Advice with labs

[West99]

I've recently had some updated bloods and I'm not sure what to tweak. I'm currently on 100mg levo and 25mg of Tiromel. My Ft3 and Ft4 seem to have dropped significantly since my last tests in August. I have been feeling anxious and more fatigue than previous. I understand the change in season usually brings a change in levels, but I was surprised at the considerable difference in FT4.

[NWA6]

I think I’d try a Levo increase first

[SeasideSusie Remembering]

West99

I am on Levo plus T3 and if those were my results I'd be very unwell, probably bedbound, so I would be increasing Levo. This will increase your low FT4 level and depending on how much natural conversion you have your FT3 should increase as well.

On combination hormone replacement where we need our FT4 and FT3 is very individual, some are fine with a low FT4 as long as thre is a good level of FT3, others (like me) need a higher FT4, I need both FT4 and FT3 in the upper part of their ranges, somewhere around 70% seems to be right for me.

Personally I would take it slowly, increase Levo by 12.5mcg initially and see what that achieves. Leave at least 6-8 weeks before retesting. I always leave 8 weeks but can still feel a difference at 10 weeks so it does take some time for levels to stabilise.

Are your nutrient levels optimal:

Vit D - 100-150nmol/L

B12 - top of range

Folate - at least half way through range

Ferritin - half way through range