The fluctuations in free T3 are a bit weird - but free T4 is consistently too low for someone on levo-only. So I'd say she definitely needs at least another dose increase of levo initially ...
It's to be hoped that an endo won't be too TSH-focused - actually I don't know why I wrote that as sadly they so often are - but I'd ask her to list out her hypo symptoms on her current level of meds to take with her and if possible can someone accompany her to the endo? - it's so useful to have someone else remember things that you the patient forget an have a third party say how you're not propely "you" and what was better before
Wired I am 65 and have spent the last 2 years on levo and lio. Taken me 2 years to adjust both doses to get a big improvement in symptoms. Below is the evidence I used with an NHS endo to get my trial of T3. I had it prepared and handed it to her.
This is a great example! I would even email it in advance so the secretary has attached it to your records then the doctor can’t dismiss it or fob you off.
Her ferritin is still low, but improving from last test in January
Eating iron rich foods like liver or liver pate once a week plus other red meat, pumpkin seeds and dark chocolate, plus daily orange juice or other vitamin C rich drink can help improve iron absorption
This is interesting because I have noticed that many patients with Hashimoto’s disease and hypothyroidism, start to feel worse when their ferritin drops below 80 and usually there is hair loss when it drops below 50.
I wonder if variation/drop in Ft3 is because she recently had B12 injection
Though conversion often gets worse with low TSH
Might consider trying splitting levothyroxine into 2 smaller doses per day, waking and bedtime. Might increase TSH, but obviously it’s more to remember
Or ask Endo to trial liquid levothyroxine. This can improve TSH
if a patient is persistently symptomatic after switching levothyroxine products, whether they are biochemically euthyroid or have evidence of abnormal thyroid function, consider consistently prescribing a specific levothyroxine product known to be well tolerated by the patient
if symptoms or poor control of thyroid function persist despite adhering to a specific product, consider prescribing levothyroxine in an oral solution formulation
Content on HealthUnlocked does not replace the relationship between you and doctors or other healthcare professionals nor the advice you receive from them.
Never delay seeking advice or dialling emergency services because of something that you have read on HealthUnlocked.
Advice on latest blood tests please 
Blood test results - advice please
Blood Test advice required please 
Blood test results and supplementing advice please
Advice on Blood Test Results Please
