# I'm so confused



## GandKsmommy (Feb 15, 2016)

I had a TT bc of graves 5 years ago. I went and had blood work bc I thought for sure I was hypo, very tired, brain fog, leg aches and weakness. My tsh came back .05 (.3-4.5) and free t4 was 1.8 (.9-1.7). Dr says I'm hyper and need to back of my Levo a bit. Two months ago I was taking 2.5mcg of t3, tapering from 20mcg bc my body couldn't handle it. It wouldn't be surpressing my tsh still, would it? Also, are my symptoms hyperthyroid? A year ago my tsh was .79, free t4 was 1.7, so I'm thinking t3 is driving my tsh down. It can't be the 2.5 mcg of supplemental t3 from two months ago, could it? All I know is this brain fog, fatigue and achy legs suck. I'm on 125 mcg and 104 lbs.


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## Lovlkn (Dec 20, 2009)

125mcg is a hefty dose for someone who weighs 104lbs. Your weight converts to 74 kilograms X 1.7mcg mfr recommended dose for a T4 med is 80 mcg.

Now, because your FT-4 got so high there is probably a good bit of Reverse T-3 in your system. My personal experience ( not knowing my RT3 ) was that when my FT-4 was at high range, I could not tolerate any T3 med such as Cytomel. Even the lowest dose caused me extreme anxiety,

When one adds Cytomel one should reduce their T4 med because the extra T3 seems to make the FT-4 raise, naturally, because it is no longer converting is my opinion.

What I did... I lowered my T4 med dose and let some excess burn off then began adding Cytomel again 1/4 a pill 2x a day until I could tolerate then 3 x a day approx 6 hours apart until I could tolerate the addition without any hyper symptoms.

I'm no expert on lowering RT3 and if your doc is not then this is about your only option. A doc who "knows" how to deal with it would likely give higher doses of T3 and reduce your T4 med even lower - basically eliminating the conversion process. Trying to explain that to a doc who does not know is like banging your head on a wall.


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## GandKsmommy (Feb 15, 2016)

I was started on 88 mcg, after my son, it was raised to 100mcg, then after my daughter, I went really hypo and it was raised to 125 mcg. The functional medicine dr thought I was not absorbing as well, so I have spent the past yr and a half cutting out most gluten and dairy, and optimizing my vitamin/mineral levels. Ironically, the last time I had my levels checked 36 hrs after my last dose of 125 mcg t4 and 2.5 mcg t3, my rt3 was at the upper end of the range at 25 (9-25). Could rt3 be making my tsh so low? It was not tested recently. I didn't think rt3 affected tsh bc it is not active.


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## Lovlkn (Dec 20, 2009)

I would focus on your FT-4 and FT-3 and RT3. Antibodies can suppress TSH.

TSH also is the signal for the thyroid to produce and since your FT-4 is so high and you possibly have RT3, I imagine either could suppress TSH.


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