Reasonable dose adjustment?: Results on 100t4+20t... - Thyroid UK

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Reasonable dose adjustment?

Clara9 profile image
8 Replies

Results on 100t4+20t3

Tsh 0.01

Ft3 6.0(3.6-6.3)

Ft4 18 (12-22)

Dr wants me to stop t3 altogether but since I refused said to lower T4 to 75 and T3 to 10. I am thinking lowering T4 to 75 to see if I feel better (I did last time I lowered T4)(might have a bit of rt3 but don't know), have tests and go from there. Does that sound reasonable?

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Clara9 profile image
Clara9
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SeasideSusie profile image
SeasideSusieRemembering

Clara9

FT4 is 60% through range

FT3 is 89% through range

Those results don't show any need for dose adjustment unless you feel that you are not optimally medicated. How do you feel?

When on combination thyroid replacement hormone some of us need FT4 highish in range, some do OK with it low in range, we have to find out for ourselves where we feel best.

If those were my results, I'd leave Levo where it is and maybe reduce T3 by 5mcg, but that is based on me knowing I need both FT4 and FT3 around 75% through range.

All you can do is tweak doses, only change one at a time and leave it 6-8 weeks before retesting and reassessing how you feel then readjust again if necessary.

If you reduce as the endo wants to 75mcg Levo and 10mcg T3 then both FT4 and FT3 will fall, the FT3 could fall quite considerably depending on how much natural conversion you have left. Also, changing both at the same time then you wont know what has affected you, the lower Levo dose or the lower T3 dose.

If you reduce Levo by 25mcg then you will most certainly have a fair reduction in your FT4 and likely some reduction in your FT3 depending on how much natural conversion you have. If you feel like reducing Levo then personally, because FT4 is only 60% through range, I'd only reduce by 12.5mcg and see how that goes.

Aurealis profile image
Aurealis

Hi, how much Levo and T3 are you taking currently? Not sure how much reduction is being considered. I would only reduce T3 by 5mcg OR Levo by 25mcg. It’s a bad move to adjust both together. As your instinct is to reduce Levo, I think that’s the way to go.

Clara9 profile image
Clara9 in reply to Aurealis

100 Levi and 20t3

Aurealis profile image
Aurealis in reply to Clara9

Sorry, I realise it was in your original post. Reducing 10mcg T3 is too much in my opinion. Follow your instinct.

SlowDragon profile image
SlowDragonAdministrator

When were vitamin D, folate and B12 last tested?

What supplements do you currently take

Can see you have ongoing issues with low ferritin

Your results don't show over medication. FT4 and FT3 both well within range

Canadian Thyroid association article on Low TSH

thyroidpatients.ca/rational...

Clara9 profile image
Clara9

Thanks. My plan is to lower levo to 75 and have tests in 6 weeks and hopefully stay at that dose and feel well.

Both free t4 and free T3 are in range so can't see any need for lowered dose. Need to find a doctor who is not obsessed with TSH

greygoose profile image
greygoose

I doubt that level of FT4 is causing excess rT3. But, even if it were, it wouldn't affect the way you feel.

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