Personally I think you should look at thyroid first thoroughly before beginning anything then after that is sorted out move onto test. I would stay away from the clinic that wanted once weekly test shots if they are in the clinic shots and not home administered.
Got my results for T3/T4 and from what I can tell is fine - 97 and 7. Or is the 97 T3 verging too low indicating borderline hypothyroid? does this explain TSH at 3.5?
Looking how I should proceed
To me, yeah I think it does explain your tsh at 3.5, thyroid is struggling to keep up. I think you should talk to your doc about it. If they won’t do anything find a different doc.
I mean if you’re symptomatic and towards the bottom of the range, I don’t see a problem with giving thyroid meds a trial run and see if they help. I’d suspect just a t3 med like cytomel, but I’m not a doc.
Yeah for TSH at 3.5 I think it’s worth a trial of Thyroid meds personally.
T4 only is really where most people start and try first, then a T4/T3 combo like Armour if necessary, then T3 as a last resort. I’d probably try something in the “middle”, like Armour, and not go straight to T3 since you have to dose 2-3x a day where if you convert T4 to T3 properly then you can take T4 only less often and your body will regulate the conversion to T3 on it’s own, so it’s easier for sure. Some people do better on one or the other so it may take some experimenting to figure out (and a doctor willing to let you try experimenting)
Optimal VS Normal Thyroid Levels for all Lab Tests & Ages
Reverse T3 competes for the same receptor as Free T3 and therefore can block Free T3, you get sick or the body is under stress, Reverse T3 increases, you get tired because your body can’t have you running around wasting your energy while your body is trying to fight an infection or disease.
T3 is not the same as Free T3, T3 is not yet bioavailable, T3 testing is obsolete. I had my T3 at 97 and Free T3 was 3.6 (ranges 2.0-4.4).
Got it - in other words, I should have had “free” t3 and t4 tested. Damnit
Free T3, Free T4 and Reverse T3. Your T4 is good.
Curious about this myself, my TSH is elevated and seems to have been for a while, neither my provider or GP seem that fussed, free t3 and free t4 seem ok though.
Latest bloods
4.53 TSH (ref 0.27-4.20)
FT4 - 17.7 (ref 12-22)
FT3 - 6.6 (ref 3.1- 6.8)
The test prior to this my TSH (approx a year prior) was similar, is this worth further investigation?
(Sorry for the hijack!)
Reverse T3 blocks Free T3, where is your Reverse T3?
Unfortunately not part of my standard annual testing (my GP can’t even order the test) - assuming your answer will be along the lines of I won’t know what’s happening until I see RT3?
Pretty much. Some doctors don’t believe Reverse T3 and that it blocks Free T3, some doctors swear by it and test it regularly. You know something is up when the medical community is split on a subject.
The Reverse T3 is three time more expensive than the other tests and with insurance companies breathing down the doctors necks to cut back on spending and reduce healthcare costs…
I’ll look into ordering that privately then.
Thanks!
There is some valid debate on whether rt3 actually works in the “blocking” manner that is often described here. The last study I read on it was saying rt3’s affinity for the t3 receptor was much less than t3’s, meaning it didn’t actually do a whole lot.
I’m no doctor or biochemist but just be aware there are opposing points of view. I haven’t seen anything that really proves rt3 works like a lot of people say it does.
I know there have been others in the UK that were able to get this test privately.
Yea have seen the RT3 discussion on here for a while, would be interested to get it tested, gives me another data point.
What else could cause elevated TSH with otherwise good levels of FT3, FT4?
Thanks, yea I can get it done via a website called for medichecks (for reference for UK peeps).
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Ok back to me, the OP. Latest results today:
TSH: 4.31 (.35-4.94)
FT3: 4.0 (2.2-4.2)
FT4: 1.01 (.61-1.82)
Strange - the high TSH would indicate hypothyroid, but my fT3 is high which indicates hyper. Possibly reverse T3 also high, blocking T3 binding and in turn causing my pituitary to put out more TSH?
I could also have something wrong with the pituitary directly. Maybe autoimmune…
I should add - in my past 2 bloodworks I had elevated bilirubin levels (1.5, then 1.8). Today my bilirubin is 2.4 and my eyes are jaundiced. Due to the trend they are going to try to diagnose and I may be going to see an endo. May be autoimmune hepatitis (I also have autoimmune skin condition) and need to start steroids (not the good kind) to suppress my immune. 
I mention in case there’s some relationship to my thyroid levels
The liver is important for the clearance of rT3, so liver hepatitis can be an issue. The hepatic enzyme is thought to contribute to T3 production and to be the main site for the clearance of rT3.