Thank you for taking the time to read my post. I need your advice after a dose increase.
6weeks ago I increased from T4 75/100mcg alternate days + T3 10mcg to T4 100mcg + T3 10mcg. Since doing so I have gradually developed a permanent sore head, brain fog and upset tummy. Is this something that is likely to go if I persevere for another few weeks?
My results from October 2021 on T4 75/100 alternate days + T3 10mcg are:
T4 14.08 (12-22 pmol/L)
T3 5.08 (2.8-7.1 pmol/L)
TSH 0.11 (0.27-4.2mlU/L)
Vit D 51.74 31-100ng/mL Normal
Vit B12 536.9 (197-866pg/ml)
Ferritin 52.48 (15-150ng/mL)
Folate 28.12 >12.19nmol/L Deficient < 7.63nmol/L
Cortisol AM 14.2 (Serum 7-9am 5.27-22.45)
Many thanks everyone.
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LynLyn
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Well there's plenty of space in your results for the dose increase, and it's not a big one, so I'm not sure why you're struggling. In your place, I think I'd try splitting the levo into 2 doses to see if that suits you better.
and I'll tag SeasideSusie as your nutrients look low to me - I'd say you really need vit D in 3 figures an ferritin higher, but she is the Nutrients Queen so follow her always-excellent advice !
It might be worth doing another test in 2 or 3 weeks to see what difference the dose increase has made. There may be room to add more Levo.
Did you have a brand change when you increased the dose? Just wondering if you've had a new brand and it's causing problems.
Vit D 51.74 31-100ng/mL Normal
Are you in Scotland? Most of the UK has nmol/L as the unit of measurement but I think I've seen ng/ml when the member is in Scotland.
The Vit D Society and Grassroots Health both recommend a level of 40-60ng/ml (or 100-150nmol/L) with a recent blog post on Grassroots Health recommending at least 50ng/ml (125nmol/L). So your level is just about right but it may not hurt to get it up to 60ng/ml.
Vit B12 536.9 (197-866pg/ml)
According to an extract from the book, "Could it be B12?" by Sally M. Pacholok:
"We believe that the 'normal' serum B12 threshold needs to be raised from 200 pg/ml to at least 450 pg/ml because deficiencies begin to appear in the cerebrospinal fluid below 550".
"For brain and nervous system health and prevention of disease in older adults, serum B12 levels should be maintained near or above 1000 pg/ml."
So you're not quite at the minimum level recommended and might want to consider supplementing to get it up to the top of the range. I don't think your level is bad enough for a separate B12 supplement, I'd suggest going for a good quality bioavailable B Complex. My preference is Thorne Basic B. If you look at different brands then look for the words "bioavailable" or "bioactive" and ensure they contain methylcobalamin (not cyanocobalamin) and methylfolate (not folic acid). Avoid any that contain Vit C as this stops the body from using the B12. Vit C and B12 need to be taken 2 hours apart.
When taking a B Complex we should leave this off for 3-7 days before any blood test because it contains biotin and this gives false results when biotin is used in the testing procedure (which most labs do).
Folate 28.12 >12.19nmol/L Deficient < 7.63nmol/L
This is OK. The B Complex will likely raise your level but as B vitamins are water soluble you will excrete any excess your body doesn't require.
Ferritin 52.48 (15-150ng/mL)
This is on the low side. Ferritin is recommended to be half way through range although some experts say the optimal level for thyroid function is 90-110.
You can help raise your level by eating liver regularly, maximum 200g per week due to it's high Vit A content, also liver pate, black pudding, and including lots of iron rich foods in your diet
Don't consider taking an iron supplement unless you do an iron panel, if you already have a decent level of serum iron and a good saturation percentage then taking iron tablets can push your iron level even higher, too much iron is as bad as too little.
Cortisol AM 14.2 (Serum 7-9am 5.27-22.45)
I'm not familiar with serum cortisol tests and, of course, it depends what time you did the test as to whether that range is appropriate.
SeasideSusie thank you so much for all your great advice.I’ll keep working on the vitamin levels. I haven’t had a brand change so I’ll keep going and test again soon. It’s probably just me needing more time for things to settle. Many thanks for everything.
But if you're not in the UK now LynLyn, test result ranges and medication brands will be different to those we have in the UK. So it's more helpful if you put your current location on your profile. Unless you're only in the US on holiday or short term visit of course
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!
Very Low TSH but symptoms much better. 
Advice welcome on t3 dose
T4/T3 advice for ongoing symptoms?
