TSH is below range which will freak out most doctors, however your FT4 and FT3 are in range so you aren't overmedicated. The aim of a treated hypo patient generally is for TSH to be 1 or below or wherever it needs to be for FT4 and FT3 to be in the upper part of their respective reference ranges when on Levo.
However, your FT3 is quite low in range compared to your FT4. They should be in balance nearer the upper end of their ranges. FT4 is 74% through it's range, FT3 is 26% through it's range. Your FT4:FT3 ratio is 4.74 : 1 and good conversion takes place when the ratio is 4:1 or less. This all indicates that you would benefit from the addition of some T3 to your Levo.
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Thyroglobulin Antibody *118.00. 0.00-115.00
Thyroid Peroxidase Antibodies <9.0 0.00-34.00
TPO antibodies are nice and low but TG antibodies are over range indicating autoimmune thyroid disease aka Hashimoto's which is where antibodies attack the thyroid and gradually destroy it. The antibody attacks cause fluctuations in symptoms and test results.
You can help reduce the antibodies by adopting a strict gluten free diet which has helped many members here. Gluten contains gliadin (a protein) which is thought to trigger autoimmune attacks so eliminating gluten can help reduce these attacks. You don't need to be gluten sensitive or have Coeliac disease for a gluten free diet to help.
Supplementing with selenium l-selenomethionine 200mcg daily can also help reduce the antibodies, as can keeping TSH suppressed.
Hashi's and gut absorption problems tend to go hand in hand and can very often result in low nutrient levels or deficiencies. Although your Active B12 and Ferritin are good (are you supplementing?), your folate and Vit D aren't.
Folate (Serum). 7.0. 2.91-50.00
Folate is far too low, recommended is at least half way through it's range. A good B Complex containing 400mcg methylfolate should help raise your level. I used Thorne Basic B, one daily, and it raised my level from very bottom to very top of range in 2.5 months.
25 OH Vitamin D *37.00. 50.00-200.00
The Vit D Council recommends a level of 100-150nmol/L. It's doubtful that your GP will prescribe anything with your level and if s/he did it would only be 800iu which is totally inadequate. Because you have Hashi's you will be best using an oral spray for better absorption, eg BetterYou. For a level of 37 I would suggest buying the 3000iu dose spray and take 6000iu daily for 8 weeks which will bring us to the beginning of April when we start to be able to make natural Vit D from the sun. Retest in April and if you only want to test Vit D then you could use City Assays vitamindtest.org.uk/
- they do a fingerprick blood spot test for Β£28.
Once you've reached the recommended level then you'll need a maintenance dose which may be 2000iu daily, it's trial and error so it's recommended to retest once or twice a year to keep within the recommended range.
There are important cofactors needed when taking D3
D3 aids absorption of calcium from food and K2-MK7 directs the calcium to bones and teeth where it is needed and away from arteries and soft tissues where it can be deposited and cause problems.
D3 and K2 are fat soluble so should be taken with the fattiest meal of the day, D3 four hours away from thyroid meds.
Magnesium helps D3 to work and comes in different forms, check to see which would suit you best and as it's calming it's best taken in the evening, four hours away from thyroid meds
Hard exercise depletes T3. Yours is already low, so keep exercise to something gentle like swimming, yoga, walking. Make sure that 'eating clean' includes being gluten free.
If you look back at my previous reply you will see that I said a good B Complex containing methylfolate will help raise folate level. What is your current B Complex? Does it contain methylfolate at a decent amount eg 400mcg?
It contains 200mcg folic acid. I would change that to Thorne Basic B as mentioned in my previous post, it contains 400mcg methylfolate and all the other B vitamins needed to balance them all.
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