Supplementing T4 with thyroid Labs

[bennygoestrt]

Hey guys. I got my thyroid numbers today. In my country we get levothyroxine without prescription in pharmacies. I am thinking about supplementing T4 to bring my TSH between 1-2.
What dose should I start with. 25 mg or better 50.
Since starting TRT my TSH is climbing continuously.

TSH: 2.23
FT3: 3.3
FT4: 1.03

Even tho I war the same amount of calories daily it’s getting harder and harder to stay on the same body fat percentage. I have to cut down more and more and if it continues like that I would need to go under 1700 calorie’s which is not optimal.

In my country they just treat you if you are above 6. So talking to my doctor would lead to nowhere.

So how should I supplement T4?
Edit---: i felt best when my TSH was 1 before TRT even tho my T4 was 0.9.

 

[JmarkH]

As one that has had Graves disease [hyperthyroid], I can tell you that you don't want to over do the T3 and T4. This is one of those things that has a sweet spot. You go over that and you will begin to get muscle wasting. I doubt this is what you're going for.

 

[bennygoestrt]

Yes. I know this happens when you're supplementing T3. I am just planing to supplement T4 With 25 mg starting dose to bring numbers back to optimal ranges. Especially my T4 number which also would bring back my TSH to around 1 hopefully.

And my doctor told me once that no matter how much T4 You take the body just used as much as it needs. So you can't really overdo with T4

 

[JmarkH]

I hope you mean MCG not MG.

 

[JmarkH]

Do you know the point of T4 is for the body to convert it to T3?

 

[Systemlord]

Since starting TRT my TSH is climbing continuously.

All this indicates is your thyroid requires more stimulation now that you’re on TRT and stepping on the gas pedal a little more.

You’re chasing your tail. You may just be dealing with subpar genetics.

My TSH went down after TRT, my pituitary slamming on the breaks to regulate itself. Your body regulated itself by increasing the stimulating hormone because of increased demand.

 

[bennygoestrt]

Do you know the point of T4 is for the body to convert it to T3?

Yes of course I do.
I meant that the body list converts T4 to T3 only to a certain degree. Anything above that isn't used by the body unlike taking T3 directly. That's a different story. Doing that you can go hyperthyroidism

All this indicates is your thyroid requires more stimulation now that you’re on TRT and stepping on the gas pedal a little more.

You’re chasing your tail. You may just be dealing with subpar genetics.

On the picture you can see that my number even based on this range are not optimal. And considering i am on TRT and its going to be worst with time i think it would be good to supplement.

My TSH went down after TRT, my pituitary slamming on the breaks to regulate itself. Your body regulated itself by increasing the stimulating hormone because of increased demand.

@Systemlord whats wrong in bringing TSH in an optimal Level the same way we do with TRT. On TRT i want my numbers to be in an optimal range as well. And i know from bloodwork before TRT that i felt good with TSH around 1.

 

[Vince]

Hey guys. I got my thyroid numbers today. In my country we get levothyroxine without prescription in pharmacies. I am thinking about supplementing T4 to bring my TSH between 1-2.
What dose should I start with. 25 mg or better 50.
Since starting TRT my TSH is climbing continuously.

TSH: 2.23
FT3: 3.3
FT4: 1.03

Even tho I war the same amount of calories daily it’s getting harder and harder to stay on the same body fat percentage. I have to cut down more and more and if it continues like that I would need to go under 1700 calorie’s which is not optimal.

In my country they just treat you if you are above 6. So talking to my doctor would lead to nowhere.

So how should I supplement T4?
Edit---: i felt best when my TSH was 1 before TRT even tho my T4 was 0.9.

Have you ever considered testing reverse t3 you may be pooling your t3.

 

[bennygoestrt]

Honestly just never tested this one. What do you mean exactly by pooling?

 

[Vince]

Honestly just never tested this one. What do you mean exactly by pooling?

Pooling would be suggesting that the t3 is not getting into the cells and the free t3 levels is just "pooling in the blood"

 

[bennygoestrt]

Thanks @Vince. If that is the issue, what would i have to do? Supplementing T3 instead of Levo/T4

 

[Systemlord]

And i know from bloodwork before TRT that i felt good with TSH around 1.

Your TSH fluctuates, so it may not have changed at all and you’re just catching it at the top end of the fluctuation. Your Free T3 may not have changed from before you were on TRT.

You even say your Free T4 is higher, than previously.

TSH isn’t a feel good hormone, so without also testing Free T3, you’ll never know if thyroid hormones actually changed from previously.

My optimal range for Free T3 is 3.3-3.6, my Free T4 is right at the bottom and TSH 0.45. I actually tried T3/T4 combo medicine and experienced hyperthyroid symptoms after only two days on the lowest dosage possible.

I have read most people do very well with Free T3 midrange or slightly higher.

 

[Vince]

Thanks @Vince. If that is the issue, what would i have to do? Supplementing T3 instead of Levo/T4

A generic low dose T3 should correct that. I buy T3 from reliable RX.

 

[Vtail]

Thanks @Vince. If that is the issue, what would i have to do? Supplementing T3 instead of Levo/T4

I came across this article a few years ago when I started looking into my Thyroid levels and symptoms of fatigue and brain fog. It explains the interconnection of Free T3 vs Reverse T3. You may find it helpful.

 

[bennygoestrt]

I came across this article a few years ago when I started looking into my Thyroid levels and symptoms of fatigue and brain fog. It explains the interconnection of Free T3 vs Reverse T3. You may find it helpful.

Thank you man. How did You solve Your problem. I don't have fatigue but getting a harder and harder time to stay on the same bodFat since starting TRT and no change to my diet.
That's why I am suspecting my thyroid.
.

 

[Vtail]

Thank you man. How did You solve Your problem. I don't have fatigue but getting a harder and harder time to stay on the same bodFat since starting TRT and no change to my diet.
That's why I am suspecting my thyroid.
.

I started supplementing with T3. 25 mcg at first, then bumped it up to 50 mcg. Before starting this my Reverse T3 was 23 and my TSH was 3.5. After taking T3 for a while my Reverse T3 fluctuated in the single digits. My understanding is the lower the Reverse T3 is the better. Any my TSH dropped to about 2.5.

My brain fog and fatigue cleared up and I was able to lose body fat much easier than ever before. I'm pushing 60 yrs and I suspect I have been border-line hypothyroid most of my life. But because my lab values were always "within range" no doctor ever mentioned it. The upper range of Reverse T3 is 24, so my level of 23 was never flagged.

Here is a useful chart.

 

[bennygoestrt]

Wow thank you guys.

 

[mcs]

I have had over 10 years of experimenting with every form of thyroid replacement (sustained-release T3, T4 monotherapy, T3 monotherapy, commercial NDT, custom-compounded NDT, T3 + NDT, T4 + NDT) and I have found the most effective to be custom-compounded NDT which I have made with ascorbic acid as the only filler. I can get the batch assay to see exactly the ranges of both T3 and T4.

Approximately 10-15% of the population does not convert T4 to T3 due to deiodinase mutations, so T4 is actually detrimental and will raise rT3 and cause worse symptoms.

You don't need to worry about hyperthyroidism unless your TSH is <0.5. I check my pulse and pressure daily. I do a full set of thyroid function labs every 60 days to track progress.

I take 162.5mg (2.50 grains) once daily first thing in the early a.m. fasting with water only (very important not to take with any other supplements, meds or food - except ascorbic acid which helps absorb T3). That gives me approx. 95mcg T4 and 27mcg T3 (I would start at a much lower dose and titrate until your TSH is suppressed within iptimal range as indicated upthread). I could still use a little more suppression of TSH but I don't want to get too much more T3.

Here are my averages for this year at that dosing:
TSH: 1.5
FT3: 4.5
FT4: 1.3
rT3: 11
TPO/TgAb: 0

 

[Ribeye]

Your TSH fluctuates, so it may not have changed at all and you’re just catching it at the top end of the fluctuation. Your Free T3 may not have changed from before you were on TRT.

You even say your Free T4 is higher, than previously.

TSH isn’t a feel good hormone, so without also testing Free T3, you’ll never know if thyroid hormones actually changed from previously.

My optimal range for Free T3 is 3.3-3.6, my Free T4 is right at the bottom and TSH 0.45. I actually tried T3/T4 combo medicine and experienced hyperthyroid symptoms after only two days on the lowest dosage possible.

I have read most people do very well with Free T3 midrange or slightly higher.

count me as one of those people who do better with free T3 midrange or higher. Hashimoto's has its way with me regularly.

 

[Wolverine]

I started supplementing with T3. 25 mcg at first, then bumped it up to 50 mcg. Before starting this my Reverse T3 was 23 and my TSH was 3.5. After taking T3 for a while my Reverse T3 fluctuated in the single digits. My understanding is the lower the Reverse T3 is the better. Any my TSH dropped to about 2.5.

My brain fog and fatigue cleared up and I was able to lose body fat much easier than ever before. I'm pushing 60 yrs and I suspect I have been border-line hypothyroid most of my life. But because my lab values were always "within range" no doctor ever mentioned it. The upper range of Reverse T3 is 24, so my level of 23 was never flagged.

Here is a useful chart.
View attachment 30732

Do you take any T4? What is your FT4 level on T3 only? Tx