How much T3 increase

[JBLOVELL]

Tsh 0.04mIU/L range 0.30. - 4.50

T4 11.8 pmol/L range 10.0 - 22.0

T3 5.2 pmol/L range 3.1 - 6.8

I’m currently taking 100mcg Levothyroxine, and t3 (that I source myself) 12.5mcg twice a day. My endocrinologist is concerned about suppressed tsh(as I expected) but understands why I am sourcing my own t3, as I have made a vast improvement since working up to this dose. Since dropping from 125mcg levo to 100mcg my t4 has dropped from 21 to 11. I now want to increase my t3 again, as I seem to have hit a brick wall with progress. Should I increase by another 12.mcg as a third dose or less and/or should I just add to my morning or afternoon dose? Thanks in advance

[SeasideSusie Remembering]

I take a combination of Levo and T3. If those were my results I'd be adding more Levo at this stage. FT4 will lower when taking T3 but we are all different as to where we need our FT4 level, I wouldn't be able to function with your ft46, I have found, after many many months of tweaking doses, that I need both FT4 and FT3 around 75% through range.

Maybe reducing Levo by 25mcg was too much and just 12.5mcg would have been better.

When increasing T3 it should be done by 1/4 of a tablet at a time, so 6.25mcg, it's very easy to overshoot.

[JBLOVELL in reply to SeasideSusie]

Sorry, I meant I take 6.25 twice a day, which equals 12.5 and want to increase by another 6.25. My only concern with going back up to 125mcg in levo is that I still felt symptomatic when on that and my t4 levels were near to the top of the range and thought more t3 would help, but also thought that I needed to reduce the t4 if I planned to increase the t3. I’m so confused.

[SeasideSusie Remembering in reply to JBLOVELL]

JBLOVELL

My only concern with going back up to 125mcg in levo is that I still felt symptomatic when on that and my t4 levels were near to the top of the range

Which is why I suggested a reduction of 25mcg Levo might have been too much and a reduction from 125 to 112.5mcg might have been better, so increase to 112.5mcg Levo first is my suggestion. Your FT4 could be way too low, some of us need it much higher on combination replacement hormone.

I would then retest in 6-8 weeks' time, see how your levels lie (your FT3 may have increased as well as your FT4) and see how you feel. Then take it from there.

Don't change both Levo and T3 at the same time, if you do you wont know which you are benefitting from.

[SlowDragon Administrator]

Looking at your results, I would also be considering increasing Levothyroxine

Like you my Levothyroxine was reduced by endo from 125mcg to 100mcg when T3 was added

I found that Levothyroxine needed to be increased back up after a few months. I stepped back up initially to 112mcg....but it wasn't enough. Ended up back on 125mcg

Increasing Levothyroxine will very likely also increase FT3

[JBLOVELL in reply to SlowDragon]

Sorry, I meant I take 6.25 twice a day, which equals 12.5 and want to increase by another 6.25. My only concern with going back up to 125mcg in levo is that I still felt symptomatic when on that and my t4 levels were near to the top of the range and thought more t3 would help, but also thought that I needed to reduce the t4 if I planned to increase the t3. I’m so confused.

[SlowDragon Administrator in reply to JBLOVELL]

Your results show LOW FT4

If you increase Levothyroxine dose by 12.5mcg (or 25mcg) this should increase your FT4 (and likely to also increase FT3 levels a little too)

Obviously you felt symptomatic on JUST 125mcg Levothyroxine .....adding T3 has helped

Many of us find we need FT4 and FT3 at least in top third of range

[JBLOVELL in reply to SlowDragon]

I was on the 125mcg levo and my t4 was in the upper range and the 6,25 t3 twice a day when I still felt symptomatic, which is why I considered an increase in t3. I was told before that my t4 was abit too high in range when taking 125mcg, considering I am taking t3, but then others are saying both should be in the upper third of the range. Which is correct?

[SlowDragon Administrator in reply to JBLOVELL]

So you might just add small increase in Levothyroxine to 112mcg and retested after 6-8 weeks, as SeasideSusie also suggested