Please could I have some advice?

[Mollyfan]

I have Hashimotos and am heterozygous for the abnormal DIO2 gene. I have been on levothyroxine 125 mcg and liothyronine 10mcg at 7am and 12 pm for about 4 months.

I feel a lot better than I did, but still lethargic and gaining weight. Nails and cholesterol massively improved.

Given the attached results, please could I have some advice from you lovely lot about...should I worry about my TSH going any lower? Should I increase my T4 or increase my T3?

I would be OK staying as I am but do not yet think I am at my best!

Thank you.

[tattybogle]

my TSH is usually lower than that , and has been for many years (although ,weirdly, it's now 1.8 for no obvious reason) I was concerned about low TSH, so looked up loads of research , and found a big long term study which found that the 'risk's to heart and bones associated with low TSH don't start until TSH is below 0.04 ... mine was usually around 0.05 /0,09.. so i 'm not concerned about it.

The risks for TSH 0.04 -0.4 were no greater than the risks for TSH 0.4 to 4 ... and to put that in perspective .. the risks associated with TSH below 0.04 were still lower than the risks associated with TSH above 4 ... and we don't hear many doctors worrying about TSH over 4 do we.. NICE guidelines say it's fine to wait until its over 10 before treating them.

Link to study is in these, (plus other useful stuff)

healthunlocked.com/thyroidu... /risks-of-suppressed-tsh-analysis?

healthunlocked.com/thyroidu... /tsh-and-the-more-mature

healthunlocked.com/thyroidu... dangers-of-suppressed-tsh?

[Mollyfan in reply to tattybogle]

Thank you, that’s really helpful!

[SlowDragon Administrator]

As you have Hashimoto’s and Dio2 are you on absolutely strictly gluten free diet

If not get coeliac blood test done BEFORE considering trial on strictly gluten free diet

When were vitamin D, folate, ferritin and B12 last tested

What vitamin supplements are you currently taking

Perhaps discuss with endo, a SMALL dose increase in levothyroxine. 125mcg and 150mcg alternate days. Or 150mcg twice week

Or consider adding 3rd 5mcg dose T3. Taking 3 doses per day at roughly equal 8 hour intervals

Only try increasing T3 or levothyroxine NOT both

[Mollyfan in reply to SlowDragon]

Thank you!I have checked for coeliac and have been gluten free for a couple of month... so far no noticeable change.

Vitamins attached..... my ferritin is a bit high, rather than low.

I currently take the folate advised in here and vitamin D 5000 IU/ day so level should be higher than it was on the last test.

I am tempted to see what a small increase in levo would do so thank you for that suggestion!