Latest results on T3/4 combo - next steps

[Lost_Girl]

Hi - some advice please before I take the next step. Thank you all so much in advance.

I have been fortunate to have had a trial of T3 added to my T4 dose.The endo prescribed 75mcg T4 (my dose had been 100mcg T4 only)with 2x5mcg T3.

After 8 weeks, he instructed my gp to reduce my T4 further to 75mcg with 50mcg on alternate days and increase T3 to 15mcg. This was without any input from me on how I felt on the initial dose.

I requested blood testing from gp after the initial 8 weeks - I’d actually started feeling better but then around week 6, became disappointingly symptomatic. The blood results came back today and my thoughts would be to stay on 75mcg T4 and increase T3 to 15mcg and see if I felt less symptomatic. I feel the way forward is to make very small changes. Many thanks.

Results on T4 100mcg only. Dec 2018

TSH 0.04 (range 0.27-4.5)

FT4. 23 (range 11-22)

FT3. 5 (range 3.1-6.8)

Results on 75mcg T4 and 10mcg T3 Feb 2019

TSH <0.01. (range 0.27 -4.5)

FT4 17 (range 11-23)

FT3 5.85 (range 3.1-6.8)

[SeasideSusie Remembering]

Lost_Girl

Your FT4 is only 50% through range. Personally I would think it inadvisable to reduce your Levo.

Your FT3 is 75% through range which is good.

My thoughts are that if you add more T3 then it may take your FT3 over range.

I take a combination of Levo and T3 and I have found that I am best when both FT4 and FT3 are around 75% through range. I don't do at all well with a lower FT4 and a higher FT3 doesn't do anything for me.

It's very much trial and error and tweaking doses over a period of time, it took me a couple of years of tweaking to eventually find where I was best. I also discovered that I need 8 weeks between a dose change and retesting for levels to settle down.

What are your vitamins and minerals like?

Vit D - 125nmol/L (recommended by the Vit D Council)?

B12 - top of range?

Folate - at least half way through range?

Ferritin - half way through range?

[Lost_Girl in reply to SeasideSusie]

Hi - thank you so much for replying. I’ve not had them retested since December - they were

Vit D 78

B12 561 range 190 - 1000

Folate 5.7 range 2-18.7

Ferritin 94 range 30-150

I have been supplementing since then but take your point I may not be optimal.

[SlowDragon Administrator]

Have you ever had TG thyroid antibodies tested?

Can see in previous post that TPO antibodies appeared to be negative

NHS refuses to test TG antibodies if TPO are negative

Suggest you get antibodies tested privately via Medichecks or Blue Horizon

thyroiduk.org.uk/tuk/about_...

As SeasideSusie says, vitamins must be optimal

[Lost_Girl in reply to SlowDragon]

Thank you - yes endo refused to test TG antibodies - said TPO were more indicative! My TPO was negative.