# Low TSH, High T4, Low T3



## Im-the-mom (Sep 4, 2014)

Hi again,

I have posted several times before. I had my TT in 09/14. My levels are still not right. I fired my ENT because he was only willing to test my TSH. I have had my GP run my labs twice.

This last test, when the nurse (a new one that I've not seen before) was taking the blood draw, I asked her to add free T3 and free T4 to the test, since the first one they ran six weeks before was only TSH, T3 and T4. She gave me a look, and said she would have to ask the DR. I told her I understood, but I wanted those tests added, that I had been researching my condition, and I have to live without a thyroid for the rest of my life. I want to be educated on my condition, and I want to know everything I can. SInce I am paying for the tests, I want them added.

This was on Friday. Today is Monday, and I can see on MyChart, the online personal medical info site, that my test results are posted, and I only see TSH, T3 and T4. Looks like I will be shopping for a new doc if she didn't approve the addition of those other tests!!

Results:

TSH 1.10 Range 0.55 - 4.78

T3 0.67 Range 0.60 - 1.81

T4 11.1 Range 4.5 - 10.9

I am up to 150 mcg of levothyroxine. I still feel bad. No energy, constipated, cold hands and feet, very dry skin, hair like straw.

I set my alarm and take my levothyroxine at 5 am every morning, and then nothing to eat or drink until after 6 am. I even read that a high fiber diet can affect the absorption of the medication, and everything I eat has fiber (constipation!!) so I am now not even eating until after 9 am. I stopped taking a multivitamin, because I was afraid that the calcium, even the little that is in it, and the magnesium, were affecting the medication. I don't use Tums. I am using everything I have learned to make sure the medication can work right, and I still feel bad. I am soooo tired of feeling tired.

What do I do next??

Thanks to any help or advise. I just want to be like other people and have enough energy to enjoy my life.


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## Octavia (Aug 1, 2011)

This is easy. You are not properly converting T4 to T3.

My advice? Talk to your doctor about decreasing your levothyroxine (a T4 drug) and adding Cytomel (a T3 drug). That will decrease your Free T4 (which is tooooooo high) and increase your Free T3 (which is too low in the range for you to feel good).


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## Lovlkn (Dec 20, 2009)

> Results:
> 
> TSH 1.10 Range 0.55 - 4.78
> 
> ...


Ask your doctor to reduce your 150 mcg of levothyroxine to 125mcg and add 5mcg of Cytomel. Split the Cytomel pill in 1/2 and take 6 hours apart. You mayu want to be on the 125mcg for a few days before adding the Cytomel to give you body a chance to lower it's FT-4 level.

I for one did not feel well until I added Cytomel.

Other tests to consider - Ferritin and Vitamin D. If low these also contribute to some of the symptoms you are having.


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## Im-the-mom (Sep 4, 2014)

Thanks for the advise. I don't know if it makes a difference, but the values I posted are not Free T3 and Free T4, but Total T3 and Total T4.


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## Lovlkn (Dec 20, 2009)

You might want to have the FT-4 and FT-3 run prior to adjusting your medications.

If your doctor won't run or you can order them for $59 at this site.

http://www.healthonelabs.com/pub/tests/test/pid/167

There are a few extra tests but it's the least expensive panel to include the tests most important.


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## cupidcashier2 (Feb 6, 2015)

reading this post is very close to my question,had labs on feb 2 - tsh 3.670 r.r.0.450-4.500 ft3 2.5 r.r. 2.0-4.4 ft4 1.58 r.r 0.82-1.77 added 5mcg cytomel once daily ..on 112 synthroid 5 days 125 synthroid 2 days.......any input on these labs ..t.t 6 yrs ago nodules and hashimoto`s....thank you


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## Changexpert (Feb 10, 2015)

Is there any natural treatment for T4/T3 conversion issue? What protocol should I follow if TSH keeps declining in this case?


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## Im-the-mom (Sep 4, 2014)

I got a call this afternoon from my doc's office, not sure if it was a nurse or someone from the front office. She told me the doctor saw my results (no free t3 or free t4), and everything looked good. She wants me to continue with my current dosage.

I told her they never added the additional tests I asked for, and that the results weren't really that good. My T4 was too high, my T3 was too low, and if the nurse that had taken the blood draw had passed any information to the doctor, she would know that I DON'T FEEL WELL!

I asked her if the doctor was familiar with Cyomel, and would she consider adding T3 to my T4 after seeing what the new tests showed. She said she would ask. Waiting for a return call.

I made a call to an endo in town that has gotten really good reviews from patients, in the area of being very thorough, listening to the patients and being open to adjusting meds until not only are the labs good but the patient is feeling good, also. She is taking new patients, but needs a referral and can't see me until mid April. She will, however, consult with my doctor and recommend what tests need to be run until I can get in to see her.


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## Im-the-mom (Sep 4, 2014)

I FINALLY have my appointment with my new endo in just over a week. I have made a list of things I want to ask or discuss, because my brain is in a permanent fog!

To calculate what the optimal t3/t4 and ft3/ft4 levels should be, do I just take the upper range and multiply by .75? I saw somewhere a calculation that took the upper range minus the lower range, then blah, blah something, something. I can't remember what it was, or where I saw it.

I am so ready to see this new doctor, and have high hopes that she will run all the tests I need, and can figure out what my dosage should be. I have felt so bad for so long, I could just cry, and sometimes I do. I have a new grandbaby coming in November and I want to have the energy to celebrate, and help my daughter and son-in-law with the new baby!

Wish me luck!


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