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Dosing advice

My Tsh was 2.3 on 50 mcg t4 and ft4 15(10-19) but I wasn't feeling well. I then increased t4 over a year and ended up with 125 t4, suppressed Tsh and ft4 high in range. Still didn't feel well. Added t3 12.5 felt better but not well. Would it make sense to decrease t4 to 50 and increase t3 accordingly (maybe by 12,5)? The thought would be that 50mcg t4 got me to middle of range and then I needed to add t3 but didn't have the opportunity.

9 Replies

Have you tried to improve t3 conversion with all the various supplements and dietary approaches?


Yes, I am supplementing and my levels are good.


You should get a new blood test and ask for a Full Thyroid one i.e. TSH, T4, T3, Free T4, Free T3 and antibodies (if you've not had antibodies tested previously).

Blood tests should always be at the earliest, fasting (you can drink water) and allow a 24 hour gap between last dose and test and take afterwards.

The tests the lab will not do you can get privately through one of our two Private Labs.

Put your results on a new post.

If GP hasn't tested B12, Vit D, iron, ferritin and folate ask for these too.


I have recent results:

112,5 mcg t4 and 12,5 mcg t3

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)

After this I decreased t4 to 100 and ups t3 to 18,75. Would it make sense to decrease t4 by 50 and add 12,5 T3?maybe start with decreasing 25 t4 and add 6.25 T3. Or better to leave as it is and have blood tests first?

All vits and minerals are optimal. I have hashimotos.



Clara, after how many hours was the blood taken in regards to the T3 dose?




Don't increase the T3 dose, leave it at 12.5 mcg and just reduce T4 to 100 mcg. Then leave it for 6 months.

How do you not feel well?

1 like

Would agree with gabkad you really don't need to increase T3

Perhaps just tweak Levo down to 100mcg

Certainly don't cut to 50mcg that's massive reduction



Are you gluten free?

Those results were decent results. I’d be interested to see what they were b4 you added in t3. It tends to be unlikely ( not impossible) that you have reverse t3 when on t3.

This is my take- I’d have left the meds as they were - monitored your temp and seen where it went to with the increases. You are aiming with a basal thermometer to get to circa 36.6 but with hashimotos you can have flare ups. It’s v important to have good adrenals and be able to say you have no stomach issues. Given the results you are absorbing- I just can’t tell if you convert or take t3 well.

A suppressed tsh matters not a jot - your levels are within range.

You could consider ndt/ meatavive which are more balanced I’d say.

Have you any cortisol/ dhea results?

The old school docs used to rely on how you feel and temp.

If you are gluten free and hashimotos is more stable then if your temp is more than say 0.9 degrees out in a day- adrenals are not stable.

It would be handy to know exactly how you feel. Somethings definitely off with those results. If on t4 don’t mix brands- you had to split yours so they all need to be the same.( or you may have an intolerance to fillers etc)

Best wishes


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