I hope this rise sorts out symptoms but if not, then I'd write all symptoms down and consider if they could be related to other factors.
It's often very difficult to differentiate which is why thyroid disease is so tricky to manage. But you could ask for further tests re. Vitamin levels, iron levels and other potential antibodies so it doesn't mean you have to live with symptoms.
Have you ruled out side effects from other medication and ruled out side effects from the levothyroxine excipients?
Probably the last person to understand why you need what you need is an endo! Most of them are diabetes specialists, who think thyroid is easy - well, they way they practice it, it is! But, they have no concept of the complications, variables and individual needs of patients. Could be several reasons why he said that, all of them suspect, but the bottom line is: he just doesn't care whether you get well or not. Sad reality.
He was recommended to me on this forum and his accolades suggest he would know better and should be more than just diabetes. But agree, and it’s maddening.
It’s just so odd. What harm is it to him if I try a higher dose?! I know what feeling hyper feels like - I had it on T4 and it’s part of the reason I got referred. I wouldn’t choose to feel hyper would I?!!! So odd.
That's something I don't understand, either. The way they behave, you'd think the price of your hormone was coming out of their personel pocket. They hate increasing doses, whereas with antidepressants they can't wait to increase it! Actually, I think they hate prescribing it at all!
You should notify admin with the name of that doctor, if he came from the list of supposedly good endos, so that he doesn't get to sabotage anyone else's treatment!
Your endo doesn't sound clued up on thyroid disease! He sounds as if he is on a power trip threatening to restrict T3....probably trying to reduce his drugs bill. T3 is very expensive in the UK!
How much levo are you taking with the T3?
You have room to increase your levo dose, but only change one thing at a time. More levo should increase FT3 unless conversion is very poor
Edit, just found this
Current results on 112.5mcg T4/15mcg T3
TSH 0.33 (0.27-4.20)
T4 16.0 (11-26)
T3 4.5 (3.9-6.8)
Have you optimised vit D, vit B12, folate and ferritin to support thyroid function/conversion?
Do you feel a benefit from 20mcg T3?
Have you considered taking it in a single dose. Some of us do this at bedtime.
You are actually lucky to be prescribed any T3....many of us have to source our own. Many have had their prescription withdrawn.
"IRRITATING" doesn't begin to describe the situation so many of us find ourselves....you are correct, we understand!
To keep me functioning ( alive even) I need at least 75mcg T3-only daily which I buy....and I'm far from alone. I had to self medicate to improve my health. Madness!
I cannot think of any other life threatening disease that is so badly managed by the people charged with " first do no harm"!
See how you get on with the extra 5mcg and optimal nutrients and re test in 6 weeks
By then you should have a better idea about what is going on and what you need to adjust
Post the new results - TSH, FT4, FT3, vit D, vit B12, folate, ferritin and antibodies.
I had T3 added as didn’t seem able to get my TSH below 1 on levo alone. Something seemed to be preventing it.
I am private so I’m paying for the drugs directly so nothing in his motivation from a cost perspective.
And yes vit d, b12 both high end optimal, folate middle and ferritin slightly below middle range. So they’re doing okay. I will test them again in a few months to ensure they’re continuing in same trend. Also gonna get B6 tested.
I’ve only been on 15mcg so far of T3 and have felt some benefits so far. I was getting terrible pins and needles which has been alleviated 75% ish but fatigue and brain acuity not so much. So hopefully the extra 5 will do it.
I don’t get it either. The care for thyroid is appalling in this country. I shall indeed try and be patient. Thanks again.
Oh I am sorry!! I really hope the extra 5mcg does the trick. I did wonder if this is going to be my endo’s attitude too?! I will see but I do expect same. That’s why you get such a short trial. Mine was 4 months. With 8 weeks wait in between blood tests it is hardly long enough to do more than one dose change. It surely comes down to cost 🙄. Fingers crossed this is just what you need 🤞🏻🤞🏻🤞🏻🤞🏻.
😱 then next you see he I would say ‘I will put your attitude down to you having a bad day the last time I saw you’ and carry on as if he hadn’t said it.
In the case of private medical doctors I have never felt that you get what you pay for 🙄 I am sorry you are having to pay for an awkward t*sser.
I just wanted to say that I hear you! I don’t think I have anything sensible much to offer, other than I think your idea of going it alone makes sense to me if it comes to it and I wonder if I’ll be going down that route too, as I can imagine being in a similar place in 5 weeks time.
It seems - in my case and perhaps in yours too - that adding LT3 lowers fT4, meaning we need more LT4 still to drag any of our frees over 50% through range, which then and produces the sort of TSH which causes endos to have heart attacks of their own, because we’re taking a lot of meds at that point. Grr.
Ah well. Onwards and upwards. I believe it is possible to source LT4 though the back door as it were. And it’s certainly been possible to stockpile over the years, admittedly more by accident than design, at first... I lost some, they replaced it, I found it. They changed dose from 100 mcg to 50 and I asked for 50 mcg tablets...! Given we now have two household members on levo, I think we can stockpile/lose packets of pills even more effectively going forward! It’s certainly utter chaos as to whose medication is whose, etc.
Anyway, take heart: I read from another forum member that their endo said 10 mcg doses means more T3 gets into the tissue, so that could be good. If not, then you’re an accomplished student of all things thyroid and I would back you to manage your condition more sensibly than the average endo And there’s plenty to try yet, dose increases, combo dosing with LT4/NDT, NDT, T3 only...
Thanks Lotika - always a reassuring word - it’s like having a virtual hug.
I just think back to when I was on thyroxine alone and I was best on 137.5mcg but my TSH at that point was still higher than 1, and my fT3 was low. When I went higher on levo I suspect I was producing more rT3 as the position worsened.
So now I feel like surely the best scenario would be 137.5 plus T3
I think you’re right re what happens. Odd isn’t it. I don’t get why they have a problem with it. I’ve done helvellas calculator spreadsheet and according some of those on T4 alone id be on a far higher dose.
Haha love your approach. I guess if I always order a tiny bit earlier each month now it’ll start building up lol.
Interesting re 10. I only saw him today but I started on 10 3 days ago. Just to see. And tbh not really noticed any difference 🤣🤣🤣 is it meant to be immediate? Although saying that I did feel like I’d been kick ass at my job this morning... maybe it’s one of those things you’ll notice over a slightly longer period.
I’d love to try NDT. That feels like a whole other challenge im not quite ready to face. This journey from 50mcg to where I am now has been hard enough. Still can’t believe that’s what they left me on, post RAI!!!! Maybe in a few years I’ll look into it.
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And there’s plenty to try yet, dose increases, combo dosing with LT4/NDT, NDT, T3 only... 
Ndt possible switch to t4 and t3
T4 T3 do you need both for improvements and recovery
Reduce t4 to increase t3? 
Advice T3 / T4
