New test results on T4/T3 and not sure what to do next

[Smorzando]

Hello,

I've just got back my MMH test results after 8 weeks on my increased dose.

Previously, these were my results, which were on 75mcg Levo (Mercury Pharma) and 10mcg Lio (Morningside)

TSH 1.34 (0.35-5)

FT4 12.6 (9-21) 30% range

TOTAL T3 1.5 (0.9-2.5) 37.5% range but Total, not Free T3

Following this my endo increased my levo dose to 100mcg daily and kept my T3 at 10mcg. I requested to change my Levo prescription to Teva as I am mildly lactose intolerant.

Today's results:

TSH 0.12 (0.27-4.2)

FT4 20.6 (12-22) 86% range

FT3 5.4 (3.1-6.8) 62.16% range

It would seem that I am absorbing Teva levo rather better than Mercury Pharma, as that's a big jump for just a 25mcg increase! Obviously I can't really compare the T3 results, unfortunately.

Sypmtom wise I felt pretty bad on the 75/10, no better than on Levo alone, to be honest. After increasing to 100/10 I did have a noticeable improvement - I had a lot more energy, was less achey and stiff, and was able to do more - simple things such as walk to the shop and back without needing to lie down for several hours to recover!

However, I would not say I felt 'optimal' (whatever that is!) and in the last week or so I have been feeling worse again - very tired, needing to go to bed in the afternoon, insanely cold feet etc.

When last tested my nutrient levels were good and I have been continuing to supplement.

I do have the DIO2 gene polymorphism.

The Monitor My Health results say I'm showing 'subclinical hyperthyroidism' because of the low TSH - I know this is nonsense, of course. I have an NHS test booked for next week though, so I'm preparing myself my GP will freak out about this.

Could anyone suggest what I could do next in terms of a dose change? I need to make an appointment with my endo but I'd like to have some ideas ☺️

I'm thinking possibly reducing Levo slightly, and maybe requesting Lactose free T3 - only problem is that only comes in 20mcg tablets.

Suggestions and comments more than welcome ☺️

[Lotika]

I think those numbers look good!

I suppose if they were mine and I’d gone from feeling better initially to worse during the latest dose change, I would be wondering about splitting pills so as to try around 88.5 mcg of levo... Just wonder if it’s gone beyond your personal optimal? May also raise TSH a fraction to keep the doctor smiling? It’s so hard to say, isn’t it?

Still, I do like seeing other people’s numbers and comments on them!

[Smorzando in reply to Lotika]

I like seeing other people's numbers too! ☺️I agree, the numbers look good - in fact that's what I've been a little worried about - along the lines of 'is this as good as it gets?'. But I still think there is tweaking to be done - just not terribly sure in what way, and the lactose issue may be complicating things somewhat...

[Lotika in reply to Smorzando]

Agreed that the lactose thing is worth trying with the T3! Pill cutter and rock! I suppose that means that you are technically changing two things at once, mind!

Don’t worry that the results look good to me - red herring! Def not as good as it gets either. I think it takes an awful lot of tinkering but that it will get better! Just that there are lots of variables. What does your gut say to try next? I think gut is quite useful as some kind of 6 the sense!

[Smorzando in reply to Lotika]

Thanks! I agree that listening to the gut is useful. Currently, my gut is telling me that I am extremely bloated 🤪It's annoying that I can't just get on with it myself. My GP surgery has insisted on a blood test there, so that's booked for next week and obviously we'll need to see what that says - and no doubt they'll have their own opinion, given the likely under-range TSH. And then I really need to get another appointment with the (private) endo for her opinion, given that she's basically in charge of the prescriptions. But worth it in the long run, I hope. It is good I have felt a fair bit better since the last dose increase, so hopefully I'm on the right track ☺️

Endo did say at my first appointment that I would likely need several 'tweaks' over the first year, I guess she was right!

[Lotika in reply to Smorzando]

Ha ha - maybe gut is complaining about T3 brand! Agreed, I also sometimes think it would be easier without the medics and sometimes I’m not so sure. Such a minefield and “trial”!!

[greygoose]

If those were my numbers, I'd be wanting to increase the T3.

[Smorzando in reply to greygoose]

Thanks Greygoose, I appreciate your thoughts. I'm wondering, though, if switching to a lactose free T3 tablet might make a difference, given how much my T4 increased when taking only 25mcg more. It's frustratingly slow to make all these tiny changes! - let alone having to get the approval of a doctor, prescriptions written and fulfilled... etc etc.. (Yes, I know one needs to learn a bit of patience when it comes to thyroid management... 😬)

[greygoose in reply to Smorzando]

Is there such a thing as lactose-free T3? I really don't know. But, certainly worth a try if you can get it.

[Smorzando in reply to greygoose]

Well, Teva make a T3 20mcg tablet as far as I know and I seem to remember reading that it was lactose-free.... I'd better try and find out! Do you think a reduction in levo is a good idea? given that I'm pretty high in range? Or is it very much 'one thing at a time'.... 🤔

[greygoose in reply to Smorzando]

Hmmm... I'm rather suspicious of that FT4 result, anyway. How long a gap did you leave between your last dose of levo and the blood draw?

[Smorzando in reply to greygoose]

Bang on 24 hours!The T3 I split the dose the day previously - 5mcg at 8am together with my levo, 5mcg at 8pm and test done at 8am the next day.

[greygoose in reply to Smorzando]

OK, well, if your FT3 increases, your FT4 could decrease, anyway. And, you only want to make one change at a time. So, I would leave the levo dose where it is and start taking the lactose-free T3, and see what happens on your next test, and adjust from there.

[Smorzando in reply to greygoose]

Thank you. I'll put that to my endo and see what she says.

[greygoose in reply to Smorzando]

You're welcome.