What’s my next step here?

[Localhero]

So, after I posted last time, I took onboard some of the advice and tried T3 again. I began really slowly. Just 2.5mcg first thing in the morning for a week or so. Then added a further 2.5mcg mid afternoon. Held that for at least another week. I was noticing on this I had times when my energy felt better and times when it waned. In an attempt to achieve more consistency, I added a third dose of 2.5mcg and have been taking 7.5mcg a day, split 6am, 2pm and 10pm for the last two months. This is in addition to 100mcg levothyroxine 5 days a week and 125mcg 2 days.

I just had my most recent test results:

TSH 0.02 (0.27 - 4.2)

FT4 17.5 (12.0 - 22.0) 55%

FT3 5.7 (3.1 - 6.8) 70%

My ferritin, folate, Vit D and Vit B12 were all optimal last time I tested 3 months ago.

On the plus side I feel a marked improvement. My energy is generally a lot better than it was, certainly than earlier this year. I’m sleeping better. My weight has stabilised and people have remarked that I’m more buoyant. So long as life is even keel, I’m really not bad.

However, the least bit of exertion still floors me. Yesterday, for example, I did not even half an hour of very gentle yoga and this afternoon I’ve come to bed as I’m too whacked to do much else. This is worrying as I am hoping to return to work next month. I’m self employed, so have some control over it. But I haven’t worked for almost two years due to exhaustion and brain fog and I don’t want to start and then find I really can’t sustain it.

Also, I’m frightened to tinker with my meds as I feel I’ve done well to get to this point and don’t want to set myself back.

Thoughts?

[radd]

Localhero,

You have done really well & sounds like you are on the right road.

I know you said you don’t want to tinker with meds but you do still have room for a dose increase. As you are managing 70% FT3 on only 7.5mcg T3 meds this is great as shows you are a good converter. So if this were me I would be increasing Levo up to 125mcg and staying with 7.5mcg T3 and that should be your final dose.

Also look at the zinc, and mitochondrial supports (vit A, selenium, co-enzme10), liver supports (ie, Vit E, milk thistle). Unless you have an actually deficiency it is much easier to buy combos.

I would say it is your adrenals that are impairing your ability to sustain energy levels. Your previous cortisol levels weren't too bad but DHEA was low. You could add an adaptogen but as you are wary about further changes to the HPT/HPA axis, stick with the optimal thyroid hormone replacement dose for several more months and you should see a difference in stamina. Isabella Wentz gives good advice in link below.

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thyroidpharmacist.com/artic...

[Localhero in reply to radd]

Thanks radd

I did wonder if increasing the levothyroxine might help matters. Especially since FT4 has come down so much since I added the T3. I’m going to ponder this.

Thanks too for the supplement suggestions. I already take coQ10, magnesium and d-ribose for mitochondrial function, but not zinc or the others. Do you know a good combination one?

[Lalatoot]

It takes time for the body to recover. I would stick where you are at the mo and see what happens longer term.

[Localhero in reply to Lalatoot]

Thanks Lalatoot

How long would you give it before reviewing things?

[Lalatoot]

No time just when you think you need more oomph.

[SlowDragon Administrator]

Do you always get same brand levothyroxine at each prescription?

Was test done as early as possible in morning before eating or drinking anything other than water and last dose levothyroxine 24 hours before test

Last 2.5mcg dose T3 approx 8-12 hours before test

Assuming yes…..

Perhaps tweak levothyroxine dose up very slightly to 125mcg 2 days and 112.5mcg 5 days week = 812.5mcg per week

At moment taking 750mcg per week

How much do you weigh in kilo approx?

[Localhero in reply to SlowDragon]

Thanks SlowDragon

Yes to all the above.

I’m about 72kg right now vs my normal 64ish.

That’s a useful thought about a small tweak to Levo.

[JAmanda]

I began feeling more energetic when I got my T3 over 6.

[Localhero in reply to JAmanda]

That’s interesting. You take T3 also, right?

[JAmanda in reply to Localhero]

Yes. 1 to 4 ratio with levo.

[Localhero in reply to JAmanda]

Thanks. I do wonder if I’d tolerate more T3. My ratio is very different right now 😊

[ljk1]

Try vit B ! I take a complex one +500 B1-saw it on Isabella Wentz and it helped me!

[Localhero in reply to ljk1]

Thanks ljk1 I already take the Igennus Vit B recommended here. Is there a better one you’d recommend?