Alittle advice T4/T3 combo

[Ninney2019]

OK some advice, currently on 75mcg Levo 4 days a week, 100mcg 3 days a week and 10mcg T3 everyday split into 2. My current levels are

T4 13.7

T3 5.3

TSH 0.85

I feel okish apart from a little fatigued and struggling with weight gain again.

Waiting 3 weeks for endo to call me back, can anyone recommend some advice. Ie increase/decrease etc

Thanks

[SlowDragon Administrator]

Can you add ranges on results

Was test done early morning, ideally before 9am and last dose levothyroxine 24 hours before test

Was last 5mcg dose T3 approx 8-12 hours before test

Do you always get same brand levothyroxine at each prescription

How long have you been on current dose

When were vitamin D, folate, ferritin and b12 last tested

What vitamin supplements are you currently taking

[Ninney2019 in reply to SlowDragon]

Hi thank you.

Ranges are as follows

TSH 0.27-4.2

T4 12-22

T3 3.1-6.8

test was done at 9.30 am no dose taken since morning before, T3 last dose was at 2pm day before. Always have same brands for last 3 years, usually Accord.

Have been on this dose since beginning of March, vits etc were done mid Feb and everything was good, endo said they were optimal.

I am not currently taking any supplements.

Thank you

[SlowDragon Administrator in reply to Ninney2019]

vits etc were done mid Feb and everything was good, endo said they were optimal.

So what were the actual vitamin results and ranges

You are legally entitled to copies of all your test results

We need optimal vitamin levels, not just somewhere within range

[Ninney2019]

I do not have a print out to hand, but if they are OK would an increase in levo be beneficial do you think as I'm concerned it's a little on the low side - which I know is normal for taking t3.

[SlowDragon Administrator]

FT4: 13.7 pmol/l (Range 12 - 22)

Ft4 only 17.00% through range

FT3: 5.3 pmol/l (Range 3.1 - 6.8)

Ft3 59.46% through range

Ft3 is falsely low as last dose T3 was too long before test

Last dose Should be approx 8-9pm

Many people on levothyroxine plus small dose T3 find they need Ft4 at least 50% through range

Trial and error what suits each person

Suggest trying increasing to 100mcg levothyroxine everyday and retest in 6-8 weeks

Meanwhile get hold of vitamin results

Extremely rare not to need any vitamin supplements when on levothyroxine and especially if on levothyroxine plus T3

[Ninney2019 in reply to SlowDragon]

OK thank you, I'll give the docs a call and ask for the printout. Now to push a callback from the endo🙄 he has more holidays than hot dinners...

[Ninney2019]

Also a quick ask if I may, I usually take my T3 6/7 am and 2pm, should I be taking it alittle later? Would it keep me awake or is this trial and error too?

[SlowDragon Administrator in reply to Ninney2019]

It’s trial and error

Many people small dose T3 at bedtime improves sleep

You could try 5mcg 6am, 2.5mcg mid afternoon and 2.5mcg at bedtime