Seasonal adjustment?

[magsyh]

How many of you need to an increase in dosage during the winter? Every year I feel terrible at this time of year, low energy and bad headaches. This is my second winter on levothyroxine. My test results in October were TSH 2.4 (0.35-4.5) FT4 17.9 (10-22) FT3 5.04 (3.1-6.8) on 62mcg. I raised it to 69mcg after that result and today my results were TSH 1.9 (0.35-4.5) FT4 13.9 (9-20) doc refused T3. I have now raised it to 75mcg. I have to raise it slowly to avoid racing heart etc. I have heard that some people require higher dose in winter. I live in the Orkney Islands and we are lucky to have 6 hours of daylight. I'm just wondering how much this will effect my dosage as soon we swing to the opposite and days get longer very quickly. In summer we can't sleep because it barely gets dark! I've only lived here two years and wonder how much this is influencing my thyroid levels?

[diogenes Remembering]

Sounds very like SAD syndrome to me (lack of sunlight affecting melatonin production). Light therapy can help.

[Hillwoman]

I have to adjust my dose in the 'colder' months, but I've found over the past few years of inconsistent low temperatures in winter, together with long cold spells in the 'warmer' months, that timing and size of adjustment is becoming tricky to judge.

I'm not as far north as you (NE England, not far from the border) but I do live at higher altitude than most, which can have just as much influence in my own experience.

[BadHare in reply to Hillwoman]

T3 makes daily dosing alterations easier with regard to weather fluctuations, & also activity.

[Hillwoman in reply to BadHare]

True, though I find the timing of my winter increase in dose really tricky. If I get it wrong, I'm either over-stimulated for a short time, or under-stimulated for much longer. My body seems to take much longer to adjust in that direction. 🤔

[BadHare in reply to Hillwoman]

I've been honing seasonal & activity dosage for the past five winters. I've learned to drop T3 if I'm coming down with something nasty that will make my temperature increase or if I'm stuck in bed & inactive. I didn't account for NSAIDs reducing the efficacy, so had a few uncomfortable weeks last month & have only just corrected the imbalance.

[SlowDragon Administrator]

Very important to regularly test vitamin D, folate, ferritin and B12

What vitamin supplements are you currently taking?

[magsyh in reply to SlowDragon]

I am taking all those plus K2 and magnesium. My ferritin was high but saturation normal at 24% I think it's a winter thing but shocked that my T4 had dropped on a higher dose.

[SlowDragon Administrator in reply to magsyh]

Suggest you get TSH, FT4 and Ft3 tested privately

Make sure to get blood test as early as possible in morning before eating or drinking anything other than water and last dose levothyroxine 24 hours before test

[BadHare]

I don’t take T4 though I do increase my thyroid hormone dosage by about 20% from the end of September, & also the ratio of NDT to T3. I double how much D3 I take at the same time.

[milkwoman]

Yes, I increase my thyroid meds during the colder months and decrease during the warmer months. Dr. Kenneth Blanchard wrote about this in his book, “Functional Approach to Hypothyroidism”. I was fortunate enough to be a patient of his before he passed in April 2017.