T4 vs T3 vs Combination

[VakarianSK]

I would like to hear from others more educated on the topic of thyroid horomones than me.

I am prescribed T3 as a part of my HRT from my doctor. I take 25 mcg everyday along with 2IU of HGH everyday. I recently had blood work done before my last consultation which showed that since starting T3 my T4 and free T4 have pretty much crashed (which I kind of suspected). Unfortunutly I did not notice that the blood work I had done before my consultation did not include T3 or free T3. But I would expect it to be normal to normal high on 25 mcg everyday. My blood work now shows
T4 - 3.4ug/dl - ref: 4.5-12.0
Free T4 - 0.51ng/dl - ref: 0.82-1.77
TSH - 0.559uIu/ml - ref: 0.450-4.500

During my consultation my provider did not seem to want to prescribe me T4 for some reason even though they are the ones that prescribed my T3. After talking to them they were going to prescribe 50mcg of T4 but I think that I should isntead do 100mcg of T4 with my 25mcg of T3. My reasoning for 100 mcg of T4 over only 50mcg is that a 1:4 ratio or 25mcg/100mcg of T3:T4 seems to be the standard and in my opinion my T4 levels are almost bottomed out.

Now my provider thinks I should hold off on the T4 altogether for atleast a month since I started telemasartan as well.

My questions are as follows.
1.) Is there any reason to not supplement T4 with T3? I know the primary purpose of T4 is to be converted into the active thyroid horomone T3 and since I am on T3 it may not be that important. But I also beleive there are other downstream effects T4 has besides converting to T3.
2.) Would you agree that 100mcg would be optimal to add to my 25mcg of T3?
3.) Does telemasartan have anything to do with any of the above? As far as I know it does not do anything significantly for thyroid function so I am confused why my provider wants me to hold off on the T4 because of the telemasartan.

 

[NattyNuts]

Your TSH is almost out of range. You should not supplement with more thyroid hormones (no t4, no t3). In case you want dual therapy you have to reduce your t3 intake to 12.5mcg and add 50mcg t4. Then take bloods one month later to see where your levels are.

 

[VakarianSK]

Your TSH is almost out of range. You should not supplement with more thyroid hormones (no t4, no t3). In case you want dual therapy you have to reduce your t3 intake to 12.5mcg and add 50mcg t4. Then take bloods one month later to see where your levels are.

I have to take T3 because my normal T3 levels are below the reference range. Forgive my ignorance but does TSH matter if you supplement with both T4 and T3? From my understanding (and I may be wrong so please correct me) TSH just tells your body to produce my thyroid hormone (T3 and T4) so if using T3 and T4 exogenously it shouldn't matter right?

 

[NattyNuts]

It matters absolutely. TSH indicates your thyroid status. You have normalized your thyroid state with 25mcg t3, as you can see looking at your TSH and probably your free t3. T4 is irrelevant as your taking t3 and your TSH is normalized.
If you take any t4 dosage you will reach hyperthyroid state as your boderline there (0.55 TSH). You have to keep taking your 25mcg, or as i stated befored if you like dual therapy youd have to decrease t3 to 12.5mcg in order to avoid supraphysiological thyroid levels.

 

[VakarianSK]

It matters absolutely. TSH indicates your thyroid status. You have normalized your thyroid state with 25mcg t3, as you can see looking at your TSH and probably your free t3. T4 is irrelevant as your taking t3 and your TSH is normalized.
If you take any t4 dosage you will reach hyperthyroid state as your boderline there (0.55 TSH). You have to keep taking your 25mcg, or as i stated befored if you like dual therapy youd have to decrease t3 to 12.5mcg in order to avoid supraphysiological thyroid levels.

Interesting and I see what your saying. It's all a balancing act. Thanks for the great info. Hyperthyroidism sounds like something you would want and would be achieved by doing the 25:100 T3:T4 because it increases your metabolism but most people don't realize that this would force your body to burn both more fat and muscle (which is not ideal). I really appreciate your response and I think I have more tests and research to do.

 

[Black Beard]

I would like to hear from others more educated on the topic of thyroid horomones than me.

I am prescribed T3 as a part of my HRT from my doctor. I take 25 mcg everyday along with 2IU of HGH everyday. I recently had blood work done before my last consultation which showed that since starting T3 my T4 and free T4 have pretty much crashed (which I kind of suspected). Unfortunutly I did not notice that the blood work I had done before my consultation did not include T3 or free T3. But I would expect it to be normal to normal high on 25 mcg everyday. My blood work now shows
T4 - 3.4ug/dl - ref: 4.5-12.0
Free T4 - 0.51ng/dl - ref: 0.82-1.77
TSH - 0.559uIu/ml - ref: 0.450-4.500

During my consultation my provider did not seem to want to prescribe me T4 for some reason even though they are the ones that prescribed my T3. After talking to them they were going to prescribe 50mcg of T4 but I think that I should isntead do 100mcg of T4 with my 25mcg of T3. My reasoning for 100 mcg of T4 over only 50mcg is that a 1:4 ratio or 25mcg/100mcg of T3:T4 seems to be the standard and in my opinion my T4 levels are almost bottomed out.

Now my provider thinks I should hold off on the T4 altogether for atleast a month since I started telemasartan as well.

My questions are as follows.
1.) Is there any reason to not supplement T4 with T3? I know the primary purpose of T4 is to be converted into the active thyroid horomone T3 and since I am on T3 it may not be that important. But I also beleive there are other downstream effects T4 has besides converting to T3.
2.) Would you agree that 100mcg would be optimal to add to my 25mcg of T3?
3.) Does telemasartan have anything to do with any of the above? As far as I know it does not do anything significantly for thyroid function so I am confused why my provider wants me to hold off on the T4 because of the telemasartan.

It's expected.


Yes you need T4 for optimal function. Taking T3 only will lower both T4 and T3 production.


Generally, most need around 100-200 mcg T4 daily and 0-15 mcg T3 daily. Target Free T4 is around 1.4-1.7 ng/dL (skip the T4 tablet before the blood work).


T4 IS an active hormone contrary to popular belief that only T3 is active.

 

[nothuman]

From a medical standpoint having hypothyroid symptoms, I tried all three ways and T4 only is the only one that completely fixed me. 100mcg is the magic amount for me. Any more and I feel worse. I take it in the middle of the night when I wake up to use the bathroom to ensure it's on an empty stomach, which is crucial.

I was surprised considering I was deep down the rabbit hole of the natural thyroid sites/info. The conventional method won this round for me.

 

[VakarianSK]

It's expected.


Yes you need T4 for optimal function. Taking T3 only will lower both T4 and T3 production.


Generally, most need around 100-200 mcg T4 daily and 0-15 mcg T3 daily. Target Free T4 is around 1.4-1.7 ng/dL (skip the T4 tablet before the blood work).


T4 IS an active hormone contrary to popular belief that only T3 is active.

Thanks, I did end up getting T4 prescribed and am currently at 50mcg but will be upping it to 100mcg soon and then get blood work done.

 

[VakarianSK]

From a medical standpoint having hypothyroid symptoms, I tried all three ways and T4 only is the only one that completely fixed me. 100mcg is the magic amount for me. Any more and I feel worse. I take it in the middle of the night when I wake up to use the bathroom to ensure it's on an empty stomach, which is crucial.

I was surprised considering I was deep down the rabbit hole of the natural thyroid sites/info. The conventional method won this round for me.

This is what I do and seems to be the common protocol for when to take T3 or T4. It just works out well because it's as far away from food as possible for me.

 

[nothuman]

This is what I do and seems to be the common protocol for when to take T3 or T4. It just works out well because it's as far away from food as possible for me.

Even coffee reduces absorption rate of T4. This has been studied so it isn't even debatable. Too bad because as bodybuilders, finding time to be on an empty stomach is a challenge to say the least.

 

[VakarianSK]

Even coffee reduces absorption rate of T4. This has been studied so it isn't even debatable. Too bad because as bodybuilders, finding time to be on an empty stomach is a challenge to say the least.

Yeah lol I don't go more than 2 to 2.5 hours without eating lol and before my first meal I'll be drinking coffee.

 

[TheOtherOne55]

Even coffee reduces absorption rate of T4. This has been studied so it isn't even debatable. Too bad because as bodybuilders, finding time to be on an empty stomach is a challenge to say the least.

This. On a higher dose of GH, i basically have to take T4 in the middle of the night almost.
My entire day i have some sort of food digesting in me lol

 

[nothuman]

Yeah lol I don't go more than 2 to 2.5 hours without eating lol and before my first meal I'll be drinking coffee.

Yup that's why middle of the night T4 dosing is ideal (assuming someone wakes up to piss at least once). T3 isn't as sensitive to food so I would worry less about when you take that.