- T3 is the active form of thyroid hormone responsible for all metabolic benefits (weight loss, energy, metabolism), so tracking free T3 levels is more useful than T4 or TSH for assessing if your thyroid treatment is working.
- Most doctors treat you with T4-only medications like levothyroxine, but your body may convert this T4 into reverse T3 (an inactive form) instead of T3, causing weight gain and fatigue despite 'normal' TSH.
- Low T3 directly causes weight gain because T3 is the most powerful regulator of mitochondrial energy production, and without adequate T3, your metabolism slows and fat loss becomes nearly impossible.
- Nutrients like zinc and selenium are essential for T4-to-T3 conversion, so supplementing these along with optimizing your thyroid medication dose can help restore the active thyroid hormone your body needs.
- If you're gaining weight and experiencing fatigue despite taking thyroid medication, ask your doctor to measure your free T3 level. If it's low, you likely need additional T3 support through medication or better conversion support.
Checking your total T3 and free T3 may be the most important thyroid tests you can look at.
Unfortunately, many physicians aren’t even ordering these tests which may lead to a missed diagnosis of low T3 syndrome.
Fortunately, there are several therapies that you can do to increase this important thyroid hormone and take steps to reduce your symptoms.
If you are experiencing weight gain, chronic fatigue, chronic pain or a slow metabolism then increasing your T3 becomes even more important.
Let’s discuss how to increase these levels and how T3 impacts weight and weight loss…
Why T3 is the Most Important Thyroid Hormone
T3 thyroid hormone is one of the most important thyroid hormones (we will go over the other arguably more important hormone below).
T3 is the active form of thyroid hormone in your body.
It can be measured by testing your total T3 in the serum and by assessing your free T3 levels.
The total amount of T3 in your body represents all of the T3 in your serum (blood), and the free T3 represents the amount of T3 available to be used and for binding.
You can think of total T3 as a reservoir for free T3, but both numbers are important.
But why?
It turns out that all of the beneficial effects of thyroid hormone in your body come from T3 (NOT T4 thyroid hormone).
T3 thyroid hormone acts directly on the nucleus of your cells via a nuclear receptor to literally turn on your genes (1) and alter genetic transcription.
This is very important because it can help you understand exactly how thyroid hormone works in the body.
The fact that thyroid hormone works on the nucleus of the cell helps to explain why it takes weeks for changes in thyroid hormone to take effect.
Altering genetic transcription, altering enzyme production, and changing cellular transcription takes time.
These changes in genetic transcription help increase energy, increase metabolism (2), stabilize hair growth (3), and do all of the functions associated with proper thyroid hormone function.
- Bottom line: T3 thyroid hormone does all of the good things that you want thyroid hormone to do. It is the most important thyroid hormone to monitor for this reason.ย
Understanding the Difference Between T4 & T3
The biggest issue with T3 is that most doctors, physicians, and endocrinologists don’t actually test for it.
And that’s why you need to understand the difference between T4 and T3.
You’re probably familiar with T4 whether you realize it or not:
Some physicians actually test for T4 (so you may actually have your free T4 levels to look at).
Even if your doctor doesn’t test for T4 and instead uses the TSH only for monitoring your thyroid function, you are probably being treated with a T4-only thyroid medication like levothyroxine, Synthroid, or Levoxyl.
And that’s the problem:
T4 is used in the body as a reservoir to be turned into T3 through a conversion process known as T4 to T3 conversion.
So why is that a big deal?
Doctors make one big mistake when treating and supplementing hypothyroid patients with T4-only medications:
They assume that your body will take all of that T4 thyroid hormone and turn it straight into T3.
And, as you can probably guess, that doesn’t always happen.
Instead, your body is just as likely to turn it into the antithyroid metabolite reverse T3.
Reverse T3 directly competes for cellular binding with T3 and can actually cause hypothyroid symptoms.
So when testing for thyroid hormone and when evaluating if you are being managed correctly it’s far more useful to know your T3 levels instead of your T4 levels.
Make sense?
Why Low T3 Leads to Weight Gain
One of the biggest issues that hypothyroid patients face is weight gain.
Part of this problem is mediated by the fact that many patients don’t actually convert T4 to T3 efficiently, and the other part is the reliance upon TSH as a measure of proper thyroid hormone in the body.
The truth is that most patients don’t actually convert thyroid hormone efficiently AND TSH is not the best marker for evaluating thyroid function in the body.
These problems, along with low T3 levels, help contribute to the weight gain and weight loss resistance that many hypothyroid patients face and struggle with.
The reason T3 is so important for proper weight management is simple:
T3 is one of the most powerful, if not the most powerful, mediators of energy production from your mitochondria.
The energy production from your mitochondria serves two very important functions:
1. Help determine your basal metabolic rate.
2. Help provide you with a subjective sense of “energy”.
That means that low levels of T3 will directly (or indirectly) result in a slower-than-normal metabolism (sound familiar?) and may result in the symptoms of fatigue and/or low energy levels.
Obviously, both of these factors are very important for maintaining a normal and healthy weight, but they are most important for losing weight.
Your metabolism accounts for the majority of calories burned throughout the entire day, so a slower metabolism results in weight gain.
Meanwhile, low energy levels may prohibit you from being able to exercise making weight loss difficult.
So what is the solution?
How to Test your T3 Levels
For the reasons listed above (and many others we won’t be discussing) testing for your T3 becomes a VERY important part of thyroid management.
I need to take a second and make a disclaimer here:
If you have to ask your Doctor for these tests there is a good chance they are NOT going to understand how to interpret them correctly.
So don’t assume that you will get proper treatment for your thyroid problems just by getting these tests done, the testing is really only the beginning.
What matters more than the actual tests is the treatment and management afterward.
So, while testing is important, don’t make the mistake of assuming that your physician or provider will be willing to treat you appropriately once you have the results.
Ok, back to testing:
These are probably the most important thyroid tests to get if you want to understand how your thyroid is functioning in your body:
- Total T3
- Free T3
- Reverse T3
- Sex hormone-binding globulin
You will probably notice that TSH and free T4 don’t even make an appearance, and that is definitely intentional.
TSH really only gives you an idea of pituitary levels of thyroid hormone and T4 is only somewhat helpful in evaluating thyroid conversion.
Instead, I want you to focus on getting the labs listed above and then interpreting the results based on “optimal” levels and not “normal” levels.
When it comes to hormones there is a huge difference between being in the “normal” range and having an adequate function and being optimal.
For instance:
As a 20 to 40-year-old woman, you don’t want your free T3 levels to be in the range of an 80-year-old.
Use the sample ranges below to determine if your levels are optimal or not.
Optimal ranges for the following lab tests (assuming you aren’t taking T3 containing thyroid hormone already):
- Total T3: Should be in the upper half of the reference range
- Free T3: Should be in the upper half of the reference range
- Reverse T3: Should be as low as possible, any number higher than 15 is a problem
- Sex hormone binding globulin: In men, this should be 20-30 and in women, it should be 70-80 (this value isn’t helpful if you are taking oral estrogen or birth control pills)
These values assume that you are NOT taking any thyroid medication (if you are, you can’t use those ranges) and it assumes that you also are experiencing the symptoms of hypothyroidism.
I want to take a second and point out the value of sex hormone-binding globulin:
SHBG helps give you an idea of the tissue levels of thyroid hormone in your liver.
As an aside, you can think of TSH as a marker of tissue levels of thyroid hormone in your pituitary.
The liver is a better marker of other tissues in your body because it contains both deiodinases.
The pituitary doesn’t contain the deiodinase which transforms T4 into reverse T3, which means that all thyroid hormones hitting the pituitary will be able to convert just fine.
But that same thing may not be true in other tissues, and that’s why SHBG is helpful.
Low T3 Syndrome & Euthyroid Sick Syndrome
Let’s say that you have your tests in front of you and you have determined that you do indeed have low T3.
It turns out that there is actually a name for your condition:
It’s known as low T3 syndrome and/or euthyroid sick syndrome.
Almost every doctor knows this condition, but they’ve probably forgotten about it over time (or don’t realize its importance outside of the hospital).
The reason is simple:
Low T3 is a compensatory response to harmful stimuli in the body.
We can sum it up like this:
Anything in your body that causes high levels of stress, high levels of inflammation, physical/emotional trauma, or any other stressor on the body may result in this condition.
Another surprising reason for low T3 is simply being overweight.
Patients who are obese have lower levels of free T3 (4) and higher levels of reverse T3.
Medications can also reduce the conversion of T4 to T3 including blood pressure medications, diabetic medications, pain-blocking medications, antidepressants, and nerve modulators (gabapentin & Lyrica, etc.).
When you look at all of the potential causes of low T3 that exist, it’s easy to see why this condition is becoming more and more common.
Nowadays it’s not uncommon for people to be overweight, stressed out, and already taking multiple medications.
I should also take a second to discuss that one of the most common causes of low T3 is calorie restriction and a history of yo-yo dieting (5).
If you’ve ever done these types of diets in the past there is a very good chance that you not only have damaged your metabolism but that you also have low levels of T3.
If you fall into this category don’t worry, we are going to talk about treatment below:
Symptoms of Low T3
But first, we need to talk about the symptoms of low T3.
If you recall I pointed out earlier that you need the combination of symptoms PLUS low lab values to diagnose low T3 syndrome.
Use this list of symptoms in conjunction with your lab tests to determine if you have low T3:
- Cold body temperature & extremities(less than 98.0 degrees)
- Low resting heart rate despite being overweight and non-conditioned(resting heart rate less than 50-60)
- Weight gain and/or weight loss resistance
- Decreased energy levels and inability to sustain activity levels for long periods of time(even low-intensity exercises like walking cause worsening fatigue)
- Other hormonal problems including estrogen dominance, low progesterone levels, insulin resistance, and/or leptin resistance
- Chronic pain and/or chronic muscle tension/cramps
- Hair loss, hair breakage, dry skin, and/or brittle/damaged nails
As you may have noticed this list mimics many of the symptoms with some exceptions…
Many of these symptoms result from a lower-than-normal metabolism and may directly or indirectly lead to weight gain and weight loss resistance.
In addition to these symptoms, you may experience any (or all) of the traditional symptoms of hypothyroidism.
It’s important to note that the symptoms of low T3 may vary from person to person, but the list above represents the most common symptoms that patients may experience.
Use the list above in combination with your lab tests to determine if you should move on to the next step…
Natural Treatment to Increase T3 Levels
I’m going to go over how to approach low T3 levels and what you can do about it.
This is really important because, as I mentioned previously, most physicians don’t pay much attention to T3 levels.
This means that they aren’t likely to change your medication, increase your dose, or even mention these lab tests, to begin with.
It’s therefore important that you are knowledgeable and do whatever you can to increase your T3 naturally.
I will also go over how to increase your T3 the easy way (taking T3 medication) below.
#1. Boost Conversion of T4 to T3
One of the easiest ways to boost T4 to T3 conversion is by taking targeted supplements to help boost this natural conversion process.ย
It turns out that there are several supplements that can help accomplish this goal:
- Zinc: Zinc has been shown to increase T4 to T3 conversion, act as a powerful anti-inflammatory and reduce oxidative stress. Zinc is also a VERY common nutrient deficiency in the US. Standard zinc supplements also fall short because they don’t contain highly absorbable formulations of zinc (6)). Doses of 30-60mg per day can help boost thyroid conversion if taken with selenium.ย
- Selenium: Selenium can also improve T4 to T3 conversion, act as an anti-inflammatory and help balance the immune system. Selenium is also very helpful for patients with autoimmune thyroiditis or Hashimoto’s thyroiditis. Taking 200-400mcg per day (when accompanied by zinc) can help boost thyroid function and conversion.ย
#2. Reduce Reverse T3 Levels
Another indirect way of increasing the effectiveness of T3 levels in the body is by reducing your reverse T3 levels.
Recall that reverse T3 directly competes for cellular binding with T3 levels.
This means the higher the reverse T3 the more free T3 you need to counteract the reverse T3.
By decreasing reverse T3 levels you don’t necessarily need to increase T3 levels because it will be easier for the T3 to do its job.
Make sense?
So how do we do it?
You have to tackle the main problems that might be causing high reverse T3 levels to begin with.
Use the list below and address any or all of the problems in your body to reduce your reverse T3 levels:
- Lower inflammation: Inflammation from any cause will increase reverse T3 levels and result in decreased thyroid function. You can test for inflammation by checking ESR and CRP. If these are elevated then you should consider taking anti-inflammatory supplements like Turmeric, fish oil, and quercetin plus bromelain.ย
- Treat SIBO or other GI-related problems: Treating your GI tract is very important for managing thyroid conversion because the gut is the place of at least 20% of the conversion process. This is further complicated by the fact that many conditions like SIBO, IBS, GERD, and SIFO reduce conversion by increasing inflammation and reducing the conversion efficiency in the gut. Approximately 50% of thyroid patients have concurrent SIBO/SIFO whether they realize it or not, you can learn more about treating and managing SIBO here.ย
- Lower insulin: High insulin levels (and also high blood sugar levels) inhibit the T4 to T3 conversion process and contribute to weight gain. If your fasting insulin is greater than 5.0 you should aggressively treat and manage your levels with supplements + dietary changes. If you have insulin resistance (or high blood sugar) consider using the following supplements: Alpha lipoic acid, Berberine, and chromium.ย
- Lower leptin levels: Leptin is another hormone that contributes aggressively to weight loss resistance and is missed by most physicians who either don’t know how to treat it or don’t understand its importance in managing thyroid levels and managing weight loss. I’ve written extensively about how to test for and manage leptin resistance and you can read more about that here.ย
- Stop dieting and consciously limiting your calories: If you are consuming less than 1,500 calories per day just to maintain your weight you are damaging your metabolism and contributing to low T3 syndrome. In order to heal your metabolism, it will be necessary to STOP consciously reducing your calories to halt and reverse this process.ย
Reducing reverse T3 levels can be quite complex and may require some digging to get to the bottom of your specific problem.
#3. Increase Thyroid Hormone Production
Another roundabout way to increase T3 levels indirectly is by increasing your total thyroid hormone production.
This doesn’t always work by itself, but if used with techniques designed to both boost T4 to T3 conversion AND reduce reverse T3 levels it can be particularly effective.
It turns out that over 10 different supplements are required for proper thyroid hormone production.
If you are deficient in any of these nutrients then you may suffer from decreased thyroid hormone production over time leading to worsening symptoms of hypothyroidism.
You can find the full list of supplements required in this post as well as how to test for and determine which supplements you may need to take.
T3 Thyroid Medication Therapy
Now let’s talk about the easy way to increase T3 (well relatively easy way).
Simply taking T3 can automatically provide a boost to your T3 levels and significantly (and usually quickly) reduce any symptoms you may be having from low T3.
We touched on medications previously, so it’s worth discussing them a little bit more in detail.
Part of the reason that so many patients feel terrible despite taking thyroid medication has to do with the conversion process of T4 to T3.
You already know that most physicians prescribe T4-only medications like Synthroid, levothyroxine, and Levoxyl.
What you may not realize is that these T4-only thyroid medications may be converted into reverse T3 instead of the T3 you want it to turn into.
So, in some cases, you might actually be making your symptoms worse by taking thyroid medication.
In some cases, you may be fueling the fire by providing your body with more substrate to produce reverse T3 with.
So how do you deal with this problem?
This problem can be dealt with by reducing (or eliminating) the amount of T4 hormone you are taking and instead providing your body with T3-only thyroid medication.
If you give your body direct T3 there isn’t any substrate to produce reverse T3 from so these levels will automatically drop.
Getting your physician to prescribe T3-only medication can be difficult, however, so this may not work for everyone – but if possible it’s certainly worth a try.
Better yet, combining all of the natural therapies listed above with T3-only thyroid medication is very effective.
NDT vs Liothyronine/Cytomel for Low T3
What about natural desiccated thyroid hormone, where does NDT fit into all of this?
As you may know, NDT is predominately a T4 thyroid medication, but it does contain some T3 in it as well.
The ratio is in favor of T4 about 3:1, however, which means that NDT can also contribute to reverse T3 production.
In some cases dropping the total dose of NDT may be required to flush out reverse T3.
In addition, some patients do quite well with the combination of NDT + T3 medication.
Recap & Final Thoughts
Having low T3 is a serious problem that tends to be ignored or underappreciated by most physicians.
Because T3 thyroid hormone is the active thyroid hormone in your body, it is the most important thyroid hormone to evaluate.
If you are experiencing any of the symptoms of low T3 syndrome or euthyroid sick syndrome make sure that you get the following lab tests: free T3, total T3, reverse T3, and sex hormone binding globulin.
If you find that you have low T3 then a combination of natural treatments plus changing your thyroid medication may be in order.
Remember that when it comes to improving your thyroid function it will likely require a combination of therapies to achieve the best results.
Now it’s your turn:
Do you have low T3?
What have you done to increase your T3 levels?
What has worked for you?
Leave your comment below and I will personally respond.
I am a 72yr old woman with Hashimoto’s thyroiditis. I’m taking 75 MCG of Synthroid. I’m gaining weight, am very tired, have dry skin and seeing hair thinning, plus lower back pain. My test results say tsh .62 t4 7.2 and t3 77. Have a doctors appt in a few days but not overly confident in his knowledge on this as I was the one asking for further test with t4and t3 levels. Will increasing Synthroid dosage help?
I’m a 17 year old female with low T3, as shown by my most recent blood test. I lost around 20 pounds when I was 13 years old, which I know is extremely young. After doing a dangerous amount of physical activity at the gym, I started noticing all the symptoms of hypothyroidism (dry, brittle, thinning hair was my biggest concern), but my blood tests never indicated that I had any problem with my thyroid. I had a hormone test done and all my hormones appear to be normal. However, last year, it showed that I was deficient in several vitamins and iron. I’ve been taking supplements for over a year now and all my levels are fine. The only thing that is coming up is low T3. I’ve been taking ONLY T3 now for around a month and nothing has improved. In fact, my hair loss might have gotten worse. My skin is still extremely dry and my body temperature is below average. Yesterday, I found out that I’m very intolerant to gluten. If I take out gluten from my diet, do you think my hair will get better? What do you suggest I do to fix my hair problems, along with the my other symptoms? I’m no longer deficient in anything, my hormones are fine, I’m at a healthy weight and have a healthy diet, and I’m taking T3, yet nothing is working.
Hi Dr Childs, I had a thyroidectomy in November of 2016. I have been taking synthroid 125mcg and having a fair success rate until about a month ago. I have trouble converting to T3 and every time my Dr tries to add T3 (I’ve tried compounded natural thyroid as well as compounded T3 only) my hashimoto’s symptoms flare up terribly. He is an integrative Dr and has helped me since my hashi’s diagnosis in 2013 so much – until now ๐ what if you can’t tolerate T3?
Hello Dr. Childs. I found your article when the nurse called and said my T3 was low but TSH was normal. I questioned why my T3 was low but didn’t get much of a response and she said the doctor would want to wait six months and test again. Six months????? I have most of the symptoms you described for low T3. I’m going to try your suggestions for supplements and natural foods and also want to read your book on foods to eat. I also want to try talking to my doctor about further testing sooner than six months. Thank you for an informative article.
Hi Denise,
Glad you found it helpful. You will find that most physicians tend to take a “wait and see” approach to thyroid management which is why I try to provide lots of other options and avenues that you can potentially take. Good luck and keep us updated!
I took T4 for years, and told my doctors it was not working/balancing my system. I finally went to a naturopath and she tested all my ranges (which standard med. doctors would not do). She put me on T3 and I take lyothirinine (spelling looks wrong. Lol) That is T3. I was still sick…but TMI for this venue. My NP recommended an immune specialist/rheumatologist. Strangely, I needed a refill for my T3 while my NP was out of town and he would not fill it. He had already told me my thyroid was balanced beautifully weeks before, but said he “did not support taking both T3 and T4!”. I told him my body does not convert well, and he said then you should raise the T4 because it gets converted to T3. Ugh. Well, sorry Doc, but that was not working for me. I had no *diagnosed* immune issues though.
Here is the thing, while a lot of what you say about thyroid is spot on from everything I have learned, the problem is that you have not learned everything about the people reading this or there health history. You have no other baselines and you have no other specifics. I have PCOS, which is basically from insulin resistance, even though they name it based on it resulting symptoms. and you are born with it. It is genetic and runs in my family. Secondly, thyroid is very important and definitely needs to be balanced by a professional. The endocrine system handles functions throughout the body and Messing with it can throw your whole system into turmoil if you are not knowledgeable. I would never recommend going at and buying thyroid meds and popping some random dosage. Go to a Naturopath…not standardized medicine doctors. Get a recommendation or ask for free consults to evaluate them. Do not pop thyroid meds without a knowledgeable professional evaluating all you health history.
I have food sensitivities and was poisoning my system with God given food. Food that I ate everyday, and would not give me problems for days. My immune system may not have a diagnosed disease, but it was so sick. Yes, my thyroid was part of that, but only part. I got a blood test of a 150 items and found I was high to high-moderate sensitive to many things. It is more common then you might think people. I could not lose weight and my thyroid alone was not the cause. My body was sick and getting sicker because I had anti-bodies attacking literally everything I put in my body. A few of sensitivities I now know I was born with…strangely one was bovine proteins…including milk and cheese. I thought it was the lactose or the milk fat…and I thought I did not digest iron for the meat side of
It as well.Wrong! I am also highly sensitive to chemicals…food coloring, nitrates/nitrites, and versions they spray on all lettuce, even organic, to make it stay fresh. I also have issues with ALL grains and oats. The grains and oats my body does not digest and my insulin resistance has something to do with it processing and storing residual sugar. Also; I used to think fat was making me fat, but not eating it was contributing to that. Honestly My elimination diet was ILLUMINATING. I could only eat a few things and walnuts was one of them. I ate more fat, but healthy, in that first 7 months including walnut oil than I think I ate my entire life. The weight melted off me, but not just because of the fat, but because I eliminated what I did not know was poisoning me. This is not a sales pitch. I take no other drugs anymore but my thyroid, a sarcode for my pineal/hypothalamus/pituitary gland, and an adrenal medicine I just started. The last two are only while I am trying to heal and work with a wellness doctor. I also take B12/B complex which many people are deficient in. Magnesium is another, and I take Magnesium lactate, which is not one avail. in stores. I also take D3, Zinc, Copper, Iron, and Iodine mineral supplements. I have gut issues and so I take liquid versions of all but my adrenal and thyroid meds. My gut does not absorb them, hence taking them for years and my body was still being deficient. I hold them in my mouth for 30 seconds to absorb them that way. All of these are necessary for thyroid and immune health, but that is not mentioned here. Deficiency in them can cause symptoms you think are thyroid related…and they get ignored.
My point is…also get testing from naturopath for vitamin and mineral deficiancies. If you have rashes, allergies (environmental or food), have digestion issues of any kind…including heartburn or indigestion, hair loss (I did and mine filled in a lot after removing these foods), brain fog, bloating, constipation, diarrhea…just to name a few. I had multiple, but I am an much older young person. Lol.
As amazing, detailed, and knowledgeable this and other websites can be about a topic, symptoms ALWAYS overlap, and no one magic answer usually fixes issues someone has lived with for over a decade or longer!! Take the time to find a doctor who will work with you, and is knowledgeable about balancing your entire system…preferably as natural as possible. The one thing I have learned from standardized medicine is that most prescription drugs made to fix major issues make you sicker, not everything works for everyone and can actually CAUSE/CREATE issues, and the medical community knows little in how the encodrine and immune system and the gut/ntestine work. They just found a whole new organ last year. Anyway…I am done now. Lol.
Dr. Child’s I live in Michigan and I see Dr. Neuenschwander in Ann Arbor he knows of the t3 I’m on 50 mcg of t3 and it’s making my blood pressure high why is that? I need prob still higher doses because of my Basel body temp are still low average in mornings 97.6 and still not much of a metabolism? I have a lot more energy my reverse t3 is 0.5 my free t3 is now in range where it should be, but now I’m nonexistent of making any t4? What would you suggest? Thank you Debbie Braun
Hi Dr Childs
I have had hypothyroid symptoms almost my entire life – there has never been any medical intervention. I am 44 y/o female and symptoms are becoming worse. My most recent lab results are as follows (I am in Canada) :
Thyroid Stimulating Hormone [TSH] : 1.96 (range 0.32-4.00 mIU/L)
*my previous test 6 months ago, results were 2.56
Thyroxine Free [Free T4] : 11 (reference range 9-19 pmoI/L)
Triiodothyronine Free [Free T3] : 3.4 (reference range 3.1-6.2pmoI/L)
Thyroperoxidase Antibody : <10 (reference range < 35)
Of course, since these results all fall within the lab's "normal range", my doctor suggests that we will retest in a few months. Can you possibly provide a bit of insight? Since Free T3 & Free T4 are definitely on the low end of the range, should I possibly be doing something?
Many thanks in advance
Dear Dr Childs,
I am without thyroid for 6 yrs, struggling with t4+t3 Meditation.I never feel really good for long time. Niw I got hyperdosed with 150 t4 and 5×5 t3, had intense blood pressure issues with my Labs in the top of the ref. Range. Now I have to dose down – how much t3 would you recommend with taking 125 t4 now? I habe 5×3=15 but feel dizzy all day and my heart rate sometimes 45… I dont know whether this is just effect of changing or generally too low. Thanks!!!
Der Dr Childs,
Another question. I had an iron Infusion, ferritine in the 20s for 3 yrs now. My Labs Werke in the very upper part oft the ref range. With the Infusion, I got severe hyperthyroid symptoms. Do you know ans reason why? Do I tolerante Mord t4 and t3 when iron deficient?
I just wanted to say thank you for this article! 6 years ago I had a great endo who had me on T3 only, and I felt better than I had in the 5 years since I had been diagnosed. I got pregnant so went back to synthroid, and my dr retired. Started a new doctor and for the past 5 years now it has been a battle with her to even test my T3. At my last appointment to tell me that my memory of how I felt on T3 was wrong. I told her thatโs not true and I had been fighting with her since to go back on just that (due to multiple pregnancies I didnโt push too hard until now since Iโm done having kids) and she looked at her notes and said oh yeah- you are right. Time for a new doctor I think…. She also told me she did research and T3 only meds was not the proper course of treatment and my last doctor was wrong. Hmmm okay?? After begging her I did get her to add a little t3 daily starting last week. Anyway, thank you for reinforcing the fact that I am not crazy!
I found your article to be very informative. I have TR 22 issue and my dr prescribed me compounded medicine from local pharmacy in 10 mg of T3 only. I’m worried about potential side effects like anxiety? Please advise.
Dr. Childs, thank you so much for your information. I was diagnosed, by an endo, with Hashimotos 16 yrs ago…was stabilized (I suppose) on .88 mcg levoxyl for 10 years. After experiencing my childs cancer and eventual death, about a month later I went to my GP and my t3 was low at 73. She changed me to synthroid and inreased it to 100mcg. After 6 months, my tsh had climbed to 3.38 (past tsh always between .8 and 1.5)and t3 still low at 74. She tried me on cytomel 5mg once a day taken with synthroid dose….cytomel helped greatly with energy and focus, but caused nausea and afternoon crash. So I tried 2.5 a.m. and afternoon helping with crashing, but not nausea. Sent to another endo…told her my history. She increased my synthroid to 112mcg. I seem to get a little better energy, etc. This past 3.5 months I have suffered from severe fatigue 2 hours after I awake in the morning. Finding myself napping a lot, very cold, very dry skin on arms and legs, constipation, night sweats and small weight gain (without any increase in food intake). Went to GP for labs. My tsh is 1.8, but t3 is 64(low). The PA decreased my synthroid too 100 and put me on cytomel 2.5 (I have to split it) twice a day (and added Zofran for nausea if needed). I am already feeling better in my fatigue level, my constipation, and concentration. I can tell you that I am a person who knows my body andI KNEW THINGS WERE NOT RIGHT, EDPECIALLY WHEN THE FOG LIFTED AFTER STARTING CYTOMEL. I don’t know if this will be the right dose or not, but I know it is a trial and error situation. But I HAVE TO ALMOST TELL THE DOCTOR WHAT I WANT….WHY????? Why will they not listen….no one has time to listen anymore. Thank YOU for listening Dr. Childs!
Hi, was diagnosed with Graves disease in 2011 and hyperthyroidism. After Meds failed and irradiated iodine course my thyroid was completely removed in 2013. Since then Iโve tried every maker, generic and brand named T4 Meds. At 400mcg I finally talked my doctor into giving T3 a shot. She agreed. There was a misunderstanding of how to take the Meds. I thought she wanted me to add T3 to my T4 which worked. Was the best I had felt in 6 years, but she says she wanted me to only tak the low dose of T3 by itself. When we tried that it didnโt work I put 20 pounds back on became very depressed and wanted to just give up. I have seen her again and agreed to try it her way with a small increase of T3 and zero T4 for two weeks and she agreed to look at it differently if there is not a marked improvement of my TSH levels which is all she looks at. Well, and my kidney function that is decreasing as I get sicker. My biggest question is… is it ok to be on T3 and T4 at the same time? As my Tsh gets higher 300+ and I gain weight of course depression takes control and Iโm feeling hopeless in a system where I think doesnโt really care
Hi! Please can you advise me… I have just had my blood results done and I am showing that my T4 is slightly above the normal range but my T3 is borderline on the low end). I have been hypo for 15 years but was told I am now hyper but I have all the symptoms of hypo not hyper. My dr. only tells me to lower my Levo T4 but this does not address the low T3 so I am going about supplementing T3 myself. Do I need to lower my Levo to do this? I am prescribed 100mcg currently.
What does it mean to have a below normal reverse t3 on a blood test?
Hello Dr. Childs,
As an adult, I have always had a low body temp, as low as 95 with the normal around 97. I also have low blood pressure, today 92/62. I have symptoms of hypothyroidism, weight gain, hair loss, fatigue, depression, but the blood test are always normal. Today I came across Wilsons Temperature Syndrome and wonder if that is my issue. The problem is that testing the blood will not prove the issue. Do you have any suggestions for figuring out if that is the problem or to treat the issue if that is the problem? thank you, Tara
Hi Dr Childs, I am a 44 yr old mom of 3 that was dx’ed with hoshomitos 14 years ago and T1D 12 years ago. My body seems to have trouble converting t4 to t3 and even being on large amounts of t3 does not raise my t3 number. After reading your article I’m wondering if my blood sugar issues do to T1D could be playing a factor in my t3 levels raising? Any thoughts on the connection with the 2? I am planning to add zinc and seleium to my supplements, any other advice? Thank you!
Hi Dr Childs, thank you for the great information. I want to take the natural route to curing the low T3 in my body. I have been taking Zinc & Selenium, also following your program which I purchased with intermittent fasting 3-4 days a week. I am wondering 2 things:
1) How long should I keep up with the supplements?
2) Generally I don’t eat 1500 cal, especially on fasting days, because I just cannot eat that much and I am not hungry, am I still damaging my metabolism this way?
Hi,
How can you naturally lower a high SHBG? Mine was 194, which was 4 months after stopping birth control pills (12 years of use). After 7 months of bcp, my SHBG was 187. My thyroid levels, rt3, etc, are all within range, but close to the limits of normal. I still haven’t started a period, either. DHEA 73, estrogen 42, progesterone 0.6, LH 27, FSH 11.1. salivary cortisol normal, but closer to the low limit. Is this high SHBG level the reason why I haven’t started to ovulate yet?
Thanks,
K
Hi Dr. Childs,
This is the best article I have come across. So easy to understand and you are so correct. My T3 has been low since 2016. It stays at 0.7 I just had it re-checked 2 weeks ago and it remains at that level. I do have an Endocrinologist but each follow up visit I tell him that I am fatigued, weight gain even with no appetite, hair loss, elevated Cholesterol and LDL, and a complete list of Hypothyroid symptoms. My symptoms of extreme fatigue and weight gain started in 2015. I asked my GYN at that time if he would do a Thyroid panel and also a hormonal panel. He just ordered a TSH which was in normal range but I had a very low level of Progesterone, Estrogen and Testosterone even though I was on HRT for 20 years. He stopped the HRT. I felt worse after that. I saw an Endocrinlogist as I have a Goiter via Thyroid Ultrasound. No biopsy has been done due to the stable size. I had a Lumbar Radiculopathy and Lumbar Spondylosis in 2015 and then due to nerve damage after surgery, had a TVH with Cystocele and Rectocele repair. Cystocele repair again 3 months after and then a Sub Total Colectomy in October of 2016. September of 2017, I had a Pain Pump insertion. I know a lot of this contributes to the fatigue, etc.
I always remind my Endocrinologist of the low T3 and he is never concerned. His PA called last week about the lab results and since it is still at that low # and I am still very tired she started me on Cytomel at 5mgm 1/2 tablet Q.O.D. Just a few days since I have been taking that I am waking up early and actually able to function.
My TSH was 3.35 on 03/21/16. your opinion I also have Sinus Bradycardia and now have a Pacemaker. Blood Pressure is very low, but Cardiologist does not seem concerned.
Could you please give me some direction?
Thank you,
Mary Ann Maycen
Thank you for helping explain this disease. I am 31 years on Levothyroxine .88 – have Raynauds Syndrome in my hands and feet since I was a child. I am constantly cold. I am not anemic. After reading your articles, I went to my doctor to ask for Thyroid tests last week – TSH was normal, T4 was normal – she only ran my T3 (which I had to beg for) and it was 51. Their range is 50-170 so she says I am “fine” and refused to order more T tests. Any thoughts about T3 being 51, or is that just one piece of the puzzle and I need the other tests? I am 54 years old and feel wired-tired and chilly most of the time.
Hi Dr. Childs,
I have a history of hypothyroidism and had been medicated with Levothyroxine for the past 11 years. However, in the past 6 months, I found that I was gaining weight (despite a very healthy diet and intense workout regime). I ended up going to a Dr. Doctor who made me check my T3 hormones and indeed they were low. He put me on a 4-month course of Tiratricol (I started 3 weeks ago), but I haven’t seen any results yet. I still maintain a very healthy diet and exercise but I haven’t managed to lose any weight and still feel very bloated.
Thank you so much for your advice!
I had a total thyroidectomy in March 2018. I am on 75mcg Synthroid. My TSH and FT4 are in optimal range but my Ft3 is .1 under the range and I’m having all the symptoms listed above. In order to get to the upper half of the range, I’m considering asking my Dr to let me add liothyronine. I’m afraid he will reduce my Synthroid to add the liothyronine and I’ll start having more symptoms. Any suggestions?
Hi Westin- I just discovered that I have low t3, but Iโm not on any medication, does all this still apply?
Hi Dr. Childs:
After years of being treated for hypothyroidism, I had a thyroid crisis in 2012 that resulted in Grave’s disease diagnosis concomitant with Hashimoto’s (positive Abs). Since then I have up/down and Dr switched me from synthroid/cytomel to Armour Thyroid. That helped for about one year but then led to more yoyoing as the batches were different for each script (every 90 days). My recent labs came back as: TSH 0.8 (i feel better when it is low); Free T4 is 0.74 ng/dl; Free T3 2.6 pg/ml. This doesn’t make sense. My Dr is switching me back to synthroid/cytomel and I have been on that for 4 weeks with no improvement in fatigue.
Can you recommend some tests that would help with this diagnosis? I have more labs slated for early June.
thanks,
judy
I have Hashimoto’s and have been on levothyroxine for 8 years. Finally found a good provider (NP) and because I was so cold all the time and still battled fatigue she checked my T3 which was low. She started me on T3 and I was looking forward to feeling better, but then I couldn’t sleep at night. So, I guess I go with the lesser of evils and remain cold and tired vs insomnia? I know I do feel better with a selenium supplement.
In 04/2018, I completed an egg donation for my older sister. Prior to the cycle, they ran my TSH numbers to see where I was at and noted my level was high. Of course they only looked at the TSH and put my on synthroid and recommended I see my dr after the procedure to get a full work up.
1st TSH (12/28/17) โ 4.660
2nd TSH (1/14/18) โ 5.437 โ started Synthroid 50mcg
3rd TSH (2/17/18) โ 3.62
Now that the donation is over (retrieval was beginning of April) I went to see my primary care to request a full workup on my thyroid. I don’t think he ran the total tests (I asked for free and reverse). He told me to get a better idea of how my thyroid is working, to go completely off the synthroid and I have been off for a month (stopped in beginning of may) and just recently had the bloodwork back. TSH is lower (3.42) and no antibodies (negative readings) but wanted to get some insight/recommendations! I think my t3 is too low which is in line with my always being cold and mild fatigue.
Tsh 3.42
T3 .7
T4 5.9
Negative for two antibodies
I’ve been keto since the end of February so no gluten or grains and am feeling Better but not as good as I know I can. I also supplement with zinc, lglutamine, b vitamins, 1-2 Brazil nuts about 3-4 times a week, collagen protein powder 3-4 times a week. I will certaintly try to up my zinc and take with Brazil nuts at the same time.
Another thing was that my pcp did an ultrasound of the thyroid and determined a small nodule on the right side. He didnโt seem concerned and just said to get a rescan in 4 months.
Thanks in advance!!
Hi Lindsey,
It looks like your thyroid may not be performing optimally but that all depends on your symptoms and how you feel/look clinically.
Hey Dr. Child’s
I just had TSH, free thyroxine index, t3 uptake, and thyroxine t4. My TSH was 5.9, free thyroxine was 1.8, t3 uptake was 22 L, T4 was 8.1. Last year my TSH was 1.96. My doctor said she isn’t worried about my results she said it’s on the border line. Should I be worried? I have gained weight and I don’t eat alot. I’m very tired which is not normal for me. Im usually very active. I was told I have tachycardia and high blood pressure. Any advice will be appreciated.
Hi Tammy,
It looks like your results are sub-optimal, but they should always be addressed in the setting of your clinical symptoms.
Had a thyroidectomy 12 years ago. On t4 only for 10 1/2 of those years. The last year and a half 25mcg of t3 has been added. Felt better, lost 20 lbs in just a few months. Lbs I could never get rid of with t4 only. Over the last month, I have gained 5 back. I am going into premenopausal stage in my life. I was curious if being premenopausal causes fluctuating thyroid and if women tend to need adjustments in meds when you reach this stage? Thanks.
Hi Dorothy,
Yes, it is my experience that other hormones are affected during the menopause transition including thyroid hormone.
Hi, I was diagnosed with autoimmune thyroiditis back in December 2017. I’m now on levo, 50mcg/day, but the don’t feel well at all. My TPO is >1300, my symptoms are weight gain, aching joints, weak legs, very painful feet, not sleeping, sweating flushes occasionally. I am vegan, have been for years, now gluten free too, I walk 20 miles per week to/from work. I am 55 years old, female. I’ve had immense stress in my life for over 20 years, relationship problems, the tragic deaths of loved ones. My job is very stressful too. I feel a mess and want my life back. My joint pains are getting worse, my lower back is painful, I suffer from sciatic pain, my hands ache, mainly the left, elbow pain, but mostly my legs are weak and my feet feel as if they could collapse, to the point that I cannot run anymore.
Any advice would be appreciated, I’m seeing my GP again on Monday to decide what happens next, thank you.
Hi Jackie,
The best thing you can do is find a physician who understands hormone balance and thyroid management to work with you! It sounds like you may be on the right track, but in general, most PCP’s don’t know how to do this.
I have been tested multiple times over the last 10 years for thyroid issues because I have all the symptoms but my labs have always come back in the normal ranges so no one wants to treat me. I recently had labs done showing:
Free T3: 2.59 (1.94-5.1)
Free T4: 0.73 (0.58-1.38)
TSH: 0.819 (0.45-5.33)
Based on your information I feel like starting me on something may help. Is Liothyronine the right medication for this? I have a provider that I feel like may be willing to help me if I was able to provide her with enough information supporting it. Thanks.
Hi Sara,
You’d want to look at reverse T3, insulin, leptin, sex hormone binding globulin and other hormones to get a better idea. This page should help you: https://www.restartmed.com/normal-thyroid-levels/
Hi Dr. Childs.
This is a great article. I am a 39 year old female. I have 98% of the symptoms you state for low t3. I just got labs back for free t3 and free t4.
My Free t4 -.9
Range 0.8-1.8 ng/dL
My Free t3 – 2.4
Range 2.3-4.2 pg/mL
These are still in “normal” range it appears. Does it mean anything specific to have low levels of both free t3 and free t4?
Hi Mandy,
I would compare your results to those ranges found on this page: https://www.restartmed.com/normal-thyroid-levels/
Hello Dr. Childs,
I’m on a journey trying to address several issues, and just realizing they may be interrelated. I found your information and am trying to figure out if I’m on the right track. Your insight is appreciated.
4 years ago, from a life insurance exam, I was found to have critically high liver counts.
Sgot: 87
Sgpt: 163
Ggt: 180
I was tested for everything. Fatty liver, hepatitis, blockages, cirrhosis….everything negative in the result.
I’m 52 y.o. female.
I went to a nutritionist took a regimen and while initially got my levels to
Sgot:25,
Sgpt: 35 &
Ggt: 45, they are now increased to
Sgot: 36,
Sgpt:39 &
Ggt:50, despite me maintaining my regimen.
Not sure why or how to control.
New symptoms now include very heavy blood clots, for hours at a time. OB-gyn doc doesn’t want to do a hysterectomy bc of needing estrogen after as I’m not in menopause yet and my liver levels are elevated.
Blood work indicated some thyroid issues….. but I’m not sure what it means
Tsh: 1.74
T4: 8.4
T3 uptake: 22 (not sure if that’s the conversion you write about?)
T7 (free t4): 1.8
T3 free 2.9
Sex hormone binding globulin: 145.6
My question is …is my thyroid and other hormonal issues and liver related? Am I potentially having liver issues (undiagnosed as to cause) because of my thyroid and is that potentially affecting this cycle change?
I’m now starting to take Douglas labs supplements with the selenium and zinc in it.
Am I on the right track? Are there other insights you can offer?
I’m on no thyroid or any other meds as this was found by my ob-gyn.
I’m 52 y.o. 5 ft 3 inches and 138 lbs.
It is difficult to lose weight and I have many hypothyroid symptoms.
Ty for any help or info. It’s all new and overwhelming to me.
Hi Dominique,
Your conditions are most likely related in some way, but you’ll need more advanced tests to figure it out. When you have a complicated history such as yourself, it’s often best to find a knowledgeable physician to help guide you and that’s probably the first place that I would recommend you start.
I started on a T3 only treatment for low free T3(lowest of normal range). While I saw tremendous positive results, after 3 months I started having heart arrhythmia(PVCโs) and what seemed like fluid retention in abdomen, thighs, etc.
Iโm now 21 days off the compounded T3 and finally have no more pvcโs. Where can I go from here? My dose over 3 months only maxed out at 15mcg once per day. My lab showed a free T3 close to the upper end of normal. My Dr. was pleased with that but skeptical that that dose would cause arrhythmia.
Hi Kate,
You may be able to tolerate the T3 if you increase your dose more slowly and then also take it in split doses throughout the day.
I have been on thyroid medication for 40 yrs in past five the numbers keep changing going up and down. I was on 75mcg for many years and then dr. kept changing to 50mcg and up again to 75mcg when lab tests came back. I finally asked Dr. if T3 medication would help my symptoms of always cold and not being able to lose an ounce of weight I am an avid exerciser and keep gaining weight. My question will the adding of liothyronine 5mcg along with levothyroxine 50mcg help with the ups and downs of lab test and help to stabilize my weight gain. Also, I am 80 yrs old and I am concerned with side effects.
Hi FloDeMayo,
The short answer is maybe, but it really depends on a lot of factors including your thyroid lab tests and other hormone levels in your body.
Female, 40 years old and weigh 179. Iโm on 90mg or Armour. TSH is 0.010 low, ft4 is 0.9 and ft3 is 2.1 low. Iโve been hypo for 5 years mostly under my PCPโs care then switched to a Functional Physician who canโt figure me out either. Meds have been increased and decreased and my ft3 remains either low or bottom of the reference range with a continuous low TSH. I keep hearing that my TSH is too suppressed and meds need to be lowered but I always feel so much worse whenever they do that. What do I do?
I had a blood test evaluation by you, am now on T3 only 70mcg am, and 45mcg pm and am feeling amazingly better. What values should I be looking at if already on T3?
I lost my doctor and am looking for a new doctor, thank you for the information that you provide, it is one of the reasons that I am well now, well, not completely well, I still have a ways to go considering all of the other hormones that need help.
Thank you so much for your path in life!
Hello,
I have been struggling with persistent low t3 for the past 4 years following a 3-4 year period of restrictive eating. Despite backing off from running, eating more and following the AIP protocol/other ant-inflammatory lifestyle practices, I have not been able to reverse it and continue to gain weight. I’ve remained incredibly distressed over the weight gain aspect–about 40-50 lbs, but more rapidly in the last year than before–to the point where it is affecting day to day functioning.
I’m a 30-year-old female, and my last 2 labs were as follows:
October 2018
TSH 1.92
FT4 .94
FT3 1.7
Thyroperoxidase Ab 2.2
Thyroglobulin <1.8
Feb 2019
TSH 2.56
FT4 .73
FT3 1.8
RT3 7
Throughout the last 4 years, the values have remained mostly consistent with the first set and changed this winter. I'm already supplementing with the mentioned nutrients.
Do you think T3 only supplementation would benefit my situation?
I began Synthroid a few months ago when my TSH showed that it was in the 4’s. It brought down my TSH into the 1’s, but my Free T3 was still undetectable low (below 2.3). 6 weeks ago, I was taken off Synthroid to see if I really do have hypothyroid and my TSH has consistently increased (now 2.98) and the Free T3 is still below 2.3. My Free T4 was 14 and now it is 13 (9-19 is the reference range). I am so confused about my extremely low T3 and always feel extremely tired, and like it is impossible to get up for work and function. I am unsure whether I should start back on the Synthroid, and don’t see an endocrinologist until November. Any thoughts?
Hello, Dr. Childโs……… wonderful article. I have learned more here than I have from multiple physicians. I have been told that Total T3 is not important and on your website, I find that it is indeed very important. I have just one simple question. My Total T3 is 73, which I find is at the bottom of the scale. Free T3 is 2.3 and free T4 is 1.34. Could the total T3 be responsible for extreme muscle pain, weight gain, fatigue, etc? Thanks so much for your wisdom on this subject!
I have had graves’ disease since 4/16. Total thyroidectomy 1/2019-I was having sever hyper symptoms -heart rate 130bpm with minimal exertion. Since surgery, I have gained 15-20# with no increase in food intake.( I have never been this heavy-#140. I have moderate fatique and take Lasix every 2-3 weeks and drop 5-8# overnight. Free t3 always low(last 1.5) (2.18-3.98). Free t4 usually normal(1.32)(0.76-1.46) and TSH usually low(o.105))(.358-3.740). Dr afraid to up Cytomel over 10mcg/day. My dose currently and Synthroid 88mcg/day. I would like to get my energy back and lose all this extra weight and feel like myself again(I also have emotional swings of which I had never been previously prone. I want my life back again, even though I know it will never be exactly the same closer to the old me would be appreciated!!
This article was very eye opening. Over the last 5 years I have been experiencing unexplained weight gain (42 lbs total). Every time I lose a few pounds it is offset by an even larger weight increase. I exercise regularly and eat healthy. When I was younger I had issues with restricting my calorie intake to loose weight. I have worked with many doctors and suspected an issue with my thyroid (runs in my family) but none would run further tests as my tsh was normal. Last year I ran a thyroid panel on my own through LabCorp and it came back mostly normal except T3 uptake was low (21). Reading this my free T3 is in the lower range and my Reverse T3 is 23 (>15). I am seeing a new PCP soon. Do you recommend informing my new PCP on this? If so, how? I don’t want to sound crazy. I am just ready to figure out what is going on so I don’t keep gaining weight and get other health issues.
Hello. I have had low thyroid symptoms my whole life, but only recently have my numbers been abnormal. My symptoms include fatigue, heavy periods, hair loss and brittleness, facial hair growth and the last three years weight gain after a cortisone shot for calcific tendonitis in my shoulder. My TSH has fluctuated the last three years, going from 1.3 to 3.7, then down again the 1.7, my free thyroxine hovers around 1.10, but my free t3 fell from 2.5 to 1.5. Also, my reverse t3 stays around 20. I fell 7 years ago and have a fair amount of inflammation in my back which has gotten somewhat better, but I believe has caused arthritis. Taking anti-inflammatories for it has caused microscopic colitis, so I can no longer take NSAIDs. I suspect I have an autoimmune problem, however all markers come back negative. Would t3 supplementation be advised? I can barely function from the fatigue.
Hi Ellen,
Yes, it would be reasonable to try either T3 thyroid medication or supplements to help increase T4 to T3 conversion.
Here is one you can look at on the supplement side of things: https://www.restartmed.com/product/t3-conversion-booster/
Hi Dr. Childs and others that are Hypothyroid…
I am new to thyroid meds and was prescribed NP Thyroid by my doctor. I read how the formula has changed though and others are having adverse reactions. I heard Armour was recalled at some point too and I am feeling uncomfortable about using these. Does anyone have a better suggestion for a prescription? My major symptoms are low metabolism and fatigue. Is there a trusted manufacturer of even just the T3 that someone can name?
There are many options available! You can find more info here: https://www.restartmed.com/thyroid-medications-that-work/
Hi Dr. Westin
Can you explain why Endocrinologists refuse to test FT3 levels? I have a highly regarded Endo at a university and he absolutely wonโt test FT3 which forces me to pay out of my own pocket just so I can actually see whats going on with me and my FT3 is usually low at (2.8) the lab reference is (2 – 4.4).
Its crazy that people without a thyroid are denied basic thyroid test and are forced to live in a body that feels foreign.
Hi Grace,
Of course, I have explained in detail why I do not recommend using endocrinologists in this article. It explains a lot about the way they think and why they do the things that they do: https://www.restartmed.com/endocrinologist-for-thyroid/
Hi, I’ve had low free t3 levels for quite some time; low reverse t3 (8.9); suboptimal free t4 (0.95); tsh 2.9; no thyroid antibodies. I’ve tried cytomel-even at a very low dose through compounding pharmacy and I can’t tolerate it. gives me straight hyperthyroid response causing insomnia etc. I’ve tried thyroid glandulars but these give the same anxiety and adrenaline response. please help! don’t know how else to fix this or why I’m so sensitive
Hi Sam,
If you aren’t able to tolerate those supplements/medications then you’ll want to focus on other problems that you can manage to help reduce your sensitivity to those therapies. I would take a look at this list to get an idea of what I am talking about: https://www.restartmed.com/natural-thyroid-remedies/
I am on Levothyroxine and Liothyronine. I had RAI treatment 20 years ago after diagnosed with Gravesโ disease. I just had my labs done by my regular doc (she included with a full panel, my annual endocrinologist appointment isnโt until Sep 1). Anyway my results came back with Total T3 low (68), whereas TSH ok (.71) and Free T4 ok (1.1). I realize this is not a full set of tests and will do with the endo. I have gained 20 lbs in the last 9 months with no changes in diet. I have also been more fatigued. I did start your T3 Conversion Booster a month ago and hope that helps. I just donโt know what is causing the T3 to be out of whack? I take 15 mg of T3 and 137 mcg of T4 daily. Any insight would be helpful so I know what to ask my endocrinologist, thanks.
Hi Dr. Childโs,
My doctor ordered a thyroid panel for me – most of my levels seem to be at the very low end of the spectrum but my doctor said my thyroid is fine. Should I seek another doctor? My results were:
TSH: .675
T4: 7.2
T3 Uptake: 25%
Free Thyroxine: 1.8
Thank you!
Lauren
Hi, I realize this article may be a little older but I came across this in my recent search. I recently got my blood drawn and my T3 was slightly out of the range by a few points (mine was 77 – range is 80-200), is this enough to cause symptoms? My TSH was 3.0 and my T4 free was 1.3 (range 0.8-1.7). Endo doc doesn’t believe in checking any other thyroid tests, says it doesn’t matter. I am scheduled to get labs drawn again soon and get the full thyroid panel checked (from a naturopathic). She also didn’t seem too concerned with the slightly lower T3 levels either. I have Hashimoto’s and experiencing symptoms ranging from being cold all the time, feeling super terrible first thing in the mornings, severe anxiety and panic attacks, but also feeling no energy or motivation to do anything, almost a tired but wired worried state. I currently take NP Thyroid at 37.5mg each morning. I am just curious how low the T3 would need to be in order to truly produce symptoms. Any thoughts would be greatly appreciated!
Hi Amber,
There is no set dose at which patients experience low T3 symptoms. It can occur in the mid-range or at the low range or anywhere in between. It’s more about your body, your other thyroid lab tests, and what medications (if any) you are taking.
Hello Dr. Childs what do you consider low T3? Anything below 3.8 which is in the middle of the T3 range? Can being lower than 3.8, but in range still be low T3?
Hi Jennifer,
Please see this resource which lists out the optimal range for all thyroid lab tests including free T3: https://www.restartmed.com/normal-thyroid-levels/