I like both free T4 and free T3 to be quite high - so yes, I'd try and get another 25 mcg a day of levo (assuming nutrients are all good). Do you spread out your T3 across the day?
Looking at your post from 3 months ago, on 100mcg Levo your FT4 was 18.8 (12-22).
Considering that adding T3 tends to lower FT4, I don't think it was necessary to reduce your Levo dose when adding T3. It's a shame that a lot of doctors really don't understand how to dose with T3 and what it actually does.
Looking at the massive reduction in your FT4 level, I'd be putting my Levo dose up immediately.
I'm another one who's on combination hormone replacement and I need both FT4 and FT3 around 60-70% through range.
Hashimoto's affects the gut and leads to low stomach acid and then low vitamin levels
Low vitamin levels affect Thyroid hormone working
Poor gut function can lead leaky gut (literally holes in gut wall) this can cause food intolerances. Most common by far is gluten. Dairy is second most common.
According to Izabella Wentz the Thyroid Pharmacist approx 5% with Hashimoto's are coeliac, but over 80% find gluten free diet helps, sometimes significantly. Either due to direct gluten intolerance (no test available) or due to leaky gut and gluten causing molecular mimicry (see Amy Myers link)
Changing to a strictly gluten free diet may help reduce symptoms, help gut heal and slowly lower TPO antibodies
While still eating high gluten diet ask GP for coeliac blood test first or buy test online for under £20, just to rule it out first
The predominance of Hashimoto thyroiditis represents an interesting finding, since it has been indirectly confirmed by an Italian study, showing that autoimmune thyroid disease is a risk factor for the evolution towards NCGS in a group of patients with minimal duodenal inflammation. On these bases, an autoimmune stigma in NCGS is strongly supported
In summary, whereas it is not yet clear whether a gluten free diet can prevent autoimmune diseases, it is worth mentioning that HT patients with or without CD benefit from a diet low in gluten as far as the progression and the potential disease complications are concerned
Despite the fact that 5-10% of patients have Celiac disease, in my experience and in the experience of many other physicians, at least 80% + of patients with Hashimoto's who go gluten-free notice a reduction in their symptoms almost immediately.
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