Thyroid problems low tsh, low t4 good t3

**jasondd1** · 08-19-2013, 03:37 PM

Ok heres a nut shell 6 months ago low t3, t4 good rt3 high and tsh was normal. So went on 40 mcg of t3 and t3 is fine now. However now tsh is tanked, t4 is low and rt3 is low. Ami i looking at a t4/t3 combo or just t4? Confused?

**Sgt. Hartman** · 08-19-2013, 04:53 PM

Why did your dr prescribe t3 to begin with instead of starting with t4 or Armour?

Thyroxine is much less suppressive to TSH and converts to t3. Did he think your body was not converting t4 to t3 at a normal rate?

**asiandudexxx** · 08-19-2013, 04:54 PM

Originally Posted by jasondd1

Ok heres a nut shell 6 months ago low t3, t4 good rt3 high and tsh was normal. So went on 40 mcg of t3 and t3 is fine now. However now tsh is tanked, t4 is low and rt3 is low. Ami i looking at a t4/t3 combo or just t4? Confused?

Depends, how do you feel? Different doctors will have different views on this.

Mainstream endocrinology says t4 only is fine so long as it keeps TSH in the normal range. Others say t4 only doesn't help symptoms as much as t3, t3/t4 combo, or a full spectrum thyroid replacement like armour.

In the end, I say go with what helps your symptoms/health.

**thisAngelBites** · 08-19-2013, 05:13 PM

Your TSH is going to be low, because you are putting T3 into your blood. Your pituitary senses it there, and stops telling your thyroid (by stopping the secretion of TSH - that's why your TSH is low) to make more thyroid hormone. Because it is not being signaled by the pituitary (via TSH) your thyroid stops making T4, so your T4 is low.

This is a problem with using only T3. I presume you did this on your own? Because it's hard enough to get physicians to do anything with T3, let alone ONLY T3.

**Sgt. Hartman** · 08-19-2013, 05:24 PM

Originally Posted by asiandudexxx

Depends, how do you feel? Different doctors will have different views on this.

Mainstream endocrinology says t4 only is fine so long as it keeps TSH in the normal range. Others say t4 only doesn't help symptoms as much as t3, t3/t4 combo, or a full spectrum thyroid replacement like armour.

In the end, I say go with what helps your symptoms/health.

I'm gonna disagree with that. There are many adverse health risks associated with hypo or hyperthyroidism and not all of them can be "felt". Just because someone feels good or feels healthy doesn't mean they're healthy and not at risk for long term adverse medical issues. That's why we do bloodwork in the first place.

**jasondd1** · 08-19-2013, 07:27 PM

She put me on t3 only because before my t4 was good to high and tsh was normal but t3 was low and rt3 was really high. The idea was i was converting t4 to rt3 not t3. Now Im thinking a combo of t4/t3. I will run this by her at next visit after latest bloods. Just curious if that was what others were thinking. I would guess t4 alone would do no good since im not converting it to t3 and t3 alone is no good because it is shutting down tsh which shuts down t4. Is my thinking of t4/t3 combo correct?

**asiandudexxx** · 08-19-2013, 08:11 PM

Originally Posted by Sgt. Hartman

I'm gonna disagree with that. There are many adverse health risks associated with hypo or hyperthyroidism and not all of them can be "felt". Just because someone feels good or feels healthy doesn't mean they're healthy and not at risk for long term adverse medical issues. That's why we do bloodwork in the first place.

For sure, no argument there. When I said "health" I meant as a general catch-all term, which also includes appropriate hormone levels. I wouldn't consider hyper- or hypothyroidism a healthy state.

**Sgt. Hartman** · 08-19-2013, 09:02 PM

Originally Posted by asiandudexxx

For sure, no argument there. When I said "health" I meant as a general catch-all term, which also includes appropriate hormone levels. I wouldn't consider hyper- or hypothyroidism a healthy state.

Thanks for clarifying, we're in agreement then.

**thisAngelBites** · 08-20-2013, 02:08 AM

Jason, no offense, but I am wondering if your doctor stayed awake in medical school. I am not a physician, and if I can understand what adding T3 only is going to do to you, your physician should have been able to realise it as well.

I understand if you decided to try this, just not knowing how it all worked. You usually can't just top up hormones that are low - it's not like putting gas in a car tank. Adding hormones can have other knock on effects so you need a doctor who paid attention in school, and this is not the person you are describing.

Yes, you will need some T3 if you are not converting well from T4 to T3, and you will need some T4, because your body stops making it if it senses enough T3 in your blood. So if you need to replace T3, you will end up adding enough T4 to basically shut your thyroid production down. But make sure you don't take too much T3. It's not the TSH being tanked that is the issue, it is the amount of free T3 and T4 - if there is too much it will be hard on your heart and start leaching minerals from your bones.

I wonder if not only do you need to add T4, but whether your T3 dose is slightly high. If you add T4, your body will convert some to T3, and I think you will need a little less T3. You can always up T3 again later if bloods indicate. And then you are at less risk of having too much active hormone.

Originally Posted by jasondd1

She put me on t3 only because before my t4 was good to high and tsh was normal but t3 was low and rt3 was really high. The idea was i was converting t4 to rt3 not t3. Now Im thinking a combo of t4/t3. I will run this by her at next visit after latest bloods. Just curious if that was what others were thinking. I would guess t4 alone would do no good since im not converting it to t3 and t3 alone is no good because it is shutting down tsh which shuts down t4. Is my thinking of t4/t3 combo correct?

**jasondd1** · 08-20-2013, 08:42 AM

Originally Posted by thisAngelBites

Jason, no offense, but I am wondering if your doctor stayed awake in medical school. I am not a physician, and if I can understand what adding T3 only is going to do to you, your physician should have been able to realise it as well.

I understand if you decided to try this, just not knowing how it all worked. You usually can't just top up hormones that are low - it's not like putting gas in a car tank. Adding hormones can have other knock on effects so you need a doctor who paid attention in school, and this is not the person you are describing.

Yes, you will need some T3 if you are not converting well from T4 to T3, and you will need some T4, because your body stops making it if it senses enough T3 in your blood. So if you need to replace T3, you will end up adding enough T4 to basically shut your thyroid production down. But make sure you don't take too much T3. It's not the TSH being tanked that is the issue, it is the amount of free T3 and T4 - if there is too much it will be hard on your heart and start leaching minerals from your bones.

I wonder if not only do you need to add T4, but whether your T3 dose is slightly high. If you add T4, your body will convert some to T3, and I think you will need a little less T3. You can always up T3 again later if bloods indicate. And then you are at less risk of having too much active hormone.

I appreciate your help with this and it really makes sense. I'm wondering how long on a t4/t3 protocol before I see change in levels through blood work? Any idea? BTW my Doc is very into HRT and will literally do anything i ask but yeah she doesn't seem to have as good of grasp on it as the experts on here that's for sure. That's why I'm here. Thanks again!