TSH fluctuates, FT3 and FT4 always in the low range
allergictodiets
Posts: 233 Member
I've just put together my blood test results from the last 12 years ( before I was diagnosed and after ) and noticed that even though my TSH fluctuates, my FT3 always seems to be the same. Before my diagnosis my TSH was between 3 and 3,5 ( I was put on meds when it went over 4 ) and my FT3 about 2,6 ( reference range is 2-4,4 ). With medication, TSH fluctuates between 0,5 and 2,5 ( but mainly is about 2 ) but my FT3 stays between 2 and 2,5. FT4 is always around 12-13 ( reference range is 9,3-17 ). Does anyone know whether it is good or bad? Why can't it go higher? I am on L-Thyroxine 100 mcg ( upped from 75 mcg last autumn when my TSH suddenly went above 3,5 ).
I have a similar problem with my ferritin level. No matter what I try with my diet and what supplements I take, it never goes over 37 ng/ml.
Endo and GP say it is "all within norm" and that "I should feel fine". I don't. I experience spells of feeling really low energy, with aches and pains all over my body. Plus I suffer from bouts of massive brain fog, interfering with my work.
I have a similar problem with my ferritin level. No matter what I try with my diet and what supplements I take, it never goes over 37 ng/ml.
Endo and GP say it is "all within norm" and that "I should feel fine". I don't. I experience spells of feeling really low energy, with aches and pains all over my body. Plus I suffer from bouts of massive brain fog, interfering with my work.
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I'm not a doctor...
Your FT4 looks good, in my opinion, but your FT3 might be a little low, even though it's in range. You may want to ask your endo if you can try a T3 replacement, such as Cytomel, in addition to the L-Thyroxine. L-Thyroxine is used to replace T4, but if your thyroid isn't producing adequate amounts of T3, you may need to use a T3 replacement as well.
On the other hand, low ferritin can also cause the aches, pains, and fatigue you're experiencing...0 -
I'll second the cytomel. There was a great study published in the European Journal of Endocrinology in 2009 (I think), that really supports the addition of T3 medication for the majority of Hashi's patients. I'll dig it up if you'd like- the full text pdf is available online if you wanted to print or send it to your doctor for support.
I agree with you- when my fT3 levels are low, I feel crummy, regardless of my TSH or T4 levels.
For the ferritin, it takes forever to rise. Last year this time mine was about a 22. I cook everything in cast iron, make sure I get about 130-200% daily value (so 20-36 mg iron), and a lot of that is from foods. I try to always take any iron supplements with vitamin C (so I'll eat an orange or a grapefruit or something as my afternoon snack, and take my supplements with that), since that helps absorption. After 6 months, my level was 32. Last month (so, after a year), it had reached all the way to 44. It's slow.
Have you had any other nutritional status panels run to see if anything else might be low? I know I'm always running a bit low on vitamin D, which is crucial for conversion of t4-t3 in the liver.0 -
Yes please!I'll second the cytomel. There was a great study published in the European Journal of Endocrinology in 2009 (I think), that really supports the addition of T3 medication for the majority of Hashi's patients. I'll dig it up if you'd like- the full text pdf is available online if you wanted to print or send it to your doctor for support.
Oh thanks for that. I thought I was the only one struggling like that! I have a vegan friend with Hashi's whose levels are in the upper range.For the ferritin, it takes forever to rise. Last year this time mine was about a 22. I cook everything in cast iron, make sure I get about 130-200% daily value (so 20-36 mg iron), and a lot of that is from foods. I try to always take any iron supplements with vitamin C (so I'll eat an orange or a grapefruit or something as my afternoon snack, and take my supplements with that), since that helps absorption. After 6 months, my level was 32. Last month (so, after a year), it had reached all the way to 44. It's slow.
I supplement B vitamins, zinc and vit D ( I was deficient last year ). The last results were OK.Have you had any other nutritional status panels run to see if anything else might be low? I know I'm always running a bit low on vitamin D, which is crucial for conversion of t4-t3 in the liver.0 -
Free T3 is optimal when its in the top quarter of the range. Yours is super low.... and considering Free T3 is the actual ACTIVE portion of thyroid hormone, its no wonder you're not feeling well. You're not converting from FT4 to FT3 very well. I use Hema-Plex to bring my iron levels up... if your iron is low you're not going to be getting thyroid hormone into your cells. How are your periods? Heavy? If they are, that could be a cause for it being low, and could suggest estrogen dominance/low progesterone.
When your doctors tell you that you're "in range" they're not looking to see if you're optimized. T4 only meds are crap in my opinion. Makes no sense to supplement a sluggish, or non existent thyroid that makes T1,T2,T3,T4 with a pill that only contains the thyroid storage hormone T4. Natural Dessicated Thyroid meds such as Armour, Naturthroid, Erfa, NP Thyroid, contain ALL the thyroid hormones.0 -
Article on T4 T3 dual therapy in the European Journal of Endocrinology, 2009.
http://m.eje-online.org/content/161/6/895.full.pdf
The study design is very robust. The methods section details how the researchers adjusted between T4 and T3 (1ug T3 roughly equivalent to 12.5ug T4).0 -
Ditto on the T3. I never felt "good" until I insisted on adding Cytomel to my Levoxyl. Many years ago it was difficult to find a doctor to prescribe it, but I think it's more common now.0
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Thank you all for your input. I'll bring up the Cytomel when I speak to my endo next time. I have no chances to get a prescription for natural thyroid meds I think as they are not considered "accurate" and "safe" enough in Germany.0
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Bump. Lots of good information here to read later.0
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I have low and steadily decreasing t3. I recently read that there is concern over cardiac issues when prescribing cytomel that scares me about requesting a prescription for it.
My vitamin d is okay but I'm anemic, does iron affect the conversion of ft4 as well?0 -
I have low and steadily decreasing t3. I recently read that there is concern over cardiac issues when prescribing cytomel that scares me about requesting a prescription for it.
My vitamin d is okay but I'm anemic, does iron affect the conversion of ft4 as well?
Talk to your doctor about your concerns, but, from what I've seen, the cardiac issues occur mainly in patients with a history of existing cardiac issues. You may also experience some cardiac troubles (high heart rate, hypertension) if your dose is too high, bringing your T3 above normal. Those problems generally go away once your dose is lowered and your T3 is back in the normal range.
I don't know about iron affecting the conversion, but it'll definitely affect how you're feeling.0 -
I have low and steadily decreasing t3. I recently read that there is concern over cardiac issues when prescribing cytomel that scares me about requesting a prescription for it.
My vitamin d is okay but I'm anemic, does iron affect the conversion of ft4 as well?
Talk to your doctor about your concerns, but, from what I've seen, the cardiac issues occur mainly in patients with a history of existing cardiac issues. You may also experience some cardiac troubles (high heart rate, hypertension) if your dose is too high, bringing your T3 above normal. Those problems generally go away once your dose is lowered and your T3 is back in the normal range.
I don't know about iron affecting the conversion, but it'll definitely affect how you're feeling.
I had a closer look at the leaflet that comes with my L-Thyroxine to see what side effects it could have. It mentions lots of scary things, heart problems ( palpitations ) among others. Ah, and it also warns you you could experience weight loss. Ha ha ha.0 -
I have low and steadily decreasing t3. I recently read that there is concern over cardiac issues when prescribing cytomel that scares me about requesting a prescription for it.
My vitamin d is okay but I'm anemic, does iron affect the conversion of ft4 as well?
Yes, having low iron does interfere. You can read about it here: http://www.stopthethyroidmadness.com/ferritin/
Ideally you would be taking an iron supplement of some kind and working toward keeping your anemia under control. Also, it's best to keep your thyroid med and your iron supplement about 4 hours apart.0
