Ah, that's handy
Your FT4: FT3 ratio is 15.7 : 4.6 = 3.41 : 1
Good conversion takes place when FT4: FT3 ratio is 4:1 or less. Your conversion is good.
Your FT4 is 37% through it's range.
Your FT3 is 40% through it's range.
Again, you can see your conversion is good.
You need an increase in Levo which will raise FT4 which in turn, because you are a good converter, will raise FT3.
The aim of a treated hypo patient generally is for TSH to be 1 or below or wherever it is needed for FT4 and FT3 to be in the upper part of their respective reference ranges.
Your pituitary is detecting that you have T4 (by taking Levo) so it doesn't need to send a signal (TSH) to your thyroid to make some, therefore your TSH will be very low or suppressed.
Your GP may panic about suppressed TSH and say you are over medicated (or even say you are hypERthyroid, which you can't be because you're hypOthyroid) but you can't be over medicated as long as FT3 is in range.
From ThyroidUK's main website > About the Thyroid > Hypothyroidism > Treatment Options:
"According to the BMA's booklet, "Understanding Thyroid Disorders", many people do not feel well unless their levels are at the bottom of the TSH range or below and at the top of the FT4 range or a little above."
The book is written by Dr Toft, leading endocrinologist and past president of the British Thyroid Association. It is available on Amazon or from your local pharmacy for about £4.95.
Also, Dr Toft states in Pulse Magazine,
"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)."
You can obtain a copy of the article by emailing email@example.com , print off and highlight question 6 to show your GP of necessary.
Arrange a new blood test for 6-8 weeks after your dose increase, see where FT4 and FT3 lie and how you feel. If necessary you can ask for a further increase in dose.
Always book the first appointment of the morning when having thyroid tests, fast overnight (water allowed) and leave off Levo for 24 hours (take after the blood draw).