Advice please?

[A2C3]

Hi everyone. For the last 6 weeks I have been on 137.5mcg levothyroxine although my endocrinologist thinks I have stuck with 125mcg for the last 2 months. I have felt an improvement in my symptoms and I am meeting him on Friday and would really like to try 150mcg daily - but wanted to get peoples thoughts please on my bloods based on 137.mcg, thanks in advance for any replies.

[SeasideSusie Remembering]

A2C3

When did you take your last dose of Levo before the test? We always suggest last dose should be 24 hours before the test, taking it before the blood draw gives a false high FT4 result.

If you took your last dose 24 hours before the test then your results show your normal circulating hormone levels and it is unlikely that your endo will agree to an increase with an over range FT4. You may be asked to reduce your dose anyway due to suppressed TSH although we know that TSH shouldn't be used to determine dose changes.

[A2C3 in reply to SeasideSusie]

Yeah I took it 24 hours before. I am going to try and discuss with him the Dr Toft info about over range FT4 but normal FT3?

[SeasideSusie Remembering in reply to A2C3]

It's worth a try

[A2C3 in reply to SeasideSusie]

I think I have asked before but there seems no harm in over range FT4 if FT3 normal and TSH detectable? 🤷‍♀️

[SeasideSusie Remembering in reply to A2C3]

Dr Toft says this but your TSH is suppressed. Although it is detectable with this lab, another lab may not measure that low.

[A2C3 in reply to SeasideSusie]

Also if I went to 150mcg is it likely to push FT3 over range? After my previous 25mcg increase FT3 changed by 0.5 I think. So maybe not?

[SeasideSusie Remembering in reply to A2C3]

I have no way of knowing if it will take your FT3 over range. At 5.8 (3.1-6.8) it's 73% through range which is a good level so allowing for an over range FT4 being required to achieve a good FT3 level your current results do just that.

[A2C3 in reply to SeasideSusie]

Okay thank you. I might ask for just at increase to 137.5mcg and hope I feel better as time goes on! Thanks again for replying!

[JAmanda]

I think you’ll be lucky to get an increase as it will push your t4 over range - indeed you’ll probably have to fight to retain the current dose. Any chance your doc will allow a T3 trial to get your T3 over6 (many including me feel better there)?

Glad you’re beginning to feel better… but maybe be prepared to consider self sourcing additional t4 or T3 to keep you well or see further improvement.

[A2C3 in reply to JAmanda]

Had my appointment he has increased my T4 to 150mcg and then said after this if still symptomatic then possible T3 trial. Hopefully the 150 will do the trick x