How much levothyroxine to add please?

[A2C3]

Hi, I have posted about this a few times and got some great advice which I am working on thank you. I have decided I want to try a slight increase in levothyroxine to try increase my FT3. My endocrinologist wants to wait 2 months for a review but I really want to try an increase to see if it helps my aching legs muscles and joints. I am currently on 125mcg daily and have been on this for 7 weeks, so would an increase of just 12.5mcg daily be reasonable? Thanks for any comments in advance!

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)

[SeasideSusie Remembering]

A2C3

Obbiously it's your choice but personally I'd wait a bit longer, some of us need longer than the 6-8 weeks usually mentioned for levels to settle. I tend to test around the 7-8 week mark after a dose change. I tweaked my dose on 11th May, retested on 5th July and saw the expected change in results, but am feeling better now 3 weeks later than I did then, so don't rule out waiting 3 months to feel the full effects of a dose change.

When you posted your results a couple of weeks ago your Vit D had reduced to 87nmol/L, are you working on improving this? This could be contributing to your muscle and joint aches.

If you are going to increase your dose of Levo, I'd only increase by 6.25mcg. You are at the top of the range already, it's suprising what a very small increase can do at these levels.

[A2C3 in reply to SeasideSusie]

Hi Susie, I am thinking about adding what you suggested to my daily dose of 125mcg but I only have 100 and 25 tablets and struggling to work out the best way to get the 6.25mcg daily increase consistently - any advice is appreciated thanks in advance.

[SeasideSusie Remembering in reply to A2C3]

A2C3

1) Cut the 25mcg tablet into quarters with a pill cutter or craft scalpel = 6.25mcg which you can add daily

or

2) Cut the 25mcg tablet in half and take the half on alternate days = averaging the extra 6.25mcg daily

or

3) Take the 25mcg tablet every 4th day, that will require you to keep an accurate record of when you take it

(1) or (2) would be my choice.

[A2C3 in reply to SeasideSusie]

Thank you very much Susie. I have a private blood test I’m going to do tomorrow so might wait for results then make a decision! Thanks again!

[A2C3]

Thanks so much! Okay I think I will consider waiting!

Yeah I’m taking 2000 IU daily thanks to your recommendation, I take the spray.

I just want to be able to exercise and walk comfortably but this is really restricting me! When I first started on levothyroxine I had a few really good spells after dose changes where I was able to run! I feel like I’m getting worse not better in this respect!

Thanks for replying 😀

[fuchsia-pink]

If it were me, I'd be asking the endo about a trial of lio when you next see him/her ... your free T4 is almost at the top of the lab range while free T3 is only just over half-way (55.75%) - and you don't feel tip-top. So it seems likely that free T4 will need to go quite a lot over-range before free T3 is say 3/4 through range ...

A lot of endos are resistant, but the whole point of lio is to make people who are "poor converters" and can't get their free T3 high enough just on levo properly well.

[A2C3 in reply to fuchsia-pink]

Thanks for your reply I was trying to avoid T3 but like you say I might have to consider it after I’ve waited 2 months to see if anything improves. I might post and see if anyone has been successful getting T3 from my endocrinologist he is on the thyroid uk list so hopefully he will consider this option eventually! Thanks for replying it means a lot!