Advice on dosing and blood testing

[SAUK]

Hi all

I have recently started on T3 20mcg (10am and 10 12) along with my normal T4 100mcg and was feeling well. My GP repeated my bloods In Jan and panicked on my TSH level and suggested I drop to 75 T4. I then spoke to my endo who said not to drop so much but rather to 87.5 daily. My GP advised not to cut tablets and suggested alternating 75/100, which I am doing but since doing this for about 2 weeks my symptoms are so variable both physical and cognitive.

My gut says increase T4 or increase T3 but worried about over dosing and becoming hyper and changing this on my own.

I am due to have repeat bloods in 2 weeks to see how alternate dose is going but do not feel I can wait this long with this variability.

One day will burn 3000 calories and next barely get to 2000. My heart rate is a lot faster generally and am losing weight, but do get tighness in my chest which I never had on T4 alone.

Last bloods I took I did not take T3 or T4 for 48hrs

TSH 0.05 (.35-5)

FT4 10.8 (9-24)

FT3 3.9 (3.5-6.5)

Does anyone have any suggestions on dosing advice?

I take levo at night after more than 3 hours of eating, T3 first things and eat about 1 hour after. T3 at noon but need to eat at 12:30 because this is how my work times work.

I'm also taking B Complex, vit d spray milk thistle and probiotic

Also does anyone know when should I stop my meds before taking bloods to get most accurate dose.

Thank you.

[SlowDragon Administrator]

Personally I think taking T3 only in morning is no good

Some of us find taking 3 doses per day eight hours apart works much better

10mcg on waking, 5mcg 8 hours later and 5mcg 8 hours later

Your FT4 was already low in range

Since reducing dose it’s likely dropped further

Testing should be done as early as possible in morning and fasting and no levothyroxine in the 24 hours prior to test and most importantly last dose of T3 at 8-12 hours prior to test

TSH is almost always suppressed in any dose of T3

What are your vitamin D, folate, ferritin and B12 levels like?

Do you have Hashimotos? If so are you on strictly gluten free diet

Blood tests should only be done after 6-8 weeks on constant unchanging dose

[SAUK in reply to SlowDragon]

Thank you for advice

I have Hashimoto so on a strick gluten and diary free diet!

Vit D 119 (>80)

Ferritin 36 (20-300)

Folate 10.8 (3-13)

B12 352 (180-1100)

But all taken at diff times and more than 6 months ago.

I don't think I can cut my T3 anymore- I split a 20mcg tab in half and already tiny and breaks.

Thanks for blood test advice. I'm not sure I can last to wait for 6 weeks for bloods with this variability .

[SlowDragon Administrator in reply to SAUK]

I cut my T3 easily using a small craft scalpel into 1/2 plus 2 x 1/4 (as advised by my endo)

scalemodelshop.co.uk/produc...

Your ferritin is still low. Around 70 is recommended

B12 over 500