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Endo halving T3

I am taking 100mcg T4 and 10mcg T3. I have Hashimoto's. My endo has told me she wants my T3 reduced because my TSH is suppressed. I have told her over the phone that some of my hypothyroid symptoms have improved but she is still reducing the T3 and is writing to my doctor asking for more investigations into my symptoms.

Even though I notice an improvement with appetite etc and I told the endo of this she has said she would rather treat me on how I feel, not on what blood tests say and to call back if I feel unwell on the reduced T3.

Symptoms now gone - loss of appetite, weight gain, hair loss, dry skin

Symptoms still there - constipation, fatigue (worse with periods), heavy periods, irregular periods, joint pain

DECEMBER 2015 - Endo now wants my T3 reduced to 5mcg from 10mcg because she doesn't want me to get heart problems or osteoporosis with a suppressed TSH
TSH - 0.02 (0.2-4.2)
FREE T4 - 20.0 (12-22)
FREE T3 - 5.2 (3.9-6.7)

NOVEMBER 2015
TSH - 0.02 (0.2-4.2)
FREE T4 - 20.6 (12-22)
FREE T3 - 5.0 (3.9-6.7)

SEPTEMBER 2015 - Endo dropped T4 to 100mcg and started me on T3 (10mcg) because previous T3 levels did not look great.
TSH - 0.02 (0.2-4.2)
FREE T4 - 24.3 (12-22)
FREE T3 - 5.9 (3.9-6.7)

JUNE 2015 - T4 increased to 175mcg
TSH - 1.25 (0.2-4.2)
FREE T4 - 19.3 (12-22)
FREE T3 - 4.2 (3.9-6.7)
TPO antibody - 276 (<34)

MAY 2015 - T4 increased to 150mcg
TSH - 5.70 (0.2-4.2)
FREE T4 - 18.7 (12-22)
FREE T3 - 5 (3.9-6.7)

MARCH 2015 - T4 increased to 125mcg
TSH - 0.65 (0.2-4.2)
FREE T4 - 12.9 (12-22)
FREE T3 - 4.1 (3.9-6.7)

NOVEMBER 2014 - T4 increased to 100mcg
TSH - 7.40 (0.2-4.2)
FREE T4 - 15.1 (12-22)
FREE T3 - 4 (3.9-6.7)

SEPTEMBER 2014 - T4 started at 25mcg, 50mcg and then 75mcg
TSH - 21 (0.2-4.2)
FREE T4 - 10.3 (12-22)
FREE T3 - 4.5 (3.9-6.7)
9 Responses
Avatar universal
A good thyroid doctor will treat a hypo patient clinically by testing and adjusting Free T4 and Free T3 as needed to relieve symptoms, without being constrained by resultant TSH levels.  Symptom relief should be all important, not just test results, and especially not TSH results.  

Also, in my Dec. 11 post in this thread. you can get the info you need to refute what your doctor is concerned about  The first link shown in the thread was written be a good thyroid doctor.

http://www.medhelp.org/posts/Thyroid-Disorders/Fluctuating-numbers/show/2800442#post_13532072

Hypothyroid symptoms can be affected by more than just Free T4 and Free T3 levels.  Have you been tested for Vitamin D, B12 and ferritin?

Avatar universal
Hi Gimel. Thank you for replying. Yes, I have been checked for Vitamin D, B12 and ferritin. I am meant to be taking ferrous fumarate but I have felt sick after taking it and the doctor kept changing the dosing - one told me to take 2 tablets a day and another told me to take 3 a day so because I felt unwell on the iron and of the confusion I stopped it.

I did supplement with Vitamin D and B12 a few months ago but I had some digestive upset with the Vitamin D supplement when I doubled the dose from 3000IU to 6000IU. I can only place blame on doubling the Vitamin D supplement because the digestive symptoms stopped when I stopped it altogether. B12 took a while to increase.  It has since risen but would it have taken longer to increase because that's just the way it is with B12? It dropped before rising which I was confused about. The Vitamin D rose pretty much straightaway so I don't know if it'd be different for the B12!

I wish I knew why some of the ranges are varied for the vitamins and minerals.

NOVEMBER 2015
FERRITIN - 21 (15-150)
VITAMIN B12 - 485 (191-663)

AUGUST 2015
FERRITIN - 17 (15-150)
VITAMIN B12 - 341 (191-663)
25-OH VITAMIN D TOTAL - 68.5 (>75) - I increased the Vitamin D from 3000IU to 6000IU but after doubling it I had gas, nausea, diarrhoea and stomach cramps so I stopped it after 2 days of this.

MARCH 2015
FERRITIN - 38 (15-150)
VITAMIN B12 - 547 (191-663)

DECEMBER 2014
FERRITIN - 19 (15-150)
25-OH VITAMIN D TOTAL - 74 (>75)

MAY 2014
VITAMIN B12 - 363 (190-900) - I started a Vitamin B12 supplement which was 1000mcg
25-OH VITAMIN D TOTAL - 58.3 (>75) - I changed the Vitamin D supplement to a 3000IU dose because I felt the 800IU wasn't very potent

OCTOBER 2013
FERRITIN - 21 (30-400) - I was prescribed 210mg ferrous fumarate
VITAMIN B12 - 341 (190-900)
25-OH VITAMIN D TOTAL - 41.3 (>75) - I was prescribed 800IU by my doctor
Avatar universal
From your test results I see no reason for increasing your Vitamin D last May.  58.3 is adequate.   Using the lab range, your B12 needs to be nearer 600.  Your ferritin has never been anywhere near high enough.  I can't imagine why you were prescribed 210 mg of ferrous fumarate.  When my ferritin was about 40 I started with 25 mg of ferrous fumarate, and increased to 50 and my ferritin rose to almost 80.  You need to try again with a much lower dose to optimize at about 70 minimum.  You might also try ferrous bisglycinate since it is easier on the digestive system.  

Do you think any of the links I gave you might affect the doctor's decision to reduce your T3 med?  Decreasing your dose is the wrong direction, since you still have hypo symptoms.  
Avatar universal
Ii think I might have meant 210mcg and not 210mg - sorry if this is the case!

Yes, the links are very helpful. Because I am not comfortable in reducing my dose of T3 I would like to keep it as it is.

My NHS doctor was happy to increase the T4 to 125mcg at one point but he was simply going by symptoms and not blood tests and that was even when the TSH was suppressed back in November. I expected the endo to agree with my doctor's way of thinking but she immediately said absolutely not.
Avatar universal
Iron supplements are in mg, so  210 mcg would be almost nothing.   210 mg is way too much.  So I suggest trying again with the right amount.  
Avatar universal
Thought I posted an answer.  Oh well, I'll try again.  

The dosage of 210 mcg would be almost nothing.  Surely it was mg.  And if so, that dose was way too much.  I'd try again starting with about 25 and work up to 50 or 75, whichever is needed to get ferritin up to 70 minimum.
231441 tn?1333892766
ONce on thyroid meds the correct numbers to look at are Ft3 and FT4.  TSH is as it's initials stand for Thyroid Stimulating Hormone.  It acts directly on the thyroid not the bones or the heart.  It is very common for TSH to be suppressed when patients are on thyroid medication... in this case TSH should be ignored and FT3 and FT4 used as a guide to treatment, along with patient's symptoms.

Your FT3 and FT4 look to be ok and IMHO worth leaving where they are for now with your current dosing and simply observing.

I had the unfortunate experience in the past of seeing an endo who thought I was overmedicated because my TSH was very very low.  So she cut my thyroid meds in half.  After 6 weeks, my FT3 and FT4 were below range and I was feeling like death warmed up, but my TSH did not rise very much at all....  I increased my meds and never saw that Dr again.
Avatar universal
Will do, Gimel - thanks! :)
Avatar universal
Thanks Sally. I am not going along with what the endo is suggesting. This is my body and not hers and I am sticking to the current doses.
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