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THE Q & A

Welcome to The Q&A with Elaine Moore. Registered members are invited to ask any question of Elaine Moore on autoimmune diseases, Graves' disease, other thyroid diseases and subconditions, laboratory work, traditional and complementary medicine, triggers and environmental influences, thyroid and immune disorders in pets and animals, and other relevant areas of inquiry.

Each thread represents one question with one answer and will only appear at the time it is answered. Once answered, further replies cannot be made to the same thread since each thread represents only one question. A new thread will need to be started for additional questions.

Questions are answered solely by Elaine Moore, a medical writer and clinical laboratory scientist, MT, CLS, with more than 30 years of experience in immunology. Moore has also authored and edited over a dozen books in the area of health sciences and is an editor for McFarland Publisher's Health Topics Series.

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The Q & A with Elaine Moore

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 3/8/2012 3:31 PM
 
Erin
No Ranking

Joined: 1/15/2012
Posts: 7

Elaine, I started seeing a new doctor 2 months ago and he put me on block and replace. I have been on 15mgMMI/d and 30mcgT4/15mcgT3(twice a day). The doctor wanted to double my replacement to 60mcgT4/30mcgT3(twice a day). I wasn't comfortable with doubling it and instead we decided to increase it to 45mcgT4/20mcgT3(twice a day). We are trying to get my TSH closer to 1.0 and bring my T4/T3 up. What is the advantage of taking a T4/T3 compound verses just T4? When increasing the replacement is it necessary to increase the T3 as well or is it better to keep T3 on the low end and adjust T4 only? Is there a reason why you have to increase T3 and not just T4?

Will the current increase in my replacement be enough or do I need to increase it more?

Current lab(3/5/12)

TSH 2.9 (.35-4.5)

FT4 .76 (.82-1.77)

FT3 2.9 (2.0-4.4)

12/28/11

TSH 2.2

FT4 1.34

FT3 3.0
New Post
 3/8/2012 8:26 PM
 
Elaine
1st Level Poster

Joined: 8/1/2008
Posts: 3374

Hi Erin,

You started on a low dose of replacement hormone and judging from your labs, doubling the dose would have been fine. Most people continue to have a low TSH, often <0.01 mu/L, while on meds. A low TSH on meds doesn't mean that you're still hyperthyroid since TSH is falsely lowered in GD. You want to be on a dose that keeps your FT4 at least at mid-range and preferably closer to the high end of the range. In your case T3 replacement hormone is a good idea (used in addition to T4) because your FT3 is on the low end. Having an FT3 that's too low can cause its own set of symptoms. Best, Elaine
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TO USERS: Q&A posts are visible to all readers. Users can delete their own threads at any time. Users must provide information which is true and correct to the best of their knowledge as well as provide sources or references to any health / medical information if not taken from personal experience. All users including the moderator must behave at all times with respect and honesty. Advertising and self-promotion is not allowed. The moderator or site administrator has the right to ban users with or without warning for not following the basic rules of this site. All posts by default are not to be considered that of medical professionals unless otherwise indicated. As sole moderator, Moore has no conflicts of interest in the sponsorship of this forum.

 

Notes

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Milestone - Wednesday, April 04, 2012

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