I take a combination of Levo and T3 (T3 is self sourced so not under an endo nor GP for this). Whilst tweaking my doses I found that I needed FT4 to be higher than half way through range, although that doesn't apply to everyone, we all have our own individual needs for where levels are best for us.
Were you changed from this on 125mcg Levo
FT3 3.8 (3.1-6.8)
TSH 1.72 (0.27-4.20)
FT4 16.4 (11.0-22.0)
directly to 75mcg Levo + 20mcg T3 to give you this
FT3 4.5 (3.1-6.8)
TSH 0.38 (0.27-4.20)
FT4 11.3 (11.0-22.0)
If so I would have just added T3 and not reduced Levo by 50mcg, your FT4 was already below half way through range in your first set of results.
Your current results show that there is plenty of room for your FT3 to increase.
You have Hashi's don't you. Are you addressing this with a gluten free diet and supplementing with selenium l-selenomethionine 200mcg daily to help reduce the antibodies, as can keeping TSH suppressed.
Are all your vitamins and minerals optimal?
Vit D - 100-150nmol/L
B12 - top of range
Folate - at least half way through range
Ferritin - at least 70, preferably half way through range
They all need to be optimal for thyroid hormone to work, and Hashi's messes with nutrient levels so that has to be addressed.
If nutrient levels are optimal then you could do with an increase in thyroid meds. You may be better with a higher FT4 and you certainly need your FT3 higher.
It's the over range Thyroglobulin Abs that show autoimmune thyroiditis aka Hashimoto's, shame it wasn't picked up on.
Hashimoto's is where antibodies attack the thyroid and gradually destroy it. The antibody attacks cause fluctuations in symptoms and test results.
Most doctors dismiss antibodies as being of no importance and know little or nothing about Hashi's and how it affects the patient, test results and symptoms (which is why your doctor probably didn't mention it). You need to read, learn, understand and help yourself where Hashi's is concerned.
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. Do you have current results for Vit D and B12 and can you say what you are supplementing with. Are you taking D3's important cofactors magnesium and Vit K2-MK7?
If these were my results then I would want my FT4 higher so I first of all would increase my Levo by 25mcg. That may also increase FT3 as well as FT4 depending on how well you convert. I'd then retest after 6 weeks, see where my levels lie and decide what to tweak next. It's not a good idea to increase both Levo and T3 at the same time, you need to know what difference each one makes. I have found it a long, hard slog trying different doses to try and find what's best for me, and I don't have the added complication of Hashi's and it's fluctuations.
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