I have been on higher doses of t4 and smaller t3 (anything from 150 to 100 mcg, and up to 20 mcg t3).
While Levo gives me a good baseline, meaning, I feel constant amount of mid-level energy, but I still can't sleep, I'm still retaining water, have other hypo symptoms. My Endo wants me to move from t4 to more t3.
Could someone please advise me how to do it safely? He wanted me just to dramatically reduce and increase (reduce by 25 mcg t4 and increase by 10 mcg t3), but I know I'll be very sick if I do that.
Right now I'm at a place where I could do with an increase of t3 (my labs were just over mid-range on ft3) as I feel quite hypo after dropping Levo from 112 to 100.
We shouldn't change both at the same time as we wont know which change has had what effect. Change one, see what happens, change the other, see what happens, we have to tweak our doses gradually to see what effect it has.
Changes in dose of T3 should be by 1/4 of a tablet at a time.
Changes in dose of Levo depends on level of FT4, sometimes 25mcg is needed, sometimes 12.5mcg, sometimes just a tiny alteration in dose.
For levels to stabilise after a change of Levo dose we generally need 6 weeks.
Level may stabilise more quickly after a change of T3 dose because T3 has a much shorter half life than Levo.
I guess my downfall was that I have reduced Levo by 12.5, felt terrible around week 3, and then increased t3 by only 2.5, but it is not enough. My feel was that I need an increase of another 2.5 of t3 as you have mentioned also.
Latest bloods on 100 t4 and 17.5 t3:
Tsh less than 0.02
Ft4 = 48% range
Ft3 = 55% range
Bloods on 112 t4 and 17.5 t3:
Tsh less than 0.01
Ft4 = 55% range
Ft3 = 70% range
(On this dose I couldn't sleep or slept very lightly, still retaining water, increasing past 17.5 was giving me palpitations, anxiety).
Edit: is it possible I have missed something? I haven't altered between 112 and 125 (118 mcg). The most normal I felt was around 125 mcg and 10 mcg, but my trouble sleeping has started then and after holding the dose for 7 weeks I was still quite hypo, so confused. My labwork was the most normal around 112 and 17.5, but still hypo after many weeks on it.
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T4/T3 trial - update @ 6 months. 
insomnia t3/t4 - this might help someone :) 
Anyone change back to levo. from NDT.
