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Need help with my thryoid

nothuman

Featured Member / Kilo Klub
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I have the following lab numbers I recently got back (besides RT3):

TSH:1.9
FT3: 2.9
FT4: 1.53
Last year's Reverse T3: 28

No doctor is willing to help me but I have access to both T3 and T4 meds. What dosing regimen would you guys recommend based on these numbers?

The "normal" lab ranges are wrong, similar to total testosterone levels.

I've read FT3 should be minimum in the upper 3's (like 3.7+). The thing is my FT4 is already at a good place.

Therefore, I think I should only use T3, but I'm not certain and I also don't know what dose to use. Perhaps 10mcg?
 
Not a fan of T3 only. Even twice a day dosing will lead to significant fluctuations in serum (free-) T3 levels and with it increased heart rate fluctuation etc. See https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5167556/

I'd instead suggest T3/T4 combination therapy. Something like 12.5mcg T3 and 50mcg T4 per day would be a good starting point. Ideally splitting the dose morning/evening, but only if you can then still take it on an empty stomach, away from coffee intake, etc. 10mcg of T3 only would almost certainly be too low.
 
Nothuman, definitely keep an eye on your heart rate if you decide to take thyroid meds. I tried some pharm T4 at only 25mcg/day and after a few days it raised my heart rate substantially. I had to stop ,I couldn’t stand that feeling of my heart racing all day
 
Probably should use a combo like armour..not just t3. Are you using GH?

Sent from my SM-N960U using Tapatalk
 
Not a fan of T3 only. Even twice a day dosing will lead to significant fluctuations in serum (free-) T3 levels and with it increased heart rate fluctuation etc. See https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5167556/

I'd instead suggest T3/T4 combination therapy. Something like 12.5mcg T3 and 50mcg T4 per day would be a good starting point. Ideally splitting the dose morning/evening, but only if you can then still take it on an empty stomach, away from coffee intake, etc. 10mcg of T3 only would almost certainly be too low.
Agree with all of this. 10mcg T3 is too low.
 
what are normal ranges for each number? if yours are low, what do you attribute it to, use of synthetic T3 over time "screwed them up"? I have never used t3 always been scared too and felt like it just complicated things too much.
 
While I think twice daily dosing makes more sense, from what I understand the vast majority of doctors, and the pharna companies who manufacture T3 meds themselves, advise once a day dosing. So I don't think there are any significant problems/disadvantages to doing it that way.
 
Last edited:
While I think twice daily dosing makes more sense, from what I understand the vast majority of doctors, and the oharna companies who manufacture T3 meds themselves, advise once a day dosing. So I don't think there are any significant problems/disadvantages to doing it that way.

Once daily administration of short-acting T3 preparations in hypothyroid individuals would not be predicted to be associated with steady T3 levels based on pharmacokinetic data (16), but based on our data could possibly be associated with steady lowering of TSH levels. Daily dosing of 50 mcg T3 was studied in athyreotic patients and resulted in persistent suppression of TSH levels over a 3-week period (17). However, blood sampling was only performed on a weekly basis, so peaks and troughs in TSH or T3 levels would not have been captured. Dividing T3 doses that averaged approximately 40 mcg daily into three times daily dosing regimens in hypothyroid patients, however, avoided any peaks or troughs in T3 or TSH concentrations within the selected periods of sampling (18).

The effects of short-acting T3 preparations on parameters such as vital signs and body weight in hypothyroid patients cannot be predicted from our data in euthyroid volunteers, although increased heart rate might be postulated. The increase in heart rate seen in these participants, however, argues against administration of this dose of T3 as a single dose. Studies using thrice daily administration of T3 in athyreotic patients suggest that there may be hepatic effects and also effects on body weight, without effects on heart rate (19). There is continued interest in developing a sustained release T3 preparation that maintains stable concentrations of T3, such that daily administration of T3 provides steady serum levels of T3. This interest is fueled by the fact that enzymatic conversion of T4 to T3 is necessary for thyroid hormone action, and the evidence in secondary analyses that a specific polymorphism in the type 2 deiodinase, possibly associated with unsatisfactory response to T4 monotherapy (20), affects approximately 15% of the population.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5167556/
 
Not a fan of T3 only. Even twice a day dosing will lead to significant fluctuations in serum (free-) T3 levels and with it increased heart rate fluctuation etc. See https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5167556/

I'd instead suggest T3/T4 combination therapy. Something like 12.5mcg T3 and 50mcg T4 per day would be a good starting point. Ideally splitting the dose morning/evening, but only if you can then still take it on an empty stomach, away from coffee intake, etc. 10mcg of T3 only would almost certainly be too low.

Thank you man this is gold. I wasn't sure how much a low dose of T3 would bump up my Free T3. I think I will do exactly this then re-test in 2 months.
 
Probably should use a combo like armour..not just t3. Are you using GH?

Sent from my SM-N960U using Tapatalk

Not using GH but even when I used to, my thyroid numbers weren't that different believe it or not

Possible low conversion of t4 to t3. Adding more t4 probably won't help that.

Definitely a low conversion of t4 to t3.

what are normal ranges for each number? if yours are low, what do you attribute it to, use of synthetic T3 over time "screwed them up"? I have never used t3 always been scared too and felt like it just complicated things too much.

Genetics probably. My mom is hypothyroid. I looked at thryoid numbers from 4 years ago and they were very similar. My FT3 and FT4 were slightly lower then actually but that was before I began using Ashwagandha.

While I think twice daily dosing makes more sense, from what I understand the vast majority of doctors, and the pharna companies who manufacture T3 meds themselves, advise once a day dosing. So I don't think there are any significant problems/disadvantages to doing it that way.

I'd do twice daily dosing but thyroid meds are so annoying in the sense they have to be on a fully empty stomach and can't even have coffee or some other supplements around it.

But yea, I'd prob do twice daily dosing anyway.
 
Last edited:
Not a fan of T3 only. Even twice a day dosing will lead to significant fluctuations in serum (free-) T3 levels and with it increased heart rate fluctuation etc. See https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5167556/

I'd instead suggest T3/T4 combination therapy. Something like 12.5mcg T3 and 50mcg T4 per day would be a good starting point. Ideally splitting the dose morning/evening, but only if you can then still take it on an empty stomach, away from coffee intake, etc. 10mcg of T3 only would almost certainly be too low.

Actually I have a question. As part of the combo therapy, is 50mcg T4 still alright even though my Free T4 is already 1.5 on its own? Would that potentially raise it too high?
 
Who says T3 has to be on an empty stomach ?
 
Looking at Pfizer, et al, all these pharma companies who actually make the drug, once daily dosing, with or without food, is what is advised. I don't doubt there are ways to improve upon that, but I highly doubt there is any serious problem with using the med as advised by the companies who make it.
 
Actually I have a question. As part of the combo therapy, is 50mcg T4 still alright even though my Free T4 is already 1.5 on its own? Would that potentially raise it too high?
The exogenous T3 and T4 will lower your TSH secretion and thereby endogenous T4 production.
The ratio of T4 to T3 secretion by the human thyroid gland under physiological conditions, is close to 13:1. So if you take a medication with a thyroid mix of 4:1, you are unlikely to end up with a high T4 and normal T3 levels. Quite the contrary. Naively one would expect T3 might be high-normal and T4 low when taking a 4:1 mix. Though in practice this would be alleviated by reduced T4 to T3 conversion so that most likely you will end up with high-normal T3 and normal T4 levels.

Take the above with a grain of salt though, I'm not too familiar with the literature.
 
Looking at Pfizer, et al, all these pharma companies who actually make the drug, once daily dosing, with or without food, is what is advised. I don't doubt there are ways to improve upon that, but I highly doubt there is any serious problem with using the med as advised by the companies who make it.
What do manufacturers of pharma Testosterone recommend for the injection frequency, every 2 weeks? Clearly that is far from optimal, yet it is what they 'recommend'.

Pharma firms create recommendations not to optimize the drugs' efficacy and safety, but to make taking the drug as convenient as possible for patients, while still getting a satisfactory effect. Why do they do that? Because their incentive is to sell as many products as possible. If patient compliance is unlikely, doctors won't prescribe it.

There must really be solid evidence from RCTs about the superiority of a certain dosing scheme for pharma manufacturers to adopt it. In the case of T3, there is a lack of such evidence. This is also why T3 is very rarely used by doctors to treat hypothyroidism: there are no large, reliable studies showing that it is as effective and safe as T4 therapy.
 

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