Hi all, I wanted to check my results to see what people think. I’m on 100mcg T4 and 5mcg Liothyronine T3 daily my recent results are below. I’ve been feeling extremely wiped out and breathless on occasions. My iron levels are fine I had them done also. Do my thyroid levels look like there is room for improvement? I am not sure what to increase if anything, higher doses of T3 did give me palps for some reason. Thanks for any advice given.
FT4 16 range 9-21
FT3 4.3 range 2.4-6
TSH 0.55 range 0.2-4.5
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mistygrey
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Was this 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 T3 approx 8-12 hours before test
Result suggests under medicated
Please add most recent vitamin D, folate, ferritin and B12 results
Have you tried adding 2nd 5mcg dose T3 approx 10-12 hours after first dose?
Approx how much do you weigh in kilo
Guidelines on dose levothyroxine by weight is approx 1.6mcg levothyroxine per kilo per day when on LEVOTHYROXINE ALONE
Hi thank you for your reply. The bloods were done faster and I had my last dose of levothyroxine 24 hrs before as you mentioned and last dose of T3 was 5pm the day before.
I am 12 stones in weight. What would be best to increase if I am under medicated, I remember on higher doses of T3 I felt palps so I am not sure if that’s going to work but I am open to trying whatever would be best. Not due to see my consultant until end of Nov now. Thank you
Hardly surprising as 75mcg is only one step up from starter dose
What were your results on just 75mcg levothyroxine
guidelines on dose levothyroxine by weight
Even if we frequently don’t start on full replacement dose, most people need to increase levothyroxine dose slowly upwards in 25mcg steps (retesting 6-8 weeks after each increase) until eventually on, or near full replacement dose
Consider starting levothyroxine at a dosage of 1.6 micrograms per kilogram of body weight per day (rounded to the nearest 25 micrograms) for adults under 65 with primary hypothyroidism and no history of cardiovascular disease.
Traditionally we have tended to start patients on a low dose of levothyroxine and titrate it up over a period of months. RCT evidence suggests that for the majority of patients this is not necessary and may waste resources.
For patients aged >60y or with ischaemic heart disease, start levothyroxine at 25–50μg daily and titrate up every 3 to 6 weeks as tolerated.
For ALL other patients start at full replacement dose. For most this will equate to 1.6 μg/kg/day (approximately 100μg for a 60kg woman and 125μg for a 75kg man).
If you are starting treatment for subclinical hypothyroidism, this article advises starting at a dose close to the full treatment dose on the basis that it is difficult to assess symptom response unless a therapeutic dose has been trialled.
Hi thanks for this, currently I am on 100mcg T4 and 5 much t3 so what would be the best increase in dose for that dosage? 75mcg was my previous dose a year ago and I’m not on that dose now. Thank you
I have been feeling exhausted lately but I also have rheumatoid arthritis so it’s hard to know between the two what’s causing what. But my results for my thyroid do look like there is some room for improvement, I’m just not sure what dose to try or if it’s worth trying a dose change. I am gluten free and dairy free, I also get b12 injections and take vitamin D. My ferritin wasn’t too low on the recent test it is usually much lower so I had thought the iron maybe was low but it didn’t look to be recently.
Hi I had the bloods taken fasted first thing in the morning around 8 am. Last dose of T4 is as the day before at 8 am last dose of T3 was at 5pm day before
So there was a gap of 15 hours so your FT3 is a false low. If it was me, I would try an increase in Levo first, perhaps 12.5 mcg and see how you feel then. That will raise both your FT4 and FT3. It’s all trial and error unfortunately.
Thank you. Yes you are right, I think that’s great advice and I did think that might be a good starting point increasing the T4 by 12.5 as my T4 pills are 25mcg already so the 12.5 would be easy to do but just splitting the pill. Thank you for your advice
Well, as far as most info I’ve seen, T3 peaks in the blood about 6 hours after taking it so 12 hours seems to be the longest you should leave before a blood test. Of course, consistency is the key. I’m no medic, only passing on my own understanding 🙂SlowDragon will be more knowledgeable than me to answer your question.
I’m afraid I can’t answer that. Everyone is different. All you can do is try, see how you feel and get your bloods done in 6/8 weeks and go from there. Good luck.
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