (8 - 18) 

Ft4 is 85.0% through range

Free T3 (fT3) 5 pmol/L (3.8 - 6.6) 

Ft3 only 42.9%

Suggests poor conversion……low vitamin levels likely

[Tjqui00 in reply to SlowDragon]

Yes, I took last dose 24 hours before and 75 mcg the day before.

I’ve always had good conversion and t3 is usually high end of the range or over range, so this result is the lowest it’s ever been I think. Think if prefer going back up to 100 mcg.

[SlowDragon Ambassador in reply to Tjqui00]

Well your Ft4 is already high

you don’t really want Ft4 any higher (Levo)

Many members find they need to adjust dose Levo a little lower post menopause

Request GP test vitamin D, folate, B12 and full iron panel including ferritin as next step

And coeliac blood test if not been done and not on Gluten free diet

[Tjqui00 in reply to SlowDragon]

Would taking selenium help the conversion of t4 to t3?

I’ll definitely start taking vitamins every day. I might get a private blood test soon as my doctor is reluctant to do them.

[SlowDragon Ambassador in reply to Tjqui00]

Ideally test first see how low vitamin D, folate and B12 are

Monitor My Health (NHS private test service) offer thyroid and vitamin testing, plus cholesterol and HBA1C for £65

(Doesn’t include thyroid antibodies)

monitormyhealth.org.uk/full...

10% off code here

thyroiduk.org/testing/priva...

if not going to test folate and B12 definitely test vitamin D

Test twice year when supplementing

Aiming for vitamin D at least 80nmol minimum

NHS easy postal kit vitamin D test £31 via

vitamindtest.org.uk

Iron

Never supplement iron without getting full iron panel including ferritin

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

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

Medichecks iron panel test

medichecks.com/products/iro...

Look at increasing iron rich foods in diet

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...

Great in-depth article on low ferritin

oatext.com/iron-deficiency-...

drhedberg.com/ferritin-hypo...

This is interesting because I have noticed that many patients with Hashimoto’s disease and hypothyroidism, start to feel worse when their ferritin drops below 80 and usually there is hair loss when it drops below 50.

Posts discussing why important to do full iron panel test

healthunlocked.com/thyroidu...

Good iron but low ferritin

healthunlocked.com/thyroidu...

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...

[Tjqui00 in reply to SlowDragon]

Thank you.

[Tjqui00 in reply to SlowDragon]

My GP has now said to reduce my dose to 75 every day when though the ft3 is only 5. Originally said to stay on same dose for 6 months.

[SlowDragon Ambassador in reply to Tjqui00]

I would get vitamin levels tested NOW ….before considering reducing dose

[Tjqui00 in reply to SlowDragon]

Do you think though, as long as t3 and t4 are in range, I shouldn’t be reducing my dose anyway?

[Tina_Maria]

I am in a similar position as you. My TSH has been suppressed since starting to take levothyroxine more than 20 years ago. I also tried to go down to 75mcg alternating with 100mcg, but my TSH never budged and I became unwell. I need my T4 fairly high, so my T3 can come up to 5.5. I am currently experimenting going 75mcg one day per week (tried 75mcg 2 times but that was a no no).

Ideally, we want the T4 not right on top of the scale, so it might be worth experimenting a bit and trying to lower the dose slightly. Try going slowly and do perhaps 75mcg once per week and see how you feel. You might have to try and stay on it for about 5-6 weeks as apparently you can feel a bit off by week 4-5, but things could improve again after that. See how you go, if its okay, you can try to go 2 x 75mcg and see. It is a bit of trial and error.

The TSH will probably not come up again, but obviously you want to see, if you can tolerate a slightly lower dose. If it works great, if not you can always go up again - but I would try and see. Good luck.

[Tjqui00 in reply to Tina_Maria]

I’m taking 100, 100, then 75, then back to 100. I was on 100 before that. This had made my ft3 go from top of range to now 5 which is the lowest it’s ever been, I don’t want to reduce any further. Do you think my ft4 is too high? If I reduce further, my ft3 will end up being bottom of the range.

[Tina_Maria in reply to Tjqui00]

Well, 18.1 is right on top of the range, so ideally it would be good to have it a bit lower. Having said that, it really depends on how you are feeling. If you need this to be well and for your T3 being high in range, then you have to have it this way. Still, I would try to do 75mcg for one day a week and see how you get on. If it still does not work, the go back to 100mcg as before, but at least you have given it a try.

[Tjqui00]

mine is 16.5 and range goes up to 18. I’m currently taking 100 for 2 days, then 75 on the 3rd day. Have been for about 6 months. Was on 100 before that for a couple of years. Before that I was on higher.

[Tjqui00]

My ft4 was 18.1 in May. Now it’s 16.5. Ft3 was 6.6 in May, is now 5.