Dosage Advice For Levo & Lio

[ILR2019]

Shockingly, my latest (Jan 2022) private blood test with Medichecks is only the 2nd test since February 2021 due to a decrease in available finances. I have been upping my Levo dosebased on how I feel in absense of results.

My current dose is 225mcg daily. Tbh, this is the best I have felt in years, but Im worried about this high dose. Would I have more chance of stabalising levels using T3? My only symptoms are I am still freezing cold (I assume this is down to low iron). My latest bloods show vits B12 & D have increased and my antibodies finally reduced. Vit D is still low (I have recently changed brand & incresed dose), but my Ferritin levels are still low and no matter how much I supplement it doesn't seem to get better (for 2 weeks I have been taking Zen Naturals high strength 20mg daily). Is there any reason (other than I may be dosing wrong) why I just can't get my ferritin levels up and would this affect my thyroid results?

With regards to my Thyroid panel, should I be satisfied with these current results? My concern is my Free Thyroxine is over range and my T3 has dropped from 6.61 last February when my dose was lower.

I have only had 1 other test between February 2021 and January 2022 and that was in November where my results were completely off kilter despite no change in Levo dose, diet, exercise, test time or how I felt in general (TSH 0.005, FREE T3 8.06 & FREE THYROXINE 31.4). What on earth can cause such a fluctuation in results?

• CRP HS X 3.35 mg/L (Range: < 5)

• Ferritin 33.8 ug/L (Range: 13 - 150)

• Vitamin B12 - Active 150 pmol/L (Range: > 37.5)

• Vitamin D 86.6 nmol/L (Range: 50 -175)

• TSH X 0.005 mIU/L (Range: 0.27 - 4.2)

• Free T3 5.80 pmol/L (Range: 3.1 - 6.8)

• Free Thyroxine 26.5 pmol/L (Range: 12 - 22)

• Thyroglobulin Antibodies 21.500 kIU/L (Range: < 115)

• Thyroid Peroxidase Antibodies X 17.90 kIU/L (Range: < 34)

[greygoose]

my antibodies finally reduced

Do you have Hashi's, then? If so, that is probably the reason for your 'off-kilter' results in November.

But, the fact that your antibodies have reduced doesn't mean anything. They are not a measure of the seriousness - or otherwise - of your disease. They fluctuate all the time, but once you have Hashi's, it doesn't go away.

My concern is my Free Thyroxine is over range and my T3 has dropped from 6.61 last February when my dose was lower.

That is probably because on the higher dose, more of your T4 is being converted to rT3, so less to T3. Did you feel better on the lower dose? If so, I would go back to it, if I were you.

[ILR2019 in reply to greygoose]

Hi Greygoose.

Yes, I have Hashi's. On a lower dose I had intermitant headaches and nausea. Both were constant symptoms right up until the dose increase to 225mcg.

[greygoose in reply to ILR2019]

So, you increased by 25 mcg levo? Why not try half that - i.e. reduce dose by 12.5 mcg. If that is enough to get rid of the headaches, but enough to lower your FT4, then that might be your best bet. Of course the way you feel is more important than blood test results, but if you can combine the two, that would be great.

[tattybogle]

Since having high fT4 and TSH lower than 0.04 are both associated with some increased risks* ...... and since you got more fT3 at a lower dose of Levo ...., (this often happens when we take higher T4 . the reason for it is well understood , if a bit complicated ) ....... it might be worth a try back on that lower dose to see how you feel .

( * not everybody agrees 'what degree of risk', and for T4 it's a very new area of research , so we really don't know yet .... but there is certainly enough evidence to avoid VERY low TSH/ HIGH fT4 if you don't have to have them there to feel well )

[greygoose in reply to tattybogle]

Well, very high FT4, anyway.

[tattybogle in reply to greygoose]

Yes , unnecessarily high T4 is the one that bothers me more ... in my opinion it's likely that the increased risks that were found with 'TSH below 0.04' were actually due to associated high fT4, or something else , and NOT due to the low TSH in isolation, .... unfortunately that study didn't have the ft4 measurements to prove it. one way or the other . So just saying that given what we know , (and what we don't ) it makes sense to try to be on the lowest effective dose, rather than continuing on a higher dose if there's no extra benefit symptom wise .

[greygoose in reply to tattybogle]

Yes, totally agree with that.

[SlowDragon Administrator]

Are you vegetarian or vegan

Ferritin is still terrible

cks.nice.org.uk/topics/anae...

In all people, a serum ferritin level of less than 30 micrograms/L confirms the diagnosis of iron deficiency

Look at increasing iron rich foods in diet

Eating iron rich foods like liver or liver pate once a week plus other red meat, pumpkin seeds and dark chocolate, plus daily orange juice or other vitamin C rich drink can help improve iron absorption

List of iron rich foods

dailyiron.net

Links about iron and ferritin

irondisorders.org/too-littl...

davidg170.sg-host.com/wp-co...

Great in-depth article on low ferritin

oatext.com/iron-deficiency-...

drhedberg.com/ferritin-hypo...

This is interesting because I have noticed that many patients with Hashimoto’s disease and hypothyroidism, start to feel worse when their ferritin drops below 80 and usually there is hair loss when it drops below 50.

Thyroid disease is as much about optimising vitamins as thyroid hormones

healthunlocked.com/thyroidu...

restartmed.com/hypothyroidi...

Post discussing just how long it can take to raise low ferritin

healthunlocked.com/thyroidu...

Never supplement iron without doing full iron panel test for anaemia first and retest 3-4 times year if self supplementing

Medichecks iron panel test

medichecks.com/products/iro...

Iron and thyroid link

healthunlocked.com/thyroidu...

Posts discussing why important to do full iron panel test

healthunlocked.com/thyroidu...

healthunlocked.com/thyroidu...

Chicken livers if iron is good, but ferritin low

healthunlocked.com/thyroidu...

[ILR2019 in reply to SlowDragon]

Thank ypu. The links are very much appreciated.