Hi Everyone, as always I appreciate any responses that might come through. I posted last week and got some useful advice, I’m on 125mcg T4 and the endocrinologist wants to wait 2/3 months before my muscle and joint pain potentially reduces as he said it can take that long after medication is sorted. I keep wondering though with my results if I would not benefit from a slight increase in T4 like 12.5mcg, I want to avoid the T3 route if I can as it seems so difficult to get right. Results are as follows, again thanks in advance to anyone who replies.
FT4 97.50%
FT3 59.46% - I read some comments about Dr Toft suggesting 58% through range is required?
TSH 0.13 ml/L (0.3-4.5)
FT4 21.7 pmol/L (10-22)
FT3 5.3 pmol/L (3.1-6.8)
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The range is a guideline and it is written by Professor Toft that it is acceptable for a T4 to go slightly over range if this delivers a better level of T3 and relieves systems.
I wouldn't hang on to reaching a certain % target figure resolving your symptoms, we are all different and we need what we need to eliminate debilitating symptoms and feel well, and it does take time for thyroid hormone medication to bed in and resolve long term issues.
The accepted conversion ratio when on T4 only is said to be 1 / 3.50 - 4.50 T3/T4 : so if I divide your T3 into your T4 - I'm getting 4.10 so just a smidgeon over the middle of the range, and most people feel better when coming in at around 4 or under.
No thyroid hormone replacement works well until your ferritin, folate, B12 and vitamin D are maintained at optimal levels and conversion can also be reduced if living with any physiological stress ( emotional or physical ) inflammation, depression, dieting and ageing.
Please keep an open mind, regarding all thyroid hormone replacement options, if you need an additional, alternative option to relieve your symptoms it's worth a try, and you have an endo guiding you, so trust in the process is also important.
Thanks so much for replying. My vits and minerals are all okay with the exception of vit D and folate. From advice in here I’ve introduced 2,000IU Vit d this week and then I will start to add a Vit b complex next week.
TIBC - 58 umol/L (41-100)
Transferrin sat - 45% (20-100)
Ferritin - 132 ug/L (15-150)
Iron - 26 umol/L (5.8-60)
UIBC - 31.9 umol/L (24.2-125)
Folate - 13.5 nmol/L (8.83-45)
Active B12 - 116 pmol/L (37.5-300)
Total B12 - 766 pmol/L (145-569)
Vit D - 87 nmol/L (50-200)
I will be patient and wait the 2/3 months the endocrinologist has suggested and like you have. I also have quite bad PMS symptoms 3 out of 4 weeks of the month so my endocrinologist is speaking to a gynaecologist to get advice on that as I have seen no improvement since starting thyroid treatment but other symptoms have significantly improved.
I will try to keep an open mind about treatment and hope that in the future if I need T3 my endocrinologist will help.
These results are from a Thriva test and you haven't used the correct ranges. They have a very confusing way of showing their ranges on the graphic with the coloured bar. The reference range is the green part of the bar - light and dark green - ignore the orange parts because they are out of range, and you ignore what they say is "optimal" because they're generally nonsense.
You showed the pdf form of results with the correct ranges in your previous post here, and they were commented on
Hey thanks for replying. It’s hard to know which of my symptoms are PMS or thyroid. My main symptom that I’m still concerned about and I’m just guessing it is joint pain is like a burning deep throb sensation in my pelvis knees and feet especially at rest and especially in my pelvis when sitting. I had lots of pelvic girdle issues when pregnant caused by the surging progesterone, so I’m not sure if some of it is caused by surging progesterone and PMS as I am now very sensitive to progesterone I’ve tried the pill three times since being pregnant and the side effects are awful it gives all the symptoms of pregnancy along with pelvic girdle pain.
He said my TSH is detectable and frees high in range and to give it 2/3 months to see if last symptom goes then review.
I have posted all my vits and minerals in a post above and I’m working on Vit d and folate 👍🏻
Not sure if this answers your questions and thanks again for replying.
Good that you are now supplementing vit D and folate, hopefully as levels rise things might improve in timeIf not the addition of a little T3 might resolve issues.
I'm T3 only and it can be difficult to find your therapeutic dose but as a last resort it can make a huge difference
Yes, I self medicate. I have a form of thyroid hormone resistance and need a large dose. My GP knows what I'm doing.
Thyroid treatment can be a long, slow, frustrating journey but perseverance is the only way to go.
Don't worry unduly about TSH, it will fluctuate throughout the day.
FT3 is the important lab result.
As you will know T3 is the active thyroid hormone which is required by every cell in the body. For good health it is required in an adequate and constant supply....either from within the body or from replacement hormone. Approaching 75% through the ref range is a reasonable guide so at 59.46% you may benefit from more. Time will tell!
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Help me to get the right dose please.
Why would SMALL increase in T3 meds have caused fT3 to go DOWN a LOT and fT4 to also go DOWN? 
Increase needed but do I increase T4 or T3?
Latest blood test results 
FT4 and FT3 rising as well as TSH - confused!
