Optimal levels taking both t4 and t3?

[Clara9]

What are optimal levels when taking both t4 and t3? Where in range is best to be? Could it be that you feel better with a high in range ft3 and a mid range ft4 than with both high in range?

[diogenes Remembering]

There's no easy answer. You will feel best where your individual optimal amounts of FT3 are obtained by whatever treatment. These can be anywhere in the range, but it is more likely that they will be higher than lower in the range. The small danger of higher FT3 and suppressed TSH in possibly increasing a risk of osteoporosis and AF later in life has to be recognised. But it may well be a necessary trade-off between feeling under the weather for many years on suboptimal treatment with a low risk of OP and AF or having a better QoL with a higher later OP/AF risk. You have to choose.

[Clara9 in reply to diogenes]

Thank you.

My latest results on 112,5 mcg t4 and 12,5 mcg t3 is

Tsh 0.008 (0.27_4.2)

Free T3 5.9 (3.1-6.8)

Free T4 20.3 (12-22)

Total t4 88.8 (59-154)

Been in this dose for 6 weeks. I'm still tired in the afternoon and have palps. Would it make sense to decrease t4 by 25 and add another 6.25 T3? Or just reduce t4 by 12,5 or best to leave as it is?

[MarthaF in reply to Clara9]

Hi Clara9

I am on low dose 5mcg T3 and alternating 100/75 levothyroxine which I started in December and the t3 seemed to properly kick in after 7 weeks. From what I've read here it really seems to vary from person to person. This only my experience but despite initial improvements it did take ages to alleviate the symptoms so maybe try leaving for another few weeks.