Blood test results and advice please

[Handsome14]

I have hashimotos and the homozygous polymorphism of the DIO2 gene.

Here is a table (below) of blood test results - in the well/unwell column there are different levels of wellness as I am better than say last summer but I still feel not quite right and keep wondering whether an increase in levothyroxine would be beneficial while leaving liothyronine dose unchanged ie increase T4 from 75mcg currently taking to 100mcg or even 125mcg and leave T3 at 40mcg or decrease to 30mcg.

Any thoughts/suggestions?

[Lalatoot]

Handsome you have cut your results off in their prime! Unfortunately we can't see the most recent results when on your higher lio dose - the last results we see are 21.1.22.You need to scroll down on your spreadsheet and take another screenshot. You can add it in the reply part as if you are replying to yourself.

[Handsome14]

Oops sorry and thanks for letting me know. I hope you can see the bottom half of the table now

Table

[Handsome14]

Sorry hope this has worked now

Table

[Warwickian]

Hi, I’m also have Hashi’s and am homozygous for DiO2. I no longer take any T4, having felt awful on it for years. I sawn private endo, tried NDT, which was slightly better initially, but am now on T3 only. I take 50 mcg a day and my TSH is low. I do get comments from the Medichecks doctors about my T4 level, which has steadily gone right down ‘below range’. I do feel well now, although I get tired in the evening. Brain fog has cleared and blood pressure down. I often wonder if I should take a little T4 as well, but don’t want to go back to feeling worse!

[Handsome14 in reply to Warwickian]

Thanks for your reply Warwickian

[tattybogle]

Nice table Handsome14

I can't be much help with the T3 advice as i don't take it myself .

Your Endo's dose changes don't seem so disorganised now we can see all of them, the logic was obviously:

Increase T4 with 10mcg T3 >> try High T4 with less /no T3 >> try increasing T3 with reducing amounts of T4.

Other members who take T3 /4 combo and T3 alone will be able to advise 'what next' better than i can.

But the one thing i would say from my own experience of adjusting Levo alone is that it can take much more than 5 weeks on a new dose before 'how you feel' settles down.

Realistically it's more like 8-12 weeks before you know how a new dose will really FEEL ... the first 5 weeks are still busy with various systems rebalancing and adjusting themselves to the change you just made.

Further improvements (if they are going to happen) start to happen once the body gets accustomed to some stability on the new dose .

You blood tests are:

6 weeks / 2 and a half weeks / 6 weeks / 4 weeks / 4 weeks / 5 weeks apart.

Assuming you didn't actually change the dose till about a few days after the bloods were taken ,then for your last 3 dose changes you had only been on each dose for a very short time before the decision was made to change dose again ...... personally i think in the future you should leave longer than this to allow a dose to properly 'settle in' before considering changing it again ..... at least 8 weeks , and possibly longer.

The other thing to consider is that when taking blood tests too soon after a dose change, it is possible that if you'd stayed on the same dose and tested again in 8/12 weeks .. the fT4 /fT3 levels would have changed again as your body accommodates itself to the new levels.

Your deiodinases (which regulate~ how fast T4 is converted to T3 ~ how much is converted to RT3 instead ~ and how fast T3 is got rid of) ... they are an active part of the process of accommodating to a different input of T4 /T3 levels ..... so it's not just a question of "put some in, then measure it" ... it's also a question of "wait the see the response to those new levels" .

In your previous post i said i thought your dose endo's changes were 'disorganised'.. i take that back ... not disorganised .... but rather too hasty perhaps ?

[Handsome14 in reply to tattybogle]

Thanks very much tattybogle for your helpful response and for your compliment on my table 😊

[tattybogle in reply to Handsome14]

i'm even more impressed you managed to move it out of your computer and print it on here.... i can only do 'point and click' , and 'copy and paste' lol

[Handsome14 in reply to tattybogle]

So if not people have commented on my post especially those on combo T4/T3 should I post again?

[tattybogle in reply to Handsome14]

please will somebody who knows about T4 +T3 dosing have a look at this post

:)

i'd give it a bit longer .... see who pops up.

But yes if you get no joy. do post again ..sometimes posts do get overlooked, it's a bit busy on here sometimes so it can happen ..... (and it's been sunny)

[Handsome14 in reply to tattybogle]

Thanks as ever tattybogle for your reply - really appreciate it and hope you are enjoying this glorious weather ☀️

[tattybogle in reply to Handsome14]

please will somebody who knows about T4 +T3 dosing have a look at this post

SlowDragon ?

[SlowDragon Administrator]

Will reply later ….just off out

Perhaps repost as well ?

[Handsome14 in reply to SlowDragon]

Ok will do

[SlowDragon Administrator]

I would say your endocrinologist is changing dose too much

Presumably you always get same brand levothyroxine at each prescription (which brand) and same brand T3 (which brand)

Testing thyroid levels early morning, ideally before 9am, last dose levothyroxine 24 hours before test

Day before test, split T3 into 3 smaller doses, 10mcg, 5mcg,and 5mcg …..taking last 5mcg approx 8-12 hours before test

Is this how you do your tests?

What vitamin supplements are you currently taking

When were vitamin levels last tested

Are you on absolutely strictly gluten free diet/dairy free diet

21/01/22 on 20mcg T3 and 125mcg levothyroxine

FT4: 21 pmol/l (Range 10.8 - 25.5)

Ft4 at 69.39% through range

FT3: 6 pmol/l (Range 3.1 - 6.8)

Ft3 at 78.38% through range

Ft4 and Ft3 both at good range

After January results

Why on earth was levothyroxine reduced by 50mcg per day

Do you wear a Fitbit or equivalent

What’s your resting heart rate

I would have kept both doses unchanged and possibly experimented with changing timings of T3 dose

Or ……if you really felt you had to change

Keeping T3 at 20mcg and initially reduce levothyroxine by 12.5mcg three days a week - so 125mcg x 4 per week and 112.5mcg x 3 per week,

Then retested after 6-8 weeks

Personally I find it important to split my dose into 3 doses

10mcg waking, 5mcg 2-3pm and 5mcg at 11pm

I also split my levothyroxine, 100mcg at 11pm and remainder about 5am

I am heterozygous Dio2 and Hashimoto’s, absolutely strictly gluten free.

Fine tuning dose …..I don’t retest until 12-14 weeks after changing T3 …..waiting a bit longer if reducing levothyroxine