Advice please

[Tanngales]

Hi

I haven't posted for awhile.

I am on 75mcg Levo

While seeing an ENT consultant for neck pain and a 'lump' in my throat, it was brought to my attention that my tsh is 3.16 and my T4 level is 17.1.

I am still symptomatic!

Is this 'normal'?

I have bought some 25mcg T3, Tiromel

As from today I am trialling 50mcg Levo and 25mcg. Only 1st day, so no idea if it will better.

Any thoughts or advice warmly welcomed.

[radd]

Tanngales,

The goal of Levothyroxine is to restore a euthyroid status and so well being. Unfortunately many people are either dosed incorrectly or have deficiencies in iron or nutrients required to encourage meds to work properly.

Adding T3 isn't always the answer if you don't need it. Was your FT3 level particularly low ? If you post any recent blood test results before starting the T3 meds, members will comment.

[greygoose]

Even if you need T3 due to poor conversion, I don't think that's the way to go about it. Normally, one reduces levo by 25 mcg and adds in 6.25 mcg T3. If your FT3 has been low for a long time and you're not used to having T3 in the blood, suddenly whacking 25 mcg into you is dreadful shock to your system. So, then, if it doesn't help, you will never know if it's because you didn't need it or because you started on too high a dose.

[SlowDragon Administrator]

The aim of Levothyroxine is to increase the dose slowly in 25mcg steps upwards until TSH is under 2 (many need TSH under one) and FT4 in top third of range and FT3 at least half way in range

NHS guidelines on Levothyroxine including that most patients eventually need somewhere between 100mcg and 200mcg Levothyroxine.

nhs.uk/medicines/levothyrox...

You do not need T3 at this stage

Your GP should be increasing dose of Levothyroxine by 25mcg

Bloods should be retested 6-8 weeks after each dose increase in Levothyroxine

For full Thyroid evaluation you need TSH, FT4 and FT3 plus both TPO and TG thyroid antibodies tested. Also extremely important to test vitamin D, folate, ferritin and B12

Low vitamin levels are extremely common, especially if Thyroid antibodies are raised

Recommended on here that all thyroid blood tests should ideally be done as early as possible in morning and fasting. This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, best not mentioned to GP or phlebotomist)

Last Levothyroxine dose should be 24 hours prior to test, (taking delayed dose immediately after blood draw).