T3 still below mid range - advice on dosage please

[Hashi-hacker]

Hi,

Here are my recent results, please can you advise on dosage or any other tweaks you'd make.

I have Hashi's and have been on 75mcg Levo and 2x10mcg lio for over 3 months. I have mostly been feeling ok, definitely no hyper symptoms but some lingering hypo symptoms e.g. brain fog, feeling cold and low mood which I'd like to improve on.

I am a little concerned at how low my TSH is (below range), is that a problem? My T4 is just above bottom range, but as I have the DI02 gene mutation is that a problem? My T3 is still below mid range, and I've had similar T3 results when I was on levo only (although I felt much worse than I do now). Should I carry on with my current doses, and/or increase/decrease levo and lio?

As to vitamin status - I stopped taking B and D supplements during this time to see if I could get enough via diet alone. I think I will start taking B's again and some D (and K) as I'd like to be a bit higher in the range for these.

As per the good advice here, I am dairy, gluten and soya free and eat as sensibly as I can. I've also been doing regular red light therapy which supposedly helps T4-T3 conversion but the only thing I've noticed is a few pounds falling off (my BMI is 20.7). I have enough energy to do moderate exercise a few times a week. I take LDN which maybe helping with keeping the thyroid antibodies and general inflammation down.

Thanks in advance,

x

[Lalatoot]

What you describe as hyper symptoms are also hypo symptoms. The same symptoms can be had for both hypo and hyper or rather undermedicated and over medicated.

If those results were mine I would increase my dose of levothyroxine. Some folks on combo medication are fine with FT4 low in range; others need it over half way through the range at least. The increase in T4 meds would also raise FT3 slightly.

[Hashi-hacker in reply to Lalatoot]

I will edit! I meant hyper symptoms!

[Hashi-hacker]

Hi greygoose SeasideSusie shaws I was hoping one of you could help me figure out what to do regarding my latest results as you've been so good over the years. Do I:

a - carry on as is (75mcg levo 2 x 10mcg lio) and accept I'm about 80% ok.

b - up lio, if so how much and would I keep the same or reduce levo? I took 20mcg single dose of Lio by mistake and it had no effect, although I guess this isn't a proper test!

c - up levo? Doesn't feel like the right solution given I'm not a good T4-T3 converter.

I will pass my results onto my sort of useful endo but would like to go into the conversation with a clearer idea of what my sensible options would be.

Thank you x

[greygoose in reply to Hashi-hacker]

If it were me, I would increase the T3, and leave the levo as it is for the time being - you can't increase both at the same time, anyway. Get the FT3 to a decent level, and then you can experiment with the levo to see if you need it any higher.

The red light therapy may or may not be helping with conversion, but no way you can verify that whilst taking T3.

Your nutrient levels certainly do need some work done on them.

[Hashi-hacker in reply to greygoose]

Brilliant, thanks x

[greygoose in reply to Hashi-hacker]

You're welcome.

[SeasideSusie Remembering]

Hashi-hacker

I've no personal experience of Hashi's nor the DIO2 gene variant, SlowDragon is your girl for that so hopefully she may pop along.

I can only answer as someone who is on combination Levo plus T3 and those results would immobilise me. I need both FT4 and FT3 in the upper part of the range, although some members do well with a low FT4.

Your low TSH is the result of you taking T3, it's just what T3 does, but that may or may not satisfy your endo.

As your FT4 is only 2% through range and your FT3 is 31.35% through range, my first thought is to increase your Levo then retest in 6-8 weeks' time to see how this has changed your results then reassess.

With your current Vit D level you need to be taking ab out 5,000iu D3, don't forget you need magnesium as well as K2, magnesium helps the body convert Vit D into it's usable form.

I would try and get your Active B12 up to 100+ (good B Complex daily like Thorne Basic B or Igennus Super B) then when you've achieved that go on to a maintenance dose, maybe twice a week.

[Hashi-hacker in reply to SeasideSusie]

Brilliant thanks. I did take the B's you mention but decided to quit them and see if I could get what I need via diet alone. I might need to go back on them and maybe keep a maintenance dose as you suggest. I take a D/K2 combo now and again plus magnesium daily. Thanks for your comments about the ranges x

[Hashi-hacker]

Hi all, here's the response I got finally from my endo.

"I suspect we will struggle to get your results and therefore any thyroid symptoms much better as your TSH is already low.

(<- it was 0.041 which is below range 0.27-4.2)

It would be worth excluding other causes, if we haven’t already, so looking at iron, vitamin d, b12 levels"

Since I got the vit test results which showed some but not huge room for improvement, I have gone back onto the B complex, vit D/K2 and continued with the other supplements eg. Magnesium. I would have hoped if they were a problem that I would have felt better within a week, however I have not felt that much different really, with some days yawning from 11am to bedtime despite having had 8-9 hours in bed.

My big concern is that she's not going to let me change either the T4 or T3 dosage (currently 75mcg levo and 20mcg lio).

SlowDragon and anyone else who would like to comment, I have the opportunity to increase my T3 without the endo knowing as I have been prescribed 20mcg lio tablets and been instructed to dilute the tablets and chuck away half to get a 10mcg dose (and then doing the same later in the day to get to 20mcg overall daily). Given the cost of the tablets (to the NHS) I have been splitting the tablets using a pill cutter and having one half in the morning on waking and the second about 5pm. What do you think?

Thanks as ever x