Please Help Me Interpret My Thyroid Lab Results

[faisman]

Just a bit of a background:
I was put on T4 since I was 16 (I am 20 now) as my thyroid activity was deemed sub par by my doctor even though I never had symptoms. I started at 25mc. Over the last few years the dose went up to 100 mcg, which is what I take now.

My research on thyroid is what led me to Ray Peat and I have found out recently that T4 on its own can be detrimental. I can tell from my last test (3 months ago) that T4 is higher than the normal range which Im guessing goes back to the same issue.

NDT is hard to obtain were I live, but I believe I might be able to find T3 on its own and then combine it with T4.

It would be great if anyone can guide me towards the next step.

 

[ravster02]

What's your diet?

TSH needs to be around 1, you could achieve this through diet or thyroid supplementation.

And it's really important to get reverse T3 tested, it helps complete the picture on your thyroid status.

 

[faisman]

What's your diet?

TSH needs to be around 1, you could achieve this through diet or thyroid supplementation.

And it's really important to get reverse T3 tested, it helps complete the picture on your thyroid status.

Im actually planning to get a new test tomorrow since this one is 3 months old, so will ask for reverse T3.

For the past 3 months diet consisted of fresh OJ, ripe fuits, milk/cheese, beef once a day, potatoes once a day, ice cream and coffee w/ gelatin, milk, sugar.

Recently im focusing on including good amounts of liver and oysters which im hoping will help with skin issues too.

But I am keen on getting new tests since they will reflect this diet

 

[faisman]

So I've just received the lab results from this morning and the results are amazing! I was not able to get reverse t3 tested at the moment sinc the lab said this was a more complicated test that they usually outsource but here are my results.

T4 is still in the high. Am I right to think I have to wean myself of the 100mcg of T4 I take everyday?

Would it be better to stop it all together?

 

[sweetpeat]

It looks like you've improved your t4 to t3 conversion. Good work!

As far as dropping the t4, I think it would be too much of a shock to your system to quit cold turkey. Do you think you could split your tablets and try taking ¾? That would give you 75mcg. It could be you just need less in the summer, if it's summer where you are. Then re-evaluate in a month or so to see if you can lower further or if you need to raise it back up going into the fall.

 

[Mittir]

RP has mentioned that T4 only treatment is more problematic for female than male.
Female liver has extra burden of detoxing larger amount of estrogen.
That is probably why incidence of thyroid disease is 5 to 10 times higher in female.

RP recommends total T3 and total T4 tests instead of free T3 and free T4.
Your test results typically happen in T4 only patients, which is
suppressed TSH and high T4. Your above average T3 is a good thing.
In healthy person total T3 is at higher end of normal or above normal
and T4 is below average. High TSH causes a lot of health issues
which are attributed to hypothyroidism.

You can try a liver friendly diet to improve T4 to T3 ratio.
Easily digestible foods free of gut irritants
can improve liver function. Vitamin B1, B2 and selenium are necessary
for healthy liver. Are you doing raw carrot salad or cooked bamboo
shoots or cooked mushroom to reduce endotoxin load to liver?
RP recommends sweet ripe oranges. Unripe orange can cause problems.
Pectin in orange can cause problem too. A lot of people have problem
digesting milk. Gelatin can cause problem too. It is helpful to pay attention
how you feel when you add a new food to your diet.

T4 has a long half life, it takes about 3-4 weeks to clear T4.
As sweetpeat suggested, it is better to slowly lower the dose every
3-4 weeks. You can also replace some of the T4 with T3.
Our thyroid gland secretes T4 and T3 in about 4:1 ratio.
If you choose to add T3 it is needed to be taken in small doses
3-4 times a day. T3 has a short half life.

Do you know what caused your thyroid problems?
If you can't get T3 from your doctor, you can try
chicken neck soup, which has good amount of thyroid hormone.
You can experiment with soup of 3-4 necks and see how it feels.

 

[faisman]

RP has mentioned that T4 only treatment is more problematic for female than male.
Female liver has extra burden of detoxing larger amount of estrogen.
That is probably why incidence of thyroid disease is 5 to 10 times higher in female.

RP recommends total T3 and total T4 tests instead of free T3 and free T4.
Your test results typically happen in T4 only patients, which is
suppressed TSH and high T4. Your above average T3 is a good thing.
In healthy person total T3 is at higher end of normal or above normal
and T4 is below average. High TSH causes a lot of health issues
which are attributed to hypothyroidism.

You can try a liver friendly diet to improve T4 to T3 ratio.
Easily digestible foods free of gut irritants
can improve liver function. Vitamin B1, B2 and selenium are necessary
for healthy liver. Are you doing raw carrot salad or cooked bamboo
shoots or cooked mushroom to reduce endotoxin load to liver?
RP recommends sweet ripe oranges. Unripe orange can cause problems.
Pectin in orange can cause problem too. A lot of people have problem
digesting milk. Gelatin can cause problem too. It is helpful to pay attention
how you feel when you add a new food to your diet.

T4 has a long half life, it takes about 3-4 weeks to clear T4.
As sweetpeat suggested, it is better to slowly lower the dose every
3-4 weeks. You can also replace some of the T4 with T3.
Our thyroid gland secretes T4 and T3 in about 4:1 ratio.
If you choose to add T3 it is needed to be taken in small doses
3-4 times a day. T3 has a short half life.

Do you know what caused your thyroid problems?
If you can't get T3 from your doctor, you can try
chicken neck soup, which has good amount of thyroid hormone.
You can experiment with soup of 3-4 necks and see how it feels.

Interesting and informative points!

I've been on T4 for a while now as I said but I have never managed to get my TSH this low or T3 levels this high, especially since ive reduced my dose of T4 since the last test.

I will go ahead with lowering the dose on a 3-4 week basis as you and SweetPeat recommended. I will test more regularly too.

As for carrot salad, yes I do have it often although I tend to forget. I also feel that liver and oysters are really helping.

As for T3 I am actually going to put an order in today with IdeaLabs, do you think I should consider Tyromix?

I do not know what caused my thyroid problems but I do believe that I could have stopped it from the beginning through diet/lifestyle changes, however, at the time I couldn't care less. Im sure my pufa laden diet had to do with it. My starting dose was very low at only 25 mcg and I remember the doctor saying, 'with this its better to be on the safe side'

 

[sweetpeat]

One of my favorite Ray Peat quotes: "After a year or more of good health, the amount (of thyroid) needed will usually decrease, if the diet has been good during that time." Hopefully that's what is beginning to happen for you!

If you can achieve good t3 status through diet and lifestyle changes, I don't know that I would bother with supplementing t3 just yet, especially since you mentioned not having any hypo symptoms. I'm curious, have you noticed any difference in how you feel with higher t3 levels?

 

[faisman]

One of my favorite Ray Peat quotes: "After a year or more of good health, the amount (of thyroid) needed will usually decrease, if the diet has been good during that time." Hopefully that's what is beginning to happen for you!

If you can achieve good t3 status through diet and lifestyle changes, I don't know that I would bother with supplementing t3 just yet, especially since you mentioned not having any hypo symptoms. I'm curious, have you noticed any difference in how you feel with higher t3 levels?

Yeah thats what I thought, maybe wait a bit more and see what happens through diet/lifestyle.

Yes! I have noticed that I feel more energetic. Also, I lift weights and usually stopping for over a month would result in considerable muscle loss and my physique would suffer. In this last period, despite rarely going to the gym due to exam season, my physique barely changed. This was surprising to me with the amount of food i was eating, I barely put on fat. All of this along with a higher sense of wellbeing pushed me to do another lab test and see whats going on.

 

[sweetpeat]

Excellent! That's a great testimony. I hope things continue to move in a positive direction for you.

 

[faisman]

Excellent! That's a great testimony. I hope things continue to move in a positive direction for you.

Thanks sweetpeat

 

[faisman]

Guys, following up on the previous I have done another blood test after lowering my dose to .75cg for 3 weeks and 0.5 for the last few days. The results are quite confusing, the TSH has jumped up quite a bit to 4 and the T4 levels have increased despite lowering my dose.

Just for background, I have been on holiday for the past week, and my diet wasn't that good (pizza and burgers here and there). My sleep pattern was also all over the place.

Can someone please help me interperet what's happening?

 

[sweetpeat]

I think when you're making dosage adjustments that quickly, it can be hard to rely on lab work. When I make dosage adjustments, I go mostly with signs and symptoms. Then once I've been stable on a dose for 3-4 weeks, I might check lab work to see where I stand. Especially if I still have lingering symptoms.

How do you feel overall? Are you tracking your temperature and pulse? Are you noticing any symptoms that could be considered hypothyroid?

@marsaday has a lot of experience using t4. Hopefully he will see this and add his thoughts.

 

[marsaday]

Hello, and yes i am a thyroid patient and have a lot of experience with this area (unfortunately).

So you are now taking LESS T4 and the TSH has moved as it should BUT the FT4 has increased when you would expect a decrease.

You must have your thyroid antibodies checked to see if you have hasimotos disease. This is where the thyroid gland attacks itself. You can get low output and then high output. It is an autoimmune illness and is harder to manage than plain hypothyroidism. So get this area checked out. Does anyone in the family have autoimmune illnesses ?

Don't be worried that you are on T4 only. It really is a great hormone and because you are male it is often all we need. I do well on it, but also use a little T3 as well (1/4 tablet doses only and maybe just use the 1/4 per day or a few times a week). I play sport so i think this can deplete the T3, so a top up for me is useful.

How you feel is more important. Do you feel worse after reducing down the T4 for example ?

 

[faisman]

Hello, and yes i am a thyroid patient and have a lot of experience with this area (unfortunately).

So you are now taking LESS T4 and the TSH has moved as it should BUT the FT4 has increased when you would expect a decrease.

You must have your thyroid antibodies checked to see if you have hasimotos disease. This is where the thyroid gland attacks itself. You can get low output and then high output. It is an autoimmune illness and is harder to manage than plain hypothyroidism. So get this area checked out. Does anyone in the family have autoimmune illnesses ?

Don't be worried that you are on T4 only. It really is a great hormone and because you are male it is often all we need. I do well on it, but also use a little T3 as well (1/4 tablet doses only and maybe just use the 1/4 per day or a few times a week). I play sport so i think this can deplete the T3, so a top up for me is useful.

How you feel is more important. Do you feel worse after reducing down the T4 for example ?

 

[faisman]

Hi, I do get my antibodies checked every once in a while as I have done in the first test I posted. They seem to be very low, however I do also feel that they could have increased due to my sudden increased gluten intake after having restricted it for a while. I haven't been feeling my best these past couple of days but then traveling, lack of sleep and a sub par diet would definitely be culprits. I think what I will do is continue on the 50mcg dose while also getting my diet and sleep in check. I will test again in a few weeks after things have stablized.

 

[marsaday]

Ok it isn't a race to get the correct dose sorted out. It can take time and patience to get on top of things.

So do what you are doing and get retested.

You want to try and get FT3 tested every time you have an FT4 test done. You may have to specifically request this though.

Aim to try and get the TSH around the 0.5-1 area. When TSH goes over 2 incidence of mental health problems and general malaise increases it has be noted by Dr Mercado (forgot his exact name) in the USA. If the TSH becomes too suppressed the conversion of T4 to T3 drops off. So 0.5-1 is a good place to be.

Ft4 wants to be mid range to upper third of the reference ranges.

Ft3 wants to be higher in range.

High Ft4 or Fts3 results and high TSH indicate the body is just pooling the thyroid hormone. It isn't being used. This means you have a cortisol issue and so need to look at the adrenals as well. The thyroid and adrenals work together. T3 and cortisol are needed to get the T3 into the cells. Too little T3 and the cortisol rises too much. Too much T3 puts pressure on the adrenals to make more cortisol. Sometimes the adrenals cannot react and so you pool.

The aim is to get a nice balance when using hormones. Not too much and not too little.