After a month trial of Levo new blood tests are almost identical.

[Windsinger]

So about six weeks ago I was prescribed Levo trial 25mcg...

I took it for about 3 weeks and then increased to 37,5 ( 1.5 tablet) to see if it makes any difference. I feel slightly more energy and a bit more positive, but body temperature still low and still a bit sluggish. I understand I need a higher dose.

Today I got my latest blood test results ( taken 24 hours from last dose of Levo in the morning before eating). Strangely the results are almost identical to the ones before taking any meds, slightly lower if anything...I am putting my new numbers first and the ones 6 weeks ago in the brackets. 6 weeks ago are results before starting T4.

TSH 0.85 ( month ago 1.54)

FT4 13.8 ( month ago 14.1) range 12-22

FT3 4.5 ( month ago 4.3) range 3.1-6.8

How is it possible that while taking T4 my levels went down?

I also was hoping to see if I am converting T4 into T3. What do you think?

Can you, knowledgeable people, please comment and give me some suggestions on how to proceed? Doctor of course thinks all is well, as TSH is 0.85... I want to feel well though, and I am not there yet!

I look forward to your replies

[m7-cola]

You are expecting things to be better and that this will show up on your blood test results. But you’ve taken a tiny starter dose which is likely to have resulted in lowering your own T4. When your dose is raised to something more akin to your needs I expect things will improve, both your energy and your test scores!

[MaisieGray]

It's perfectly possible for that to happen. It's easy to assume that if we appear to add an amount of thyroxine to the amount being produced by our failing thyroid, that we naturally then have the total of both amounts. But when starting out and only on a small amount of exogenous thyroid hormone, the effect is to interrupt the production of your endogenous hormone so in effect you can end up with less circulating in your blood stream. It is an indicator that you need to increase your dose. Until you are optimally medicated on Levo, with FT4 optimally in range, you can't really make any accurate assessment about T4:T3 conversion. However, your FT4 is currently only 18% in range and your FT3 is 37.8% so to date there doesn't seem to be a problem with that, but both numbers reinforcing that you are under-medicated.

Edited to add that the high level of FT3 relative to the low level of FT4 may also be indicative of the body doing all it can to safeguard an adequacy of FT3 in the presence of a very low in range FT4.

[Windsinger in reply to MaisieGray]

Thank you, for both replies, MaisieGray and m7-cola. That makes sense. So I am on 37.5mcg of T4 now. Going up to 50 from tomorrow. Will stay on it for 4 weeks and then increase another 25mcg... Does it sound like a plan? I guess I would need to inform my GP post factum that I have done it, as he thinks I am fine and do not need anything, as I am in range... What do you think?

[MaisieGray in reply to Windsinger]

If your prescription re-ordering is fairly tightly controlled by your surgery, if your GP doesn't know to increase your dose you will run out of tablets at some point.

[MaisieGray in reply to Windsinger]

Just tagging m7-cola for you otherwise she might not see your reply

[Greybeard in reply to Windsinger]

Hi, you need to be on the same dose for at least 6 weeks, upping the dose part way through means you aren't getting a representative set of results.

[Windsinger in reply to Greybeard]

Thank you. Got it I will stick with 50 mcg for 6 weeks. Then re check and go up 25mcg. Right? When I run out I will go to the doctor and confess... Otherwise I just do not know how can I increase my dose...

[Greybeard in reply to Windsinger]

Yes thats right. I had a look at your previous post and see that you tried ndt a while ago, presumably that didnt go well. Its important to understand that there are no quick fixes where the endocrine system is concerned. Quite often symptoms lag behind dose increases, sometimes by many months, so patience is the order of the day. Ive been at it for 2 years now and I am still improving.

[Windsinger in reply to Greybeard]

Something to look forward to I tried NDT for two days! I felt awful and then was advised to stick with T4 to see if I am converting... Seems that I am, so might not need NDT... I will try and be patient. Have had fatigue for over 20 years, and now I seem to have a hope to shake it off, I can't wait! I see your point though... Thank you very much for the reminder

[silverfox7]

Sound advice to stay on T4. You can't tell about conversion on any form of T3. Once optimal and settled, which could take some time, then you may not need to change from Levo

[Windsinger in reply to silverfox7]

Wonderful! Thank you Does Levo have any long term side effects if on he right dose? Is there any studies? I changed from Teva to Wockhardt.