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Low T3

Hi I received a letter from my endo saying that she wants my doctor to check my thyroid hormone levels in 6-8 weeks but I don't know if she meant from the date of the letter (17 June) or from when it was typed up (15 July)
She said that I'm symptomatically euthyroid and she wants my TSH to be under 2 and my free hormones to be in the upper limit of normal and no increase in dose. At the moment only 1 - the FT4 - is in the upper limit and my dose has stayed the same at 150 micrograms which I've been on since April. I have been on thyroxine since November last year.

JUNE 2015 - 150mcg thyroxine unchanged
TSH: 1.21 (0.27-4.20)
FT4: 19.3 (12.00-22.00)
FT3: 4.2 (3.90-6.70)

MAY 2015 - 125mcg thyroxine changed to 150mcg
TSH: 1.37 (0.27-4.20)
FT4: 12.7 (12.00-22.00)
FT3: 4.5 (3.90-6.70)
TPO antibody: 317 (<34)
TG antibody: 265 (<115)

Does it look as though my endo has overlooked my FT3 being low in June and should I contact her as to why no action seems to be taken on it?

Thanks :)

MARCH 2015 - 100mcg thyroxine changed to 125mcg
TSH: 7.04 (0.27-4.20)
FT4: 15.6 (12.00-22.00)
FT3: 5.1 (3.90-6.70)
Best Answer
Avatar universal
Can't imagine how the doctor could come to the conclusion that you were symptomatically euthyroid.  Perhaps she meant to say that she considered you to be biochemically euthyroid since your test results were within the lousy reference ranges that are far too broad to be functional across the entire breadth, for many people.  

I just noticed that you are in the UK.  That presents even more problems due to the dictates of the NHS regarding testing and treatment of hypothyroidism.  A good thyroid doctor will treat a hypothyroid patient clinically, by testing and adjusting Free T4 and Free T3 as necessary to relieve symptoms, without being constrained by resultant TSH levels.  Symptom relief should be all important, not just test results, and especially not TSH.  In the UK the typical approach is to test for TSH and if above 5, then test for Free T4, and if within range, no thyroid med is prescribed.  At least you have been prescribed thyroid med, so now it is a matter of getting the doctor to recognize that you still have very typical hypo symptoms, and a few other possible issues, and revising your meds to provide a source of T3, and then gradually increasing your Free T3 level to relieve symptoms.  

If you can get the doctor to do that the next battle would about the resultant TSH level.  Many hypo patients taking adequate thyroid meds find that their TSH level becomes suppressed below range, and the doctor wants to reduce the med dosage.  That is also wrong because TSH frequently becomes suppressed in those conditions, and there are scientific studies that show that.  

If you cannot convince your doctor to do these things, then you will either have to resort to the approach of a fellow UK member, shown below, or go private.  The UK member had a lot of trouble getting the testing, treatment she needed so this is how she described how she was finally successful.

"What I have learned from my experience is that you have to go to the Dr's office and TELL THEM WHAT YOU WANT and to go backed up with knowledge.  You have to tell them that you have done your reading and looked into your condition and care about the long-term treatment of your health and thyroid.  If you fight for what you want, you will eventually find someone that is happy to go along with your wishes.  But we all have to take charge of our own health, right?"




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Avatar universal
Sorry, not April. I meant May.
Helpful - 0
Avatar universal
I'd say definitely from June since 6-8 weeks after last tests is a usual interval for followup testing.  

Why did your doctor say that you were symptomatically euthyroid?  Your Free T4 is high in the range and your Free T3 is low in its range, which is related to inadequate conversion of the T4 med to T3.  Since Free T3 correlates best with hypo symptoms, your level of Free T3 is usually related to having hypo symptoms.  Are you symptom free as the doctor claimed?
Helpful - 0
Avatar universal
Thanks for replying. I don't know why my endo said I was symptomatically euthyroid. I told her the following symptoms I still have:

Hard stools
difficult swallowing
heavy periods
joint pains
tired, feeling wiped out
feeling cold
sleeping a lot
weak leg and arm muscles
no appetite
pins and needles in feet and legs

Helpful - 0
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