Based on my last test results my GP has agreed for me to try a slight increase in my Levothyroxine, I currently take 100mcg.
Earlier this year I increased to 125mcg but it seems it was too much as I lost weight - feeling my body was shrivelling inside - not a pleasant feeling.
I would like to try increase of 12.5mcg daily so I get an even input of Levo rather than doing 100mcg/125mcg alternate days - which I tried for a short while.
My dilemma is that it seems the only drug company that provides 12.5mcg Levo is Teva. Having read on this site that Teva is not tolerated by a lot of people I am hesitant to try.
Any thoughts on best way forward would be much appreciated.
Written by
SmPea
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Sorry to be a wet blanket, but I really don't think increasing your levo by any amount is the answer. You're not converting T4 to T3, and increasing the level of FT4 will make conversion worse, not better.
It is low T3 that causes symptoms, and yours is too low for you to be well. So, what you really need is a small dose of T3 added to a reduced dose of levo.
But, you also need to increase your nutrient levels - they are all low except ferritin - which might help a bit with conversion.
I agree with Greygoose. Your conversion isn't particularly good. Good conversion takes place when the FT4:FT3 ration is between 3:1 and 4:1, yours is 4.26 : 1
I think adding more Levo will take your FT4 over range and then you may start making reverse T3 rather than Free T3.
I would work on your vitamins and minerals, B12 is particularly low as anything below 70 it's suggested testing for B12 deficiency. Do you have any symptoms of that - check here b12deficiency.info/signs-an...
Optimal levels for vitamins are
B12 - near the top of the range
Folate - at least half way through range
Vit D - 100-150nmol/L
Fortunately your ferritin level is good.
I would also supplement with selenium l-selenomethionine as that can help with conversion. Also maybe test zinc (and copper) as zinc is said to help with conversion so it's worth seeing if that's low.
The generally recommend ded amount of selenium is 200mcg.
See what your zinc level is first. Mine was very low in range but I don't take a separate zinc supplement, I take a multi mineral that doesn't contain iron, calcium or Iodine.
You can buy a pill cutter for next to nothing from a pharmacy or supermarket, if you decide to increase your dose, which is a boon if you have dexterity problems. But I agree with greygoose in that your T4 to T3 conversion is poor - a dose increase is likely to push your T4 to the absolute top or over range but your T3 won't be anywhere near, based on your current levels. Have you had the DIO2 genetic test to see if you may have a fairly common fault which can sometimes affect conversion? But in any case, rather than more T4, I'd agree you probably need T3 added to your existing T4.g
Are you taking ongoing maintenance dose of vitamin D? If not you should be, and it needs increasing. Vitamin D needs to be at least 80nmol and around 100nmol likely better
Vitamin D mouth spray by Better You is good as avoids poor gut function. Suggest you supplement 1000iu for 2-3 months and retest.
It's trial and error what dose each person needs.
Once you Improve level, very likely you will need on going maintenance dose to keep it there.
Folate is too low. Supplementing a good quality daily vitamin B complex may be of benefit, one with folate in not folic acid
If you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 3-5 days before any blood tests, as biotin can falsely affect test results
Your FT3 is too low. If it doesn't improve after increase in Levothyroxine and getting vitamins optimal and absolutely strictly gluten free diet then look at seeing a recommended endo from Thyroid UK list for prescription for addition of small dose of T3
Email Thyroid UK for list of recommended thyroid specialists, some are T3 friendly
please email Dionne
tukadmin@thyroiduk.org
DIO2 gene test may help get you T3 on NHS if you test positive
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So what do people think of teva (new formulation) levothyroxine? 
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Teva
