Increasing FT3/FT4?

[Paco1016]

Hello all. I have been treated for hypothyroidism for about 7 years using t4 (75mcg) only. I have never felt completely back to what I would call “normal” since then but it has mostly been manageable.

Over the past year I have noticed an increase in constipation, newly diagnosed high cholesterol, dry skin, muscle and joint aches, difficulty losing weight, and generally just feeling less well.

After quite a bit of pressuring, I was finally able to get some tests. Here are my results. I would be interested in hearing recommendations for next steps in improved treatment ( if I can convince anyone to actually help me feel better rather than just telling me I’m aging—I’m 35—or depressed):

TSH: 1.5 (0.358-3.74)

FT4: 0.96 (0.76-1.46)

FT3: 2.46 (2.18-3.98)

Iron: 92 (50-170)

I’m still waiting to get my Vit D and B12 results back.

Any thoughts are greatly appreciated.

[Aurealis]

You have lots of symptoms of undertreatment therefore you need an increase in dose. When you feel well then get re-tested to see where in the ranges you feel best. It is insufficient to have test results in range, you have to be at the correct place in the range for you, otherwise you won’t feel well. Good luck

[Frances0008]

Both ft3&4 are low in range. Most people feel best with ft3 in top quarter. Your conversion looks reasonable tho not brilliant, so you may be able to achieve that through an increase in t4 (levo), but you’d need to see what your blood tests look like on a higher dose. If you cannot achieve what you need without going overrange on t4 you may need to add in some t3 after increasing your levo as much as you can without going over.

[SlowDragon Administrator]

All thyroid tests should ideally be done as early as possible in morning and fasting. When on Levothyroxine, take last dose 24 hours prior to test, and take next dose straight after test. This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, GP will be unaware)

Is this how you do your tests?

If so, Agree with other replies, you need 25mcg dose increase in Levothyroxine

FT4 is under half way in range and FT3 very low

Have you ever had thyroid antibodies tested? Both TPO and TG antibodies ideally

Also post results and ranges of vitamin D, folate, ferritin and B12 when you get them. Quite likely some will be low

What supplements do you take?