Advice on thyroid dosing

[mistygrey]

Hi

I saw my Endo last end of Jan, she put me up to 100mcg T4 and kept T3 the same at 5mcg. Previous to that change I was on 75mcg T4 and 5mcg T3 daily.

My results then were:

TSH 1.7 Range 0.2-4.5

FT3 5.6 Range 2.5-4.9

FT4 14 Range 9-21

My query is, 3 months on ish, I am not feeling great with some breathlessness and groggy, feeling exhausted a lot. The upped T4 I think has maybe given me more energy during the day but I’m having slumps of energy and look tired a lot. My iron levels were also low at this time and I’m on iron tablets via Gp however have always had low iron issues.

Was this dose change a bad idea? My Endo suggested it, however starting to wonder if it was even a good idea. Also, after I take my dose of T3 5mcg which I take in the afternoon around 3pm, I feel a slump a few hours after and feel completely wiped. Not sure if this has any relevance but it’s interesting and doesn’t make me feel very good.

Any advice would be very helpful, I don’t see Endo until May but no doubt due to current situation this will be postponed. My Gp is saying I can’t have thyroid and iron bloods until lockdown has settled but I might go back to him and say I’m still feeling rubbish as he did say to do this if no better. It would be helpful to have some opinions from you as I know you are very helpful and knowledgable on these issues,

Thanks for any advice ☺️

[SlowDragon Administrator]

Seems an odd idea to take T3 in afternoon...

Is your levothyroxine same brand that you always have?

Suggest you get full thyroid and vitamin testing via Medichecks or Blue Horizon

TSH, FT4 and FT3 tested. Also EXTREMELY important to test vitamin D, folate, ferritin and B12 regularly

Recommended on here that all thyroid blood tests should ideally be done as early as possible in morning and before eating or drinking anything other than water .

Last dose of Levothyroxine 24 hours prior to blood test. (taking delayed dose immediately after blood draw).

If/when also on T3, make sure to take last dose 8-12 hours prior to test, even if this means adjusting time or splitting of dose day before test

Is this how you do your tests?

thyroiduk.org.uk/tuk/testin...

For thyroid including antibodies and vitamins

Medichecks Thyroid plus ultra vitamin or Blue Horizon Thyroid plus eleven are the most popular choice. DIY finger prick test or option to pay extra for private blood draw. Both companies often have special offers, Medichecks usually have offers on Thursdays, Blue Horizon its more random

[mistygrey in reply to SlowDragon]

Thanks for your reply.

I think with more persuasion my Gp may give me bloods I have to ring him back and let him know I’m still now feeling great.

Yes it’s the Henning lactose free brand of Levothyroxine I’ve been on for a few years now.

I know, I’m not sure why Endo suggested t3 in afternoon I don’t think it’s doing me much good taking it then.

My previous results show I can do with increases but the 100 t4 and 5 t3 I’m just not sure is working great. I don’t want to go back down to 75 t4 and 5 t3 incase I then got hypo again.

[SlowDragon Administrator in reply to mistygrey]

As you have Hashimoto’s are you on strictly gluten free diet? Lactose free too?

What vitamin supplements are you currently taking?

See from other posts you are having B12 injections

What were last vitamin D, folate and ferritin results?

[mistygrey in reply to SlowDragon]

Hi

Yes I’m gluten and lactose free and Hashimotos. My thyroid meds are also lactose free. I’m on b12 injections just had loading doses about a month ago then have 8 weeks to wait until next injection.

My folate was 11.8 vitamin d wasn’t tested but I’ve been on vitamin d high supplement for a long time. I’m taking ferrous fumarate daily, vitamin d, Cod liver oil and was taking folic acid small dose during the loading doses of b12.

[mistygrey in reply to SlowDragon]

I managed to get bloods tomorrow at my Gp, I’ve had my last T4 dose at 730 am today.

My T3 is due anytime now what time is best to take it? My bloods are at 8.40am.

Many thanks

[SlowDragon Administrator in reply to mistygrey]

I would take last dose T3 twelve hours before blood test

[mistygrey in reply to SlowDragon]

Thanks for your help ☺️

[SlowDragon Administrator]

Have you done Dio2 gene test?

thyroiduk.org/tuk/testing/D...

If you have Dio2 gene variation you would likely need higher dose T3 split into 2 or 3 doses per day

You may need that anyway

[mistygrey]

Thank you both