Advice on latest results please!!

[Molly161018]

Hello friends!! Just looking for some advice on my latest results...

I have recently added Tiromel (T3) to my levo and have definitely felt better, but do also feel there may be a bit further to go...my energy is definitely better generally, but I have noticed my hair has been falling out and I have also been quite emotional of late, both of which have happened in the past when my thyroxine has needed increasing...

Looking at the results below I think I have scope to increase my thyroxine as it is quite low in the range. Not sure about T3 though, whether it would be worth looking at this too?

I am currently on 100mcg levo and 18.75mcg lio.

Inflammation:

CRP HS 1.15 mg/L (< 5)

Iron Status:

Ferritin 98.5 ug/L (13 - 150)

Vitamins:

Folate - Serum 6.69 ug/L (> 3.89)

Vitamin B12 - Active 113.000 pmol/L (>37.5)

Vitamin D 137 nmol/L (50 - 175)

Thyroid Hormones:

TSH X 0.15 mIU/L (0.27 - 4.2)

Free T3 5.82 pmol/L (3.1 - 6.8)

Free Thyroxine 15.100 pmol/L (12 - 22)

Autoimmunity:

Thyroglobulin Antibodies 19.100 kIU/L (< 115)

Thyroid Peroxidase Antibodies X 39.8 kIU/L (< 34)

Look forward to replies from this very kind and wise community!! 🤗

[NWA6]

I’m assuming that you added T3 because you have difficulty converting Levo? If so I think I’d be looking at adding more T3 rather than increasing Levo as your FT4 result is ok for someone on combo treatment.

Your FT3 is 73% through range and so there is room to add more. I’m on 20mcg T3 and my through range is about 90%. This is what suits me, it’s my optimal.

When my through range was around 70% I felt really well (it was a huge leap from 0% through range as you can imagine) but there were a couple of issues that I thought I could address with more T3. I was correct and adding that extra 5mcg took me to optimal treatment. My sweet spot was found 🤗

[Molly161018 in reply to NWA6]

MT for your reply!

Yes I had consistently low T3 levels even though my T4 ended up above the range at one point, so I clearly have conversion issues when on T4 only.

I tried to find the online calculator for the % through the range, but couldn't, so thanks for doing the calcs for me! I wasn't sure if there was scope to increase T3 or not, so your experience is helpful.

I'm glad you have found your sweet spot!! I'm hoping mine isn't too far away too!!

[SeasideSusie Remembering]

Molly16108

Everyone's experience is different as to where they need the individual hormone levels to be, so nobody can say that either of your levels is OK for someone on combination therapy, they can only say what is right for them.

Here is the calculator chorobytarczycy.eu/kalkulator

Your FT3 is 73.51% through range.

Your FT4 is 31% through range.

For me, that FT4 level would be making me ill regardless of the FT3 level. I personally need both to be fairly well balanced, somewhere between 60-70% through range.

So you need to find your own optimal levels and it can take many months of tweaking and testing and observation.

With those results I wouldn't be increasing T3, I would be increasing Levo to get my FT4 level up, which would also increase FT3 level depending on how much natural conversion you have.

Looking at your previous posts, it was 25th March that you were asking for a supplier, so you've probably only been taking T3 for a maximum of 2 months. Just as a comparison, it took me about 2 years of tweaking to find my optimal doses, I went as high as 31.25mcg T3 at one time, but have settled on 12.5mcg daily with the right amount of Levo to give me my optimal levels.

but I have noticed my hair has been falling out and I have also been quite emotional of late, both of which have happened in the past when my thyroxine has needed increasing...

Looking at the results below I think I have scope to increase my thyroxine as it is quite low in the range.

I think you are spot on with these comments so I would go with your instinct and increase your Levo. You could try 12.5mcg to start with, it doesn't have to be 25mcg.

Remember to leave 6-8 weeks after any dose change before retesting, I find I need 8 weeks for everything to settle down.

[Molly161018 in reply to SeasideSusie]

Thank you for your helpful reply, as always SeasideSusie! Your point about increasing T4 dose and this in turn increasing T3 is very valid.

I think I will try increasing my T4, as you suggest and see what effect this has. I thought I had read somewhere that a lot of people still need T4 fairly high in the range, so perhaps I'm one of these...

Thanks again!