Graves disease, low tsh, low free t4 and high free t3, need advice

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Hi all,

I am glad i found this group. Hope anyone can help me.

I was diagnosed with graves 2 years back. Currently i am taking 100 mg PTU. My current levels are:

Tsh: 0.017

Free t4: 0.70 (0.82-1.77)

Free t3: 4.9 (2.2-4.4)

I don't know why my free t4 is below the range and free t3 is above the range. Its very difficult to decide the dose.

I read here about acetyl l-carnitine and want to try it.

But don't know what it will do with my level.

Any advice is really appreciated. Thank you.

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13 Replies

  • Posted

    Hi, you could read about T3 thyrotoxicosis. This is sometimes caused by autonomous nodules that are secreting too much T3.

    Normally, the ratio of T4 to T3 is 0.8 to 0.2 so it unusual that your thyroid is producing so much T3.

    Regarding AL-Carnitine, I would suggest to get it in powdered form as it is easier to adjust the dose. You could start by taking 200mg per day dissolving it in a large glass of water. It tastes slightly sour like water with a dash of lemon juice. It is best to drink it with a straw and to take it in the morning.

    Btw, I took 500mg per day for about 2 years and stopped after being in remission.

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    • Posted

      Hi danR,

      Thank you so much for your reply. I really appreciate it.

      I was on methimazole before starting PTU in Feb'2017. I was good on methimazole. The problem began when i started taking PTU. I had ultrasound on Feb'2017. Doctor told it was graves. She did not tell about nodules. Do you think i should ask her about autonomous nodule.

      Do you think its good idea to take 500 mg AL-carnitine on alternate days. I searched for the powder, found out NOW supplements, but its 1/2 teaspoon is 1.2 gram, so it will difficult to take 200 mg by it.

      Any brand you like it.

      Thank you again.

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    • Posted

      Also, i read here that Al-carnitine decreases free t4 and free t3 and increases tsh. So what do you think, what it will do in my case. As my free t4 is below the range, does Al-carnitine pushes it more low. Or it will help in balacing my levels.
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    • Posted

      I was using the supplement Bulk Powders Pure Acetyl L-Carnitine. Each pack comes with a small plastic spoon that holds 750mg powder. So 1/3 would be roughly 250mg. It might be preferable to start with a small daily dose instead of 500mg every other day. 

      If you had an ultrasound scan and nothing suspicious was found then you probably have no thyroid nodules.

      Btw, I started taking the supplement a few weeks before my next thyroid test was scheduled. It helps to estimate if the values have changed at all. 

      Before taking the supplement it would be good to read about possible side effects and to inform your doctor.

      The symptoms and how you feel depends largely on the T3 level as T4 is the precursor of the thyroid hormone.  

       

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    • Posted

      Hi Dan, Pleasure reading all your knowledgable and informative posts. I just need a quick clarifing: when you say "you took 500 mg ALC for about 2 years and stopped after being remission", does that mean you had stopped taking med 1 year before stopping ALC? In another word, you continued taking ALC for about 1 year after stopping your antithyroid med. Am I reading your post correctly? (my understanding about remission: it is that there is no relapse after stopping med for 1 year.)

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    • Posted

      Hi koa61308, I started taking ALC hoping that it will help speed up the recovery of my muscles. (I had severe muscle pain while being hyper.) I was on Carbimazole for about 18 months and my dose was tapered from 30mg to 2.5mg per day. Then I was told by my endo to stop taking Carbimazole. I continued taking ALC for about 3 months as far as I remember.

      By remission I meant that without medication my thyroid levels remained in a normal range. I have been without thyroid lowering medication for approx. 1 year.

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    • Posted

      Hi Dan, Congratulations! biggrin You are now officially in remission from hyperT. Similar reason, restoring/strengthening muscles, I took ALC after taking MMI plus hoping to raise TSH. It's a long way to go I reckon... just imagining someday I could be off MMI and wonder if staying with ALC a while afterward? (so I ask your experience)   Thanks and be happy!

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    • Posted

      Hi danR,

      I am taking Al-carnitine powder now more than a month. I started initially with very low dose and slowly increase now 1/4 level teaspoon ( i think 750 mg). But my main issue is my teeth is really sensitive to sour food. I mix it in 300 ml of water. It still taste too sour. Any advice on, can i mix it in 1 ltr of water and sip throughout the day. If i decrease the quantity, i am unable to know how much i am taking.

      Is it any problem if i dissolve it and sit for long time. Does it loose its effectivity or gets bad.

      Thank you.

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    • Posted

      Hi Sweetlove,  Just wondering after a month of taking ALC, how does it affect/improve your blood test result and health condition? How do you feel now? Hope you are doing better.
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    • Posted

      Hi, I always used a straw to protect my teeth from the sour drink. I would imagine that sipping throughout the day might possibly cause more damage to the enamel of your teeth. It is a good idea to dilute the ALC drink such that it is still pleasant and not too sour. But in that case, I would rather advise to drink a full glass several times a day.
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    • Posted

      Hi danR, thank you so much for replying smile

      I will try to drink it with straw.

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    • Posted

      Hi koa61308,

      Sysptoms wise i can't tell much difference. My labs improves, but i am still hyperthyroid. My t3 is still out of range. Last time my free t3 was 13.1 (2.0-4.2) and now it is 7. I am taking 10 mg methimazole and 1/4 level teaspoon Acetyl l carnitine.

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