Dosing advice please

[Hannah9]

Am taking 18.75 mcg t3 and 125 levo

Latest results

Tsh: 0.01 (0.35-5.5)

Ft4 15 (12-22)

Ft3 5.9 (3.1-6.8)

Still feel unwell what do you advice that I increase t4 or t3?

Thanks!

[Hannah9]

No one? Or do these results indicate that it's something else that makes me feel unwell?

[Clutter]

Hannah9,

Thyroid levels are good with TSH suppressed and FT3 in the upper third of range. Have ferritin, vitamin D, B12 and folate been checked?

[Hannah9 in reply to Clutter]

Yes, they were all optimal in June.

[ITYFIALMCTT]

SeasideSusie might be able to comment on your results. It would be useful to know how long you've been taking this medication and if you've recently had any dosage changes or brand changes if you've only recently begun to feel unwell again.

As a cold read all of those results are in the expected range for someone taking both medications, however, if you're still feeling unwell, it's possible that it's something else entirely, that you need a different balance of results to feel well, or that there are other reasons why the improved thyroid results are not making a difference to you as yet.

It would be helpful if you also have the results of any vitamin and mineral tests to share, along with their reference ranges (e.g., iron, ferritin, folate, B12, and vitamin D). It's quite common for people with hypothyroidism to have absorption issues that can affect vitamin and mineral levels and it's commonly said that thyroid hormones (both your own and supplemented ones) need these levels to be in optimal ranges to work effectively.

ETA: x-posted with Clutter.

[Hannah9 in reply to ITYFIALMCTT]

All the vitamins are optimal according to this site last time I tested (in June).

Have been on t3 for 2,5 months and this dose for 6 weeks. Felt better first and then after about a week on this dose worse again and it getting worse and worse with all the symtoms creeping back.

[SeasideSusie Remembering]

Hannah9 I take a Levo/T3 combination and I found when tweaking to find my best doses that if my FT4 went too low I felt dreadful. Personally I need my FT4 nearer the top, say around 75% through range, with FT3 in the top quarter. But we are all different, you may need your levels in a different place to feel well.

As Clutter has mentioned - have you had your vitamins and minerals tested? They are very important and need to be optimal (not just 'in range') for thyroid hormone to work properly.

[Hannah9 in reply to SeasideSusie]

Thanks! Will try to get my ft4 up and see if that helps. What symptoms did you have when your ft4 was too low but you had enough ft3? Also how much t3 and t4 are you taking.

[SeasideSusie Remembering in reply to Hannah9]

Hannah

I reduced my Levo 25mcg and kept T3 at same dose, FT4 went from 75% through range to 8% through range (19.5 down to 12.8). It also reduced my FT3 from 94% to 40% (so I do still have some conversion going on, it seems to have improved since optimising vitamins and minerals, etc). So I didn't actually have enough FT3, as well as FT4, at the time either.

My symptoms were common hypo symptoms returned, in particular overwhelming fatigue which meant that I was needing to lie down for an hour or two in the afternoon. [It may have helped if I could sleep in the afternoon but I can't, sleep is still poor during the night, that has never improved.]

[Hannah9 in reply to SeasideSusie]

Thank you so very much for sharing.