Well I expect your endo is like most and specialises in diabetes not thyroid, and therefore doesn't have much idea.
FT4 13 (8-21)
FT3 3.9 (3.8-6)
These are much too low. 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 if that is where you feel well. You look undlermedicated. However, you wont know for definite until we know your TSH. Once your TSH is around 1 we can then see how well, or not, you convert T4 to T3 by your results for FT4 and FT3. Only then will you know if you need to add T3.
Tpo 177 (0-34)
Did you know you have autoimmune thyroid disease aka Hashi's, and are you addressing it with a strict gluten free diet and supplementing with selenium l-selenomethionine 200mcg daily which can help reduce the antibodies, as can keeping TSH suppressed.
Ferritin 158(13-150)
Ferritin is recommended to be half way through range. If you're not supplementing maybe yours is high due to infection or inflammation, the Hashi's could be causing it.
Vit D 65.5(50-200)
Vit D is recommended to be 100-150nmol/L by the Vit D Council, the Vit D Society and Grassroots Health so you should supplement for that. I'd suggest BetterYou oral spray 3000iu daily and when you've reached the recommended level you'll need to find your maintenance dose which may be 2000iu daily, maybe more or less, maybe less in summer than winter, it's trial and error so it's recommended to retest once or twice a year to keep within the recommended range. You can do this with a private fingerprick blood spot test with City Assays vitamindtest.org.uk/
There are important cofactors needed when taking D3 as recommended by the Vit D Council -
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
an Active B12 result <70 requires further investigation into B12 deficiency so an MMA (Methylmalonic Acid) test is recommended at this stage. You can check for signs of B12 deficiency here b12deficiency.info/signs-an... and if you have any you should list them and discuss with your GP.
If you want a baseline to see what you are holding onto then it's said 4-5 months is needed to be off supplements.
If you are supplementing and want to know if what you are taking is keeping you at the right level then you don't need to stop, just don't take it before your blood draw. This is what I do now my level is optimal and I now know that just taking sublingual methylcobalamin 1000mcg twice weekly keeps my level stable.
I have only ever had serum B12 tested, so I don't know what my Active B12 level is, I will have to do that one day.
OK, so 100mcg Levo isn't a big dose, even though your TSH is 0.5 your free Ts are way too low.
There are a few things you can be looking at here.
1) Addressing the Hashi's. Hashi's and gut absorption problems tend to go hand in hand and can very often result in low nutrient levels or deficiencies which is showing in your B12 and, to a lesser extent, your Vit D. I would be looking to address any gut problems. You could have low stomach acid, you could have leaky gut, you could have other malabsorption issues. Check out SlowDragon's reply near the bottom of this thread which includes information and links about this
2) Increase your Levo in accordance with the article written by Dr Toft that is mentioned in SlowDragon's post, where it says about TSH being low in range and the FT4 can be in the upper part, even slightly elevated, as long as FT3 remains in range.
I think you need to get FT4 higher in range, it's currently only 38% through range and should be around the top third or top quarter, then see if that increases your FT3. If your FT3 stays low then consider adding T3 or maybe switching over to NDT.
3) See your GP about getting tested for Pernicious Anaemia/B12 deficiency. Also maybe coeliac or other malabsorption problems.
By the way, there's no result for Folate. That should be at least half way through range.
I'm not medically qualified and just making suggestions based on my own experience, reading and research.
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