The Wellness Q&A with Elaine Moore

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dosing advice and T3 vs FT3
Last Post 31 Jul 2022 07:03 PM by Elaine Moore. 1 Replies.
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renoUser is Offline New Member New Member Posts:
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27 Jul 2022 01:12 PM
    Hello Elaine,
    I have two questions today. First, my primary (who I no longer have) recently told me that she will not order FT3 as she says she spoke to an Endo and they now recommend testing for T3 and don't recommend FT3 levels. I do take this with a grain of salt, as this is the same primary who insisted on basing my methimazole dose on TSH levels, not FT4. I have changed my primary over this, but am curious if you are aware of any reason or recent change in recommendations regarding ordering T3 instead of FT3.
    My second question is regarding dosing methimazole from my lab work. Thank you so much for your help!

    Newly out of remission
    4/18/2022
    FT4 (ref 0.76-1.46) 2.88
    TSH (ref 0.36-3.74) < 0.01

    STARTED ON 10 mg/day methimazole

    5/18/2022
    FT4 1.06
    T3 (ref 71-180) 140
    TSH <0.01.

    Reduced methimazole to 5 mg/day

    6/30/2022
    FT4. 1.02
    T3 121
    TSH. 0.03

    Reduced methimazole to 2.5mg

    7/22/2022
    FT4 1.28
    T3. 142
    TSH. <0.01

    Increase methimazole to 3.25 mg

    My question is: I thought I might be starting to go into remission as my TSH had begun to increase, but then it went back to zero the next month, along with an increase in FT4. Do you think I went down in methimazole a bit too fast, and it kicked up my antibodies? Does 3.25 mg seem appropriate now? I'm feeling pretty good, but certainly don't want to go hyper again. I seem very responsive to methimazole in general.

    Thanks Elaine!

    Elaine MooreUser is Offline Veteran Member Veteran Member Posts:3875
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    31 Jul 2022 07:03 PM
    Hi,
    I've been wondering about there being more problems with the FT3 test and that may be why some docs are using T3 although. Covid vaccines cause those of us with autoimmune thyroid disorders to produce more thyroid antibodies. You may have had a transient flare from the vaccine or a transient episode of thyroiditis. It's not unusual for TSH to fall to <.01 when antibodies rise. My TSH has been <.01 for 30 years.
    Your levels look good at 2.5 mg MMI. I don't think I'd raise this dose as your FT4 could fall too low for your body's needs.
    I'll have to research the FT3 lab problem because more and more people are having inappropriately elevated FT3 results.
    Best, Elaine
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