FT3 not improving??

[Klax79]

I know Hashi's usually don't convert well, mine is really not improving much. My symptoms r not that bad yet, coz I caught this problem early. Crazy weight gain & poor recovery after workouts are the main concerns. The nagging pain at my elbow was gone once I started the meds.

Jul'14
FT4 - 13.38 (9.0-19.0)
FT3 - 3.58 (2.63-5.7)
TSH - 6.59 (0.35-4.94)
-> On 5mcg Cytomel + 50mcg T4 in the morning

Sep'14
FT4 - 14.90 (9.0-19.0)
FT3 - 3.60 (2.63-5.7)
TSH - 2.14 (0.35-4.94)

Doc seems pretty happy with the ratio. I agreed that my FT4 is in the good range now but FT3 still quite ****** (it technically didn't "budge" at all). She's maintaining the T4 dosage & I managed to convince her to up the T3 (she prescribed 7.5mcg).

Looking at the results, my body's not converting any more FT3 with the increase in FT4. Is splitting Cytomel dosage the only way? I've never really asked abt NDT meds coz she wasn't really keen during my 1st visit. Any other possible reasons for the poor conversion? I'm already taking 200mcg Selenium & doc seems surprised that this is not even helping.

[Klax79]

Thanks gimel!

My doc was out of compounded T3 for a while, so I managed to get T3 from a friend who's in bodybuilding. The tabs came in 25mcg, so I did some trial & error cutting up the pill and testing out incremental doses (to make sure I don't get heart palpitations or other overdose symptoms).

Technically, I've been on 25mcg daily in the morning for 6wks prior to the blood test.  I don't get particularly hyper in the morning but slightly better than when I was on 7.5mcg. So I was a little surprised that at such dosage my FT3 only increased slightly.

Will try to get a Ferritin test on my next visit (Jan'15). My GP (not Endo) was telling me to try take a blood test 2hrs after taking my 25mcg T3 med to see how it affects the reading. She's interested to know how the FT3 numbers look like with the med at such a high dosage.

[gimel]

Your Free T4 is about 55% of its range.  Your Free T3 has increased to about 39 % into the range.  Many members say they needed Free T3 to be in the upper part of the range.  It really depends on how you are feeling.  If still having symptoms, there is plenty of room to raise your T3 med some more.  

B12 is fine.  D could be a bit higher, to a recommended level of 55-60, so you could supplement again, but go back on a lower dose of D3.  Those iron tests are okay, but I would like to also see a ferritin test done at next opportunity.  I say that because ferritin is somewhat of a precursor to serum iron levels.  Low ferritin can affect conversion of T4 to T3, plus a deficiency can cause symptoms as well.

[gimel]

Copied and pasted your latest post below so that all info is in one place.  

Klax79 | 1 hour
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Requested to test for Iron, Vit D & B12 since I'm not converting well. FT3 hovers between 3.6-3.8 regardless of how much Cytomel I'm taking. Been taking 50mcg T4 & 7.5mcg Cytomel.

FT4 : 14.45 (9.0 - 19.0)
FT3 : 3.84   (2.63 - 5.70)
TSH : 1.36 (0.35 - 4.94)

Iron : 20 (11 - 27)
TIBC : 59 (39 - 60)
% Fe Saturation : 33 (14 - 50%)

B12 : 704 (138 - 652)
Vit D : 40.2 (30 - 99.9)

Doc said Iron, B12 and Vit D all look good. I have been taking Vit D (5000iu) & B12 (5000mcg) daily even before I was diagnosed with Hashis. Stopped for 2 weeks before taking these tests to get a more accurate reading. Do I still need to supplement for Vit D and B12??

[flyingfool]

We are not Dr's so we won't generally advise anyone on specific dosages.

An increase from 5 to 7.5 mcg of cytomel is a normal jump. yes it is small, but T3 is pretty powerful stuff.  They say T3 ijs 4 times or 400% more effective than T4.  So while the increase is small, it can pack some punch.  It is usually always better to go up slow.

This is a small bump.  And you will have to wait a couple weeks to get blood drawn again to see what it is doing.  One thing you can do is pay close attention as to how you are feeling.  And the next time you get tested and talk with your Dr tell the Dr that the increase made you feel better (unless it makes you feel worse).  This will give some credibility to you and some confidence on the Dr's part to be open and least potentially to another small increase.  If you say it did nothing then your Dr will most likely look at you and tell you "told yo so" and stiffen in their opposition to further adjustments to increase.

I can't remembner if you split your dose.  But now that you are on 7.5 daily. It gives you the opportunity to take the 5 mcg in the morning and the other 2.5 mcg in the afternoon maybe between 1 to 3 PM.  Having this 2nd dose may allow you to feel better later in the day and in fact be a felt improvement.

Hope this helps.

[Klax79]

Anyone has an idea what kind of T3 dosage I should be asking for? I think 7.5mcg is still insufficient…..

[Klax79]

She felt that my latest bloodwork's "ratio" is pretty good, so she was ok to up my T3 a TINY little bit (duh). My numbers and symptoms are probably not that BAD enough to warrant a higher dosage of T3, so she's rreeeaallly conservative on upping the med.

My FT3 are not even in the mid range right? Hopefully we can identify the cause of non conversion from the tests and work from there, and at the same time bug her for more T3!