Advice on results, FT3 higher now than I'm on liothyronine but more tired

[Highland49]

Hi,

I have more information on my profile but would like advice again before I return to consultant. Am on liothyronine 10 mcg daily (split dose) and 75mcg thyroxine daily. Just had results from Medichecks (allowed 24 hours between levo and just over 12 hours after T3 before blood test).

TSH 0.067 (0.27-4.20)

FT4 21.3 (12-22)

FT3 6.3 (3.10-6.60)

Vitamin D 74 nmol/L (50-200)

In September, before liothyronine started, TSH was 0.252, FT4 22.50 and FT3 was 5.01, same ranges. Vitamin D was 107 (50-200) in May.

My feeling of suffocation is 80% better on T3 but lethargy and fatigue has been worse. Once I reached 5 weeks of T3, it seemed to wear off a bit.

I've had food poisoning recently and stomach pains, burping and hiccups after so looking into SIBO. Surprised that my vitamin D level has dropped that much. I don't regularly take my D3/K2 regularly so starting again.

Could anyone advice if my symptoms are more likely to be low vitamin D or whether I still need an increase in liothyronine, or both?

Many thanks 😊

[SeasideSusie Remembering]

Highland49

Well, you definitely need to increase your Vit D level, 125nmol/L is recommended lby the Vit D Council.

There really isn't room to increase your liothyronine, your FT3 is already 91% through the range.

It takes a while to find the right balance of FT4/FT3 and the right level of replacement hormone, some people do better with a lower FT4 when on combo meds, I need both my FT4/FT3 around 75% through range.

Have you had ferritin, B12 and folate checked? I'd be looking at those.

[Highland49 in reply to SeasideSusie]

Thanks SeasideSusie,

I'm self injecting b12 alternate days so that seems to keep my balance problem in check. My folate is always above range. I read the other day this is connected to SIBO as folate is a byproduct, so shows high in the blood result.

I eat liver once a week to help my ferritin and folate level, plus take gentle iron once a week with vitamin C. My ferritin was around 80 earlier in year.

[SeasideSusie Remembering in reply to Highland49]

That all sounds good

[Highland49 in reply to SeasideSusie]

Thanks for your help Susie. It's just frustrating that I'm still struggling to have a normal day.