Increase in levo but free T3 going down? Recent bloods are baffling me.

[Moog77]

Ive recently increased from 50mcg to 100mcg of levothyroxine.

Recent results are:

8/12/2021 - after 6 weeks on 75ncg

Tsh - 2.41 (0.27 - 4 2)

Free t3 - 4.11 (3.1 - 6.8)

Free T4 - 16 (12 - 22)

31/01/2022 - after 7 weeks on 100mcg

Tsh - 0.92 (0.27 - 4.2)

Free t3 - 3 88 (3.1 - 6 8)

Free t4 - 17.7 (12 - 22)

Folate - 6.95 >3.89

Ferritin - 54 (13 - 150)

Vit D - 70.4 (50 - 200)

B12 - 83 1 (37.5 - 188)

I know my vitamins need some work but is it time to look at some t3 treatment. I've felt pretty yuck last couple of months and there have been suggestions that I need to think about HRT so that is another option.

Has my t3 went down because I'm not converting? My t4 hasn't moved very much either.

Bloods taken at 7am fasted with last levo taken 24 hours before.

Private endo wants both ft3 and ft4 in top 3rd of range so there is room for improvement in t4 as well as the obvious t3 issue.

[SlowDragon Administrator]

This is extremely common…as TSH reduces conversion rate reduces

A normal working thyroid makes 10-20% Ft3

On just levothyroxine we frequently get higher Ft4 and lower Ft3

Looking at previous posts you’re diagnosed as coeliac so it’s likely you will need addition of T3 prescribed alongside levothyroxine

Email Thyroid U.K. for list of recommended thyroid specialist endocrinologist and doctors who will prescribe T3

[e-mail]

Meanwhile working on improving vitamin levels may help improve conversion slightly

[Moog77 in reply to SlowDragon]

SlowDragon do you think I need a slight levo increase as well? T4 could come up. Is it better to raise t4 before adding in t3?

[SlowDragon Administrator in reply to Moog77]

Well…..you only just increased to 100mcg …perhaps wait and retest first

[Moog77 in reply to SlowDragon]

My recent bloods were after 7 weeks on 100mcg - do you mean give it another 6 - 8 weeks and retest after optimising vits?

[SlowDragon Administrator in reply to Moog77]

Yes….you don’t want to increase too quickly

Only just increased from 50mcg to 100mcg…..meanwhile work on improving low vitamin levels

Retest again in approx 8 weeks

See if Ft4 is going up or down

And see if conversion is improving

[Moog77 in reply to SlowDragon]

Ah patience!! That old chestnut 😀

I was considering just letting everything settle for a bit but was alarmed by the ft3 level. It's a real slow march this thyroid stuff but I'm not too keen on putting myself through the upheaval of another doseage change just yet. Its been quite full on and I'm trying to separate what is thyroid and/or perimenopause.

[SlowDragon Administrator]

Ft4 is only 57% through range But Ft3 only 19% through range

Helpful calculator for working out percentage through range

thyroid.dopiaza.org

Suggest you retest again in 6-8 weeks see if levels are improved