High T4 - reduce levothyroxine?

[Mayaaaa]

Hello, I've been on 50mg of Levothyroxine since Jan 2022 and my TSH has gone from 5.5 to 1.5 to 2.4 and today it is 0.814 iu/ml T3 is 3.19 pg/ml (ref 2.0-4.2) and T4 is 18.0 pg/ml (ref 8.9-17.2).

Never had a high T4 before and wondered if i should reduce my levothyroxine medication? I am due to start my 4th round of IVF next month and I am not sure what these results mean.

I also have hashimotos - In January 2022 my TPO antibodies were 600 and i started a gluten free diet. Antibodies up to 700 in April 2022 and I am waiting for the recent results of anti gluben and TPO (last anti-gluben were negative).

Thank you for any advice!

[SlowDragon Administrator]

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

What vitamin supplements are you currently taking

50mcg levothyroxine is only a starter dose

[Mayaaaa in reply to SlowDragon]

Thank you. I’m taking a lot of supplements at the moment to improve egg quality, including DHEA , vit d, myoistol and ubiquinol. My DHEA result came back a little high too yesterday so I’ve stopped taking that supplement

[SlowDragon Administrator in reply to Mayaaaa]

Was last dose Levothyroxine 24 hours before test

[Mayaaaa in reply to SlowDragon]

My Last Dose was taken at 2am and the test was at 6pm

[SlowDragon Administrator in reply to Mayaaaa]

Test should always be early morning, ideally BEFORE 9am and last dose levothyroxine 24 hours before test

So testing late afternoon would give low TSH

Testing only 16 hours after last dose levothyroxine would give higher Ft4 than testing after 24 hours

[Mayaaaa in reply to SlowDragon]

Thank you for sharing. I’ll bear this in mind next time I get my levels checked. It was an ivf appointment so didn’t have thyroid on the forefront of my mind. I’m taking b12, b complex, magnesium, vit d and Selenium alongside gluten free to help with reduce the antibodies. Will keep my levothydroxine dose the same and check levels in a few months again. Thank you for your advice

[grumpyold]

I wouldn't reduce my levo with those results.

Your FT4 is only just above range and your FT3 is well within, so you are not over medicated.

With Hashi's, levels do tend to jump around a bit, but your FT4 is so marginally above, I really don't think you are having a "hyper swing".

And as SlowDragon says, 50mcg levo is just a starter dose.

If you are trying to conceive, you need your FT3 as close to optimal as possible, and if your FT4 were to reduce, it is likely that your FT3 would reduce too. I'd leave your dose alone.

[Mayaaaa]

Thank you. is an optimal t3 and t4 range towards the higher end of the reference?

[humanbean]

i started a gluten free diet.

I am waiting for the recent results of anti gluben

If you want any testing related to gluten you need to be eating lots of gluten for six weeks beforehand. Once you stop eating gluten testing for gluten intolerance or coeliac disease or anything else related to gluten the results won't be reliable. Most likely any gluten related testing you do on a gluten-free diet would always return a negative result.