purplejuicy With those new results there's no real need to reduce your dose. Your TSH is in a perfect place ie 1 or below to put your FT4 in the upper third ie 18+ and you're feeling good. All that's missing is knowing if your FT3 is in the upper quarter. It's so maddening that GPs/endos don't get this. FT3 is the important one, the one that has to be kept in range so why aren't they testing yours before messing with your meds and how you feel.
Your TSH isn't too low, it's within range. How come when a patient is looking for a diagnosis and has a TSH over range, doctors don't always attach much importance to it and refuse a diagnosis and treatment. Yet, here we are, your TSH is still in range but it's not good enough for your doctor, you're feeling better than you have for a long while, yet that's not taken into account. Nothing is out of range so they don't need to lower your meds based on those results.
With your first tests mentioned in your original post, your FT3 was low in range with a mid-range FT4 and a too high TSH. Your conversion rate was 4.32 : 1. Good conversion takes place at 4:1 or lower so yours wasn't too far off.
The increase in meds has had a good effect, seems to be absorbed properly, has reduced your TSH and increased your FT4 which is exactly what should happen. The obvious step would be to see how much your FT3 rose along with the other changes. It could be that the extra T4 is converting to enough extra T3 to put your FT3 at tje upper end of it's range.
If your FT3 had been tested along with these latest tests, and had come back quite low in range (say low to mid-range), then that would indicate you're not converting that well and the ideal way to deal with that would have been to lower your levo a bit and add in a bit of T3. Then some tweaking could be done to get your T3 up. I don't understand why this is so hard for doctors to get into their heads.
Do you know, I'm quite mad on your behalf. You feel pretty good, your results are in range, but they want to mess about, lower your meds and make you feel unwell. Why? Because the endo likes the number 2. What's so magic about 2? Don't you just wish they could have hypothyroidism and someone insists they can't have enough meds to make them feel well, that they have to be kept ill with a myriad of symptoms and get told 'tough boobies, live with it!'
I'm rambling, sorry. Here's something that you can show to your GP and endo, maybe challenge them to go against the guidelines of one of the leading endos in the UK.
Dr Toft, past president of the British Thyroid Association and leading endocrinologist, wrote this in a Pulse Online magazine article:
"The appropriate dose of levothyroxine is that which restores euthyroidism and serum TSH to the lower part of the reference range - 0.2-0.5mU/l.
In this case, free thyroxine is likely to be in the upper part of its reference range or even slightly elevated – 18-22pmol/l. Most patients will feel well in that circumstance.
But some need a higher dose of levothyroxine to suppress serum TSH and then the serum-free T4 concentration will be elevated at around 24-28pmol/l.
This 'exogenous subclinical hyperthyroidism' is not dangerous as long as serum T3 is unequivocally normal – that is, serum total around T3 1.7nmol/l (reference range 1.0-2.2nmol/l)."
If you email email@example.com she will let you have a copy of the article which you can print out and show your GP and endo because they seem to need educating.
And if all this fails, in your shoes I would just go along with them, take your prescription for Levo, say thank you very much, then buy your own T3 and tweak your meds yourself, keeping an eye on your test results by doing Blue Horizon tests. It sounds bit scary but there are plenty of members here who do it and can help you.