Should I increase T3 or Levo ?

[Sampydoodle]

After some advice from you knowledgeable people as not seeing any improvement after Endo changed dose. Not sure what to do next as they appear happy with results.

Looking at latest results my FT4 has increased a little but FT3 gone down, I was thinking maybe increase Lio back to 20mg ?

Any advice would be greatly appreciated.

Thanks

My results are as follows:

Dose : Lio 20mg Nov 2020

TSH 0.95 (0.3 - 4.2)

FT4 6.4 (9 - 19)

FT3 4.2 (3 - 5.4)

Dose: Levo 25mcg Lio 20mg Aug 2021

TSH 0.01 (0.3 - 4.2)

FT4 11.0 (9 - 19)

FT3 4.6 (3 - 5.4)

Dose : Levo 50mcg. Lio 10mg March 2022

TSH. 0.01 (0.3 - 4.2)

FT4 8.9 (9 - 19)

FT3. 4.0 (3 - 5.4)

Dose : Levo. 75mcg. Lio 10mg May 2022

TSH. 0.02 (0.3 - 4.2)

FT4 12 (9 - 19)

FT3. 3.5 (3 - 5.4)

[Lalatoot]

Sampydoodle I would try an increase in lio but only increase by 5mcg at a time. This is gentler on the system and gives time for the body to adjust.

[Sampydoodle in reply to Lalatoot]

Thank you , that’s what I was thinking

[SlowDragon Administrator]

Were all tests done as recommended

Early morning, ideally before 9am and last dose levothyroxine 24 hours before test

Day before test did you split T3 into 2 or 3 smaller doses spread through the day and last 5mcg dose approx 8-12 hours before test

When were vitamin D, folate, ferritin and B12 last tested

What vitamin supplements are you currently taking

I would agree with Lalatoot

Increase T3 to 3 x 5mcg

Wait 6-8 weeks and retest

You may need to increase levothyroxine after next test

Many people find they need both Ft4 and Ft3 at least 50-60% through range

[Sampydoodle in reply to SlowDragon]

Hello and thankyou, yes I followed the pre test recommendations.Haven’t had D, folate, ferritin tested recently. Don’t test B12 as have injections.

May have to do them privately as GP is reluctant to test anything and not due Endo review until Nov.

[SlowDragon Administrator in reply to Sampydoodle]

What vitamin supplements are you currently taking

[Sampydoodle in reply to SlowDragon]

Hello, I’m not taking anything at the moment, I really need to get tested as I probably need to take something, have previously found to be low in D, ferritin or folate , assuming I don’t absorb well.

[Sampydoodle in reply to SlowDragon]

Can I ask about optimal, I thought I’d read it was best to be around 75% through range , is this not the case? Thankyou

[helvella Administrator Thyroid UK in reply to Sampydoodle]

Many do better around there. But not all.

We are all individuals and applying any rule-based assessment can mislead. All such rules can really do is suggest that something might need to be considered.

If it were that simple, we'd all be very pleased.

[Sampydoodle in reply to helvella]

Thankyou, yes I suppose it will vary from person to person.