High TSH On T3 Monotherapy (WTF? )

Porridge

Member
Joined
Aug 5, 2019
Messages
6
Sup guys/gals,

I'm 23yo, always had an underperforming thyroid (subclinical hypothyroidism) with normal T3 & T4 but TSH > 4 on average, even hitting 5 at times.
No Hashimoto or anything (in 2015 I checked my thyroid antibodies and did an ultrasound scan).

Before I started Liothyronine (T3) monotherapy my levels were:

January 2019:
FT3: 2.96 pg/mL
FT4: 0.83 ng/dL
TSH: 3.32 µUI/mL
(and that's been my lowest level, usually it's been 3.5 up to 5)

Then I got sick and tired of my underperforming gland (fatigue, bloating, constipation),
and on July 2019 I hopped on T3 (20mcg/day taken at morning) plus Peating with food/supplements.

After one year (August 2020), here's the new bloodwork:

NOTE: I waited for my morning T3 dose in order to avoid spiking values and seeing the remaining FT3 after 24h of T3 withdrawal.

FT3: 3.26 pg/mL (imagine if I took the 20mcg morning dose, lol)
*FT4: 0.60 ng/dL (we don't need you, good ol'T4)
TSH: 4.53 µUI/mL (mmh...)

Now my question is: WHY THE HELL IS TSH STILL ELEVATED?

Shouldn't be there a negative feedback loop after 13 months of daily rigorous Liothyronine (T3) monotherapy (as it happens with T4 supplementation)?

Should I allocate zero f*cks towards TSH now that I'm on T3, or is it some form of 'atrophic thyroiditis'?

Final note: I'm also on test prop 12.5mg/day without any HCG or AI, due to hypogonadism I had since 20/21yo (my E2 and prolactin are in perfect range, my balls never shrunk significantly, I love being sterile, seriously)
 

tallglass13

Member
Joined
Dec 29, 2015
Messages
510
my dad's TSH came down three points from 7 to 4 by taking T4. Your body is probably trying to make more reverse T3, so by giving T4 it should bring down your TSH.
According to Ray peat your T3 dosage should only be a few micrograms every hour for most of the day. If the dose is too large it will inactivate your liver from making T3. That happens fairly quickly he said. Each dose should only be about 5 micrograms. Otherwise the body will start rejecting the thyroid hormone, so your body is probably trying to make more t4 in order to make reverse T3.
 

tallglass13

Member
Joined
Dec 29, 2015
Messages
510
Just an FYI your test dosage is 3 times to high for what you make naturally , so you are risking shut down on that as well
 

wintagal

Member
Joined
Jun 9, 2017
Messages
80
Your t3 dose is below normal replacement levels. Drugs.com says: "recommended starting dosage is 25 mcg orally once daily. Increase the dose by 25 mcg daily every 1 or 2 weeks, if needed. The usual maintenance dose is 25 mcg to 75 mcg once daily." But if you feel good on 20, don't change it.
The low t3 dose might explain your high TSH. But it doesn't explain your low FT4. Maybe your thyroid can produce TSH but not T4. Do you have adequate iodine and tyrosine in your diet? Sea salt doesn't provide adequate iodine. Iodized salt does.
 

orewashin

Member
Joined
Jun 16, 2020
Messages
327
My fT3 was 4.1, fT4 0.6, and TSH 9 while taking 30 mcg of T3 daily. Guess I’m on the same boat.
 

wintagal

Member
Joined
Jun 9, 2017
Messages
80
This is so weird to me. But maybe I'm the weird one. A little t3 suppresses my TSH and FT4 to way below normal range. I was lucky to finally find a doctor who would look at my Ft4 levels, not just my TSH.
 

Wilfrid

Member
Joined
Nov 26, 2012
Messages
709
When thyroid gland has lost too much of its function, as in early thyroid failure for example, FT4 drops and then TSH rises for a key purpose — to protect FT3 levels under conditions of diminished thyroid reserve. Thus your FT3 rises accordingly.
I think that your current thyroid situation (and considering its evolution) needs a careful medical follow-up and attention.
Have you tried to contact RP? Or do you have a good endocrinologist?
 

schultz

Member
Joined
Jul 29, 2014
Messages
2,417
What thyroid product are you taking? (Sorry if I missed it)

Someone mentioned this already, but you should split the dosage up and at least take it twice a day with food. TSH rises at night. Are you saying you took T3 in the morning went to sleep that night, woke up the following morning and got your blood tested without having took your T3 dose for the day? I imagine your thyroid would be suppressed by the time you had your blood drawn.
 

orewashin

Member
Joined
Jun 16, 2020
Messages
327
What thyroid product are you taking? (Sorry if I missed it)

Someone mentioned this already, but you should split the dosage up and at least take it twice a day with food. TSH rises at night. Are you saying you took T3 in the morning went to sleep that night, woke up the following morning and got your blood tested without having took your T3 dose for the day? I imagine your thyroid would be suppressed by the time you had your blood drawn.
T3 is most potent at around 7 hours, IIRC, wouldn’t the TSH be at its minimum from it then?
 

schultz

Member
Joined
Jul 29, 2014
Messages
2,417
T3 is most potent at around 7 hours, IIRC, wouldn’t the TSH be at its minimum from it then?

At 7 hours maybe. I doubt it would be after 24 hours though.

Ray has recommended taking T4 with T3 at night to keep TSH low from what I remember.
 

orewashin

Member
Joined
Jun 16, 2020
Messages
327
At 7 hours maybe. I doubt it would be after 24 hours though.

Ray has recommended taking T4 with T3 at night to keep TSH low from what I remember.
Yes, it reduces free fatty acid liberation during the night. I wonder if he recommends taking all of a person’s T4 daily dose at bedtime, or just a large portion of it.
 

schultz

Member
Joined
Jul 29, 2014
Messages
2,417
Yes, it reduces free fatty acid liberation during the night. I wonder if he recommends taking all of a person’s T4 daily dose at bedtime, or just a large portion of it.

I'd have to find the clip and verify, but I think he said the entire dose at night.
 

Wilfrid

Member
Joined
Nov 26, 2012
Messages
709
The first blood drawn was made in January during winter time and the second one (with T3 supplementation) in August during summer time.
You were diagnosed with subclinical hypothyroidism and in such case, the dose required for replacement of thyroid hormone are often higher in winter than in summer. And the TSH is as well often lower in summer than in winter (where are you living? Northern Europe?).
Yet, your blood tests results worsen and you were taken T3 during the period of your second blood drawn. Other hormones that could interfere with efficient thyroid function should be thoroughly investigated by a skilled practitioner.
 

Porridge

Member
Thread starter
Joined
Aug 5, 2019
Messages
6
So far, a compilation of bull**** misinformation or useless responses about stuff that I already know in my humongous knowledge of endocrinology,

exception being made for @Wilfrid -
yes I think it's thyroid failure brah, elimination of T3 is almost 2 days so I never had low FT3 levels, it's simply my stupid gland trying to produce T4 and revving up without a concrete purpose like the final swan song...
(Single Dose T3 Administration: Kinetics and Effects on Biochemical and Physiologic Parameters - watch Table 2 for real T3 half-life & elimination)

Still zero f*cks given since it never worked and I'm perfectly fine letting it rot altogether, only FT3 matters in the end.

My 3rd world country (Italy) only has 20mcg T3 as a maximum dosage (no caps available, liquid flasks only, you can imagine why it's a cesspool country) so I bought some 25mcg blisters from another private pharmaceutical company and I'll use those.

For the geeks who still think about splitting T3: I've tried splitting the dosage but I feel worse, trust me on that, the heart needs rest before bed and giving it T3 at evening is not a wise choice (Inb4 insomnia) - again see link to understand the real half-life.
 
Last edited:

orewashin

Member
Joined
Jun 16, 2020
Messages
327
@Porridge

Sometimes, the body uses T4 inappropriately. You say T3 causes insomnia, but neither caffeine nor T3 cause insomnia for me. What does, is T4, and a cold sleeping temperature (which RP said reduces sleep quality). In most people, T4 is converted into T3 during sleep, and the T3 helps maintain the brain stem's ability to induce restful sleep. But if it's converted into reverse-T3 in the brain due to a brain injury, then restful sleep is inhibited and replaced by hibernation.

The solution for this is a timed-release or slow-release preparation of T3. Is this available in your country?
 

Risingfire

Member
Joined
May 10, 2016
Messages
448
I haven't gotten my levels checked recently. I've experimented with T3 a few times over the last 3 years with basically no benefit. The moment I used Cynoplus I started losing weight. I'm guessing as it improved my metabolic rate which probably lowered my TSH
 

Porridge

Member
Thread starter
Joined
Aug 5, 2019
Messages
6
@Risingfire

Nobody asked you, don't derail the thread. Thanks.

@orewashin

No, of course it is not available in my country. Do you realize T3 cannot be converted into reverse-T3 and that they are two different separate entities?
What is the point in using T4 if I already achieve optimal FT3 levels with T3 monotherapy. You tell me. Waste of $ (or € in my case).

Taking T3 at evening/night is absolutely retarded, I have Oura ring data that confirms that sleep quality is impaired. Once a day is enough or twice maximum (the 2nd dose in the afternoon), if you are really paranoid about FT3 drops/troughs (which never happened, if you've seen my bloodwork and table 2 I linked before).
 

orewashin

Member
Joined
Jun 16, 2020
Messages
327
@Risingfire

Nobody asked you, don't derail the thread. Thanks.

@orewashin

No, of course it is not available in my country. Do you realize T3 cannot be converted into reverse-T3 and that they are two different separate entities?
What is the point in using T4 if I already achieve optimal FT3 levels with T3 monotherapy. You tell me. Waste of $ (or € in my case).

Taking T3 at evening/night is absolutely retarded, I have Oura ring data that confirms that sleep quality is impaired. Once a day is enough or twice maximum (the 2nd dose in the afternoon), if you are really paranoid about FT3 drops/troughs (which never happened, if you've seen my bloodwork and table 2 I linked before).
You know whenever RP wakes up in the middle of the night, he takes a dose of T3, eats something, and goes back to sleep?

And yes, using T3 instead of T4 to suppress reverse-T3 is the point.
 

Porridge

Member
Thread starter
Joined
Aug 5, 2019
Messages
6
You know whenever RP wakes up in the middle of the night, he takes a dose of T3, eats something, and goes back to sleep?

And yes, using T3 instead of T4 to suppress reverse-T3 is the point.

"a dose" doesn't mean 10-12.5mcg
 
Similar threads
Thread starter Title Forum Replies Date
Razvan High TSH High T3 High T4 What Is This? Thyroid and Hormones 1
S Dr Paul Saladinos Blood Work (High T, Low TSH) Metabolism 10
encerent Bloods Results. High Cortisol, Prolactin, Low TSH. Not Sure What To Do Ask For Help or Advice 2
D High TSH & High T4 Ask For Help or Advice 2
L High Vitamin D, Low TSH, But Still Low Testosterone? Blood Work, Labs 20
Elize High TSH And Testosterone. Low T3/T4? Metabolism 1
F Low TSH, High Free T3 And T4? Thyroid and Hormones 1
MaxGarbuz Where Do I Start / High Prolactin And TSH Blood Work, Labs 4
D High Creatinine/TSH Blood Work, Labs 8
F Confusing Blood Tests - High FT3 And FT4 And High TSH Ask For Help or Advice 9
ecstatichamster What Are Signs Of High TSH (not Hypothyroidism) Thyroid and Hormones 0
ecstatichamster High TSH Elderly Men Live Longer? Scientific Studies 10
B NDT, High T3, Low TSH, High Adrenaline, Low Progesterone- Help! Ask For Help or Advice 7
Y Any Suggestions For My High TSH/Cholesterol/triglycerides Blood Work, Labs 16
G High TSH, IBS and others... Ask For Help or Advice 14
SQu Labs - Tsh, High Cholesterol And Triglycerides Blood Work, Labs 27
Isadora High TSH, Low T4 Could Rebuild Thyroid Tissue? Articles & Scientific Studies 15
B High TSH, Normal T4 Blood Work, Labs 9
J High sugar diet has wrecked my teeth, Decay and dentist say i need filling Oral Health 19
Advocate2021 High Cholesterol and High Thyroid on Bloodwork- Confused Blood Work, Labs 27
N Do you need extra calcium with high dose k2? K 2
N Extremely High Cortisol Ask For Help or Advice 3
youngsinatra High Dose Niacinamide Self-Experiment. Experiments 20
haidut Heart attack survivors have high stress (cortisol/adrenaline) hypersensitivity, low androgens Scientific Studies 2
M High testosterone low libido Diet 10
J Levo gives me high BP- is anyone using small doses of T3 with meals in lieu of levo? Supplements, Pharmaceutical Drugs 2
Hgreen56 Is this how high dopamine personality looks like? Health 3
J High Saturated Fat/Cholesterol Causes Clogged Pores/Sebaceous Filaments Skin 7
Lokzo Cyproheptadine Prevents High Altitude-Induced Testicular Disturbances Scientific Studies 0
Bogdar Low PTH, Low D, High Calcium - How Is It Possible? Blood Work, Labs 12
Starship Is It Possible To Keep Metabolism High And MTOR Low? Metabolism 2
DANIEL A High Serotonin Society | Morning Routines, Self-Improvement, Habit Tracking Miscellaneous 1
Mito Effect Of High-Dose Omega-3 On Major Adverse Cardiovascular Events Polyunsaturated Fats, Seed Oils 0
U What's Worse High Fat No Starch Or Low Fat Higher Starch? Diet 12
2ManyHistamines After Years Of High Hemoglobin. Polycythemia Vera Diagnosis Blood Work, Labs 0
L High Volume Of Side Effects Expected With Cov-vax Miscellaneous Health Discussions 5
Hgreen56 Ray Peat (high Sugar) Diet Works Only Temporarily (?) Diet 0
forterpride Mothers PTH Level Is High Ask For Help or Advice 1
Hirri High Prolactin Question Thyroid and Hormones 6
H How To Lower High Prolactin? Blood Work, Labs 13
haidut Low, Not High, Metabolism Creates Oxidative Stress Scientific Studies 2
N Phosphatidylserine Gives Me Weird Feeling In My Kidney (High Cortisol) Cortisol, Serotonin, Histamine 1
S Hypoparathyroid And High Blood Calcium? Blood Work, Labs 4
johnwester130 Lamb Lungs Surprisingly High In Glycine Meat, Organ Meat, Gelatin, Seafood 5
M Any Long Term High Sugar Consumers Here? Discussing Dietary Models 28
D High Pulse, Low Morning Temperature Ask For Help or Advice 33
Hgreen56 Are White Potatoes High In Oxalate? Diet 8
M HTMA Results Help (Toxic Ratios High) Labs 3
ursidae Environment For High Cortisol Individuals Ask For Help or Advice 3
J Starch And High "manic" Libido Male Issues 19

Similar threads

Top