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Q. My triiodothyroxine is high even with 50 mcg Thyronorm. Please suggest new dosage.

Answered by
Dr. Zulfiqar Ahmed
and medically reviewed by Dr. Vinodhini. J
This is a premium question & answer published on Aug 13, 2020 and last reviewed on: Sep 03, 2020

Hi doctor,

I need to consult an endrocrinologist. My Tri-iodothyronine total (T3)^ 0.80. I am already taking 50 mcg Thyronorm. Please advise the new dosage.

Dr. Zulfiqar Ahmed

Diabetology Endocrinology


Welcome to

I have seen the report (attachment removed to protect patient identity).

Your total T3 is mildly low but it is normal because your T4 and TSH (thyroid-stimulating hormone) are in the proper range. So you do not need to change your dosage of Thyronorm. Please continue the same dose.

But your Vitamin D is on the lower side. You need to take Vitamin D3 50,000 units once weekly for two months then once in two weeks for one month and check your Vitamin D levels. Your cholesterol and HBA1c (glycated hemoglobin) is high. Your liver function tests are also deranged. AST and ALT are high. Your weight is high as well.

What is your waist circumference? It all shows that you may have metabolic syndrome. You need to modify your lifestyle to decrease weight which will normalize all these problems. Your liver enzymes are deranged most probably due to fatty liver but it may be due to other issues as well. Did you check for hepatitis serology?

Lifestyle modifications are the best as treatment of pre-diabetes and weight loss. Low carbohydrates diet and no added sugar. No sugary juices. No bread rice pasta and potatoes if you cannot stop at least take as less as possible. Take more vegetables salads and fibers. Consume fruits only as a sweet dish. Do not take mango, grapes, and banana. Apple not more than one piece. Strawberries and other berries are fine along with peach apricot and small amounts of plums.

Intermittent fasting will also help you to control your prediabetes and weight. You can fast for 16 hours like taking your dinner at 7 pm and do not eat anything after that, then next you can take breakfast at 11 AM. During fasting, just drink water and green tea without sugar. You can extend fasting to 24 hours then 36 hours as your body adopts. You can do fasting two times a week or as you feel comfortable it will control your sugar. Drink more water. Sleep well.

Exercise at least walk 30-40 minutes daily. The more you will practice these things the better will be your control. Your fasting sugar is normal but you can check sugar after two hours of eating and it should be less than 140 mg/dL.

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Thank you doctor,

My waist is 34 I think. Yes, I will work on lifestyle change. Please advise a supplement for low hemoglobin as well.

Dr. Zulfiqar Ahmed

Diabetology Endocrinology


Welcome back to

For hemoglobin, you can take Triferic tablet once daily for a month. Please try to follow lifestyle modifications.

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