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What does this mean?

I take 3 grains naturethroid.  I keep getting test results that show FT4 as low (outside of range).  FT3 is normal (but near low edge of range).  How is it possible to take a fairly high dose of thryoxine and yet not have it show up in blood test results?
Thank you.
Best Answer
Avatar universal
Because of the high T3 content in NT, it's not unusual for people on it to have lower FT4.  However, considering you're taking a pretty high dose, we would expect it to be at least in range.  Your FT3 is also very low for someone taking 3 grains.  

You have a few alternatives.  1) You could try taking it sublingually.  A lot more is absorbed that way, and you would still be able to use your current supply.  2) You could just take more.  For whatever reason, not much of what you take is getting into your bloodstream.  3) You could try another brand in case it's one of the fillers that's making it hard for you to absorb.  Some of our members who take desiccated find that there are subtle differences in different brands that can make one far superior (for them, not for everyone).

Have your labs ever been "good" on any thyroid meds?    
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1202943 tn?1347840652
I had heavy arms and legs when I was hypo with low FT4 & FT3.  I now take armour and slightly chew the pills before swallowing. I also have gone gluten free and feel it's helped with my absorption.  You might give that a try.  Also, my DHEA was on the low end and have felt better since taking 5 mg each morning. Low iron and Vit. D can be a problem too.
Helpful - 0
Avatar universal
Yes, ERFA would be prescription only.  There's another product that's sold out of Thailand, called Thyroid-S.  I don't know a thing about this one, but we do have a member who recently started taking it.

Sorry, I can't be much help with the reproductive hormones...not my forte.  I don't think thyroxine is made from progesterone.  Thyroxine is a combination of thyroglobulin, which is the protein precursor of T4, and iodine.

Vitamin D and iron (ferritin is also important) should not just be in range, but well up in the range.

I remember that feeling in my arms when I was hypo.  When very hypo, I couldn't sit for more than a few minutes without falling asleep.  I was almost narcoleptic.  

Well, I figured that if I knew what a pole-axe was I'd know what it was like to be pole-axed.  How does it differ from a regular axe?  Okay, okay, I get the idea.  LOL

I think hypopit is treated by replacing the hormones the pituitary controls, which is what you are already doing.  Of course, in the case of a pit tumor, surgery might take care of it.
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Avatar universal
oh.  I elided an answer to you with that to goolara.  sorry.

I had my adrenals tested about a year ago, before I started taking thryoid medication.  At that point at least it was totally fine.

I could look into pituitary.  I think this all started when I originally had normal ft4 etc. but nearly undetectable TSH, so maybe it's not working.  I was thinking that the pituitary was just a bit sluggish.  I'll get another test to see what it's doing.

I would have thought my oestrogen & progesterone would not be high if I had that.  Can your pituitary be disfunctional in respect of some hormones only?  Is the Stim test nasty?

is there anything you can do to treat hypopituitarism?
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Avatar universal
jeez, it's so refreshing to get this feedback after the medical care for thyroid in the UK.  I had RT3 (normal) done privately a year ago and it is meant to take 2 months!  It actually took 6 months!  the UK is hard work.

yes. I split my dose.

I had a look at canada and I only see prescription-only chemists.  I can get naturethroid from the states without prescription.  its hard to get a prescription for armour in the UK (it may be impossible.).

I had testosterone, done a year ago and it was normal.  dhea at same time. low-ish. oestrogen was is quite how.  now sky-high (out of ref range). progesterone high-normal (I was surprised).  I know that oestrogen can interfere with thyroid.  I'm adapting my diet still further to try and address the oestrogen.  (no fun for me).  I'm sounding a bit negative, I notice.  I'm looking into agnus castus, etc.  maybe extra progesterone?  I don't know. It's way low compared to the oestr., but I could adjust the ratio.  Isn't thyroxine made from progesterone?

(I got Vitamin D tested - OK.  I've never had iron tests that came back low)

Yes, that's exactly it.  Extreme tiredness in my arms.  Then I gradually get too tired to sit up and whoopf I'm asleep.  It's a useful sign that hypo is coming on.

Pole-axed is how you would feel if you were hit with a pole-axe!
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Avatar universal
I take NP thyroid by acella--it is very similar to what armour used to be before it was ever reformulated.

I notice that not only are your FT3 and FT4 low--but your TSH is on the low end---it's not supposed to work that way.  If both FT levels are low, ideally, yout TSH should be on the higher end.  You have an abnormal reading.  These are the kind of test I was getting----it is possibly an incicator of a pituitary problem.

Have you had any of your other hormone levels checked, such as testosterone, DHEA, estrogen, etc.?    Mine were all off, and my cortisol and ACTH were also low.  I had a Stim test and was diagnosed with secondary adrenal insufficiency.

My actual diagnosis is central hypothyroidism---so a TSH will never be reliable on me.  (personally, I don't think they are a reliable test, anyway).

Central hypothyroidism is a form of hypopituitarism---just something you might want to ask about since your TSH is low along with both FT levels.
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Avatar universal
I'm not sure I know what "pole-axed" feels like.  LOL  That's not an expression we use!

Do you split our dose?  Don't forget that if the dose you've been taking hasn't been being absorbed in your gut, you might have to reduce your dose when you take it sublingually.

It's hard to recommend another brand because some people seem to like one, and others another.  I think the way people react to the brands is very individual.  Armour lost some of it's lustrous reputation after the last reformulation.  Many people who were on the old, "good" Armour seem to have gone to ERFA (Canada).  

Is it like an extreme "tiredness" in your arms?
Helpful - 0
Avatar universal
Goolarra,
Thanks again.

I tried sublingually today and I felt pole-axed about 1/2 hour after taking it, but it's first time, so...I'll try raising the dose and another brand.  Do you have any recommendations?  

(I have another question (less important).  Is dead arms a hypo symptom?  They're not painful exactly.  Everything I pick up - kettle, plate - seems to weigh a ton.  My arm muscles complain.  I can't hold a phone conversation holding the phone because my arm begins to ache.  Can't do my hair.  Only arms. not legs.)
Helpful - 0
Avatar universal
Thanks again, goolarra.  
I do do that.  I take my medication on an empty stomach, eat about 2 hours later.
Yes, its strange in itself that the blood tests show low FT4 and that I feel pretty weak, but my gut appears fairly normal.  I had a fairly nasty issue with malabsorption in the past, about a year ago.  I found taking a bile supplement cleared it up almost instantly (the next day).  Since then I've been ok.  My gut seems to have been ok as long as the antibodies have been normal (hooray).  I'm very careful about my diet.  It's time-consuming but worth it.
Do you think it's worth swapping to another brand?  I live in the UK and have to get naturethroid from abroad.
Helpful - 0
Avatar universal
As you said, your FT3 and FT4 are impressively LOW considering how much NT you're taking.

An absorption issue is just the first thing that comes to mind.  Even if your gut is functioning well, other factors can affect absorption (e.g. sometimes the fillers in the tablets).  Do you take your meds on an empty stomach and then eat/drink nothing for 0.5-1.0 hour?  
Helpful - 0
Avatar universal
Thank you.  I do appreciate your response.  
TSH 1.06 ( ref. 0.27 - 4.2)
FT4  10.5* (12.0- 22/0)
FT3  4 (3.1 - 6.8)
All antibodies negative now.  Hooray!  Hooray!
Feel hypo (polaxed w. fatigue for periods week)  The usual hypo symptoms except constipation.
Surprised to hear about gut as it's functioning pretty normally.
Helpful - 0
Avatar universal
Your gut may not be absorbing it as it should.  Have you ever asked your doctor about taking it sublingually?  

It really doesn't matter how much you take.  All that matters is how much makes it to your bloodstream.  On NT, your FT3 should probably be around 70+% of range, or whatever it takes to relieve symptoms.

How do you feel?

Please post your labs and ranges.
Helpful - 0
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