Firstly sorry if you feel i have askes this before butbi can't get my head round it and need it explaining again.
So i am lookingbto start levo dose 50 as my lates TSH was 5.3 (0.35-4.9) so sub hypo. However, my T4 was higher than ever 13.4 (9.1-17.6) end march
I know people on here have sais no good withput T3 last time i had T3 was feb resilults T3 -4.1 (2.4-6) T4 10.8 (9.1-17.6) TSH 3.5 (0.35-4.9)
So my questions - the fluctuatio s in a months seems dramatic so my TSH gone up from 3.5 to 5.3 T4 has gone from 10.8 to 13.4. From whatbi understand i am wanting a higher T4 and lower TSH. I thought thatbas the T4 was higher in my last test my TSH shoukd surely be lower?
Also still strughling to inderstand that if i start Levo next week on 50 this is likely to lower my TSH isn't this by increasing T4 as that is the medicine? But my T4 is decent. So advice has said starting on 50 things may get worse before i need ro up.my dose. But why doesn't it just enhance what my thyroid is already doing? People have tried to explain that because my thyroid may be produxing more that 50.by introduxing just 50 means i am not ln high enough dose. I don't unserstand why this stops your own thuroids produvtion and overtakes it?
I have just done another set of bloods including T3 but these may not be accepted. As GP said the need speacialist order!
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From whatbi understand i am wanting a higher T4 and lower TSH. I thought thatbas the T4 was higher in my last test my TSH shoukd surely be lower?
But, once again, you are ignoring the possible effect of the FT3. I suspect that your FT4 has risen because less of it is being converted to T3. If the FT3 is low, the TSH will be high.
Good that you've done a test with T3. Never mind if your GP doesn't accept them, he doesn't know what T3 is, anyway, he only looks at the TSH. But you need to know.
I understand your confusion about things getting worse before they get better. But when we first started discussing all this, you were talking about starting on 25 mcg levo, and that is an entirely different matter - the dose would be much too low. So, start on 50 mcg and see what happens - it's all trial an error, anyway. And you have no way of knowing that your thyroid is producing 50 mcg T4, that was just an example I used to try and explain how it works. Obviously, I failed!
I am not ignoring it (T3) Just as we know not all GP's in uk are allowed to test in. My GP is actually one of the better ones and has requested everything I have asked for. So i have just had blood for T3, wth T4 and TSH and Tagb and Iron panel as you suggested. He raised the request just if labs allow them now. If not the private ones.
So guess wait for results but still and start on 50 is the plan. But I am still confused has to why the intro of 50 levo wont just compliment and add to my natural store?
Sorry if you feel you have explained just may need laymens terms for when I speak to GP.
But I am still confused has to why the intro of 50 levo wont just compliment and add to my natural store?
Your thyroid makes Ft4 (and a little Ft3) in response to TSH (thyroid stimulating hormone) a message from the pituitary gland. Higher TSH means “make more” …..lower TSH means “make less”
Pituitary is highly sensitive to noticing how much thyroid hormone is in your blood stream
Initially for first few days starting on levothyroxine you would have “extra” Ft4 in your blood stream. But your Pituitary quickly notices this ……reduces TSH and your own thyroid production then reduces …..
So you have less thyroid hormone in your blood……but because you are taking a steady replacement dose…..your body has something reliable to work with everyday
Over 6-8 weeks on constant dose your metabolism starts to improve, you start feeling better/doing a bit more
Ft4 starts to drop a bit because your body is using it up …..TSH starts to slowly rise back up
A few symptoms start to return…..all typical and indicate that you are then ready for next increase
That’s why we wait 6-8 weeks between each dose change
I get this but still don't understand wht the 50 we intoduces doesn't just cimpliment the natural supply why do we need to overtake it with levo rather than the body takes from both..Sorry if you feel you have explained it i just really dont getbwhy it switches it off
But why when it can read ya natural hormones! Why can it only ready tge levo...surely tge levo can be the stable and your own T4 could flucuate to keep you balanced...as it does naturally and as the pil can't do?
These was my result pre hemi in sept;2.7 TSH (0.35-4.9)
T3 4.2 (2.4-6)
T4 13.3 (9.1-17.6)
I was discaharded from ENT feb after hemi;
3.5 tsh
10.8 t4
4.1 t3
Lasted tsh is 5.3 but T4 13.4 no T3.
My question. I seamed to funtion well pre hemi... slightly raised TSH but i wss functioning fine and T4 T3 look sound. Shoukd i be aiming to get back to my more here.
Well, I do use layman's terms because I am a layman. lol
When I said you're ignoring the T3 again, I didn't mean you're not testing it, I know you've had it tested. What I meant was you're ignoring the effect it has on the TSH. You asked why your TSH was still high when your FT4 was OK. And I tried to explain that it's not just about the FT4, you also have to take the FT3 level into consideration. And if the FT3 is low, the TSH is going to be high. That's what I meant.
Taken in isolation your FT4 may appear ok....but thyroid hormones don't work in isolation they work together.
So, to get a picture of what is going on we need both FT4 and FT3 along with TSH which is a pituitary hormone.
TSH is basically a messenger. When the system is working correctly it reflects how much hormone is in the blood and instructs the thyroid to produce more or less hormone as is required.
Unfortunately it is not a reliable marker and should not be relied on without including FT4 and FT3
FT3 is the most important result....it is the active hormone
T4 is the storage hormone and must be converted in various tissues in the body to the active hormoneT3.
How do we know if T4 to T3 conversion is robust?
We compare FT4 and FT3...if FT4 is high and FT3 is low we usually find that conversion is poor which is causing the low FT3
If FT3 is low our health suffers, we become hypothyroid
It is complicated but as you learn more it will become clearer!
But why doesn't it just enhance what my thyroid is already doing?
Because that's not how the body works! It suppresses natural production
By adding T4 (or T3) we are replacing the hormone in the system.....not topping it up. As a result we have to work out how much replacement hormone we need, based on lab results and symptoms
(TSH alone is not reliable marker)
To do this accurately we need to measure TSH, FT4 and FT3......the problem is that doctor's do not understand this, so patients don't recover properly.....and many of them end up her looking for help from the people with lived experience!
Time for a reassessment of the treatment of hypothyroidism
John E. M. Midgley, Anthony D. Toft, Rolf Larisch, Johannes W. Dietrich & Rudolf Hoermann
I think you have to accept that exogenous hormone (T4 or T3) replaces what the body has previously produced, which has proved inadequate. That natural supply then shuts down in favour of the more reliable, effective supply of exogenous hormone
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