T4/T3 combo update, new labs

[jrbarnes]

September 2022

112mcg levo and 10mcg T3

TSH 0.19

FT4 1.2 (0.8-1.8)ng/dl

FT3 3.8 (2.3-4.2)pg/ml

Ferritin 51 16-232 ng/mL

Iron total 85 40-190 mcg/dL

saturation % 31 16-45 %

Iron binding cap 277 250-450 mcg/dL

August 2022(same reference range as above)

alternating 112/100mcg levo and 5mcg T3

TSH 1.87

FT4 1.3

FT3 3.2

Ferritin 31

Iron total 57

Saturation% 20

Iron binding cap 282

Okay sorry for the long ramble but I haven't updated in awhile so thank you for any feedback. It was time for new labs since taking Thorne iron 100mg every other day so I included thyroid levels. Last week I increased my Levo up to 112mcg daily with 10mcg T3, previously I was alternating 112mcg and 100mcg(3 days.) Some months ago my ferritin was 19 and all iron levels were bottom of range due to being hypo for too long. From the looks of the new labs my iron is improving quickly. My T4 levels still remain low(40% in range) and unsure if that will improve in the coming weeks. Since adding the 10mcg of T3 then increasing the Levo I've felt the most improvement but still fatigued(facial swelling), although much more functional and able to do things I enjoy. Mentally my brain and mood is good. I'm getting tired at nights and falling asleep normally, no insomnia. Back in March I had the most improvement after increasing calories but the sudden weight gain has made it difficult to find the right levels for my new weight.

I've been slowly increasing Levo over the past 6 months but realized I could not do this without adding T3 back in. I know this is a problem for most people with hypo. I found that when trying to increase my FT4 levels above 60% in the reference range I developed nagging neck tension pain, achy cracky bones, vision issues, no appetite, low mood, and cognitive problems. With my Ft4 levels left at 60% my FT3 levels remained just below 50% in range. My Total T3 levels were scraping the bottom of the barrel. It wasn't enough and I'm never going to get there on Levo alone so I followed the advice on this forum and slowly adjusted my T4 and T3. It takes such massive amounts of patience to stick with it and not sabotage your results by increasing or changing too quickly. Ultimately I was my own worst enemy, hopping from one hormone to another, not waiting enough time.

My results above show the TSH is responding to the added T3. I could never get a TSH near 1 or below on Levo alone or even when increasing calories/carbs and doing all I can to improve T4/T3 conversion. Increasing calories and eating more often, not waiting several hours between meals, has significantly improved T4/T3 conversion. Years ago, had I the same FT4 levels as today my FT3 would have been less than 10% in range but now since eating better I can get almost 50% FT3 with the same FT4 levels but it's still not enough T3.

I can feel my thyroid levels are still low and based upon my results I'm not over medicated. Yesterday BP was 107/68 and heart rate under 100. For the first time in my life I feel warm, no socks required. I'll retest my thyroid levels again in 4 weeks since I have to do iron testing then.

[radd]

jrbarnes,

It's so great you are starting to feel better.

'I can feel my thyroid levels are still low and based upon my results I'm not over medicated'.

FT3 is nearly 80% through range, FT4 is 40% and bearing in mind you are seeing improvements and have said previous higher FT4 make you feel bad, I would stick at this dose for several months.

If its making you feel better and feel warm, then meds must be working positively, and I found recovery to be cumulative. In fact I was still seeing slow improvements up to several years later. 

Sometimes its worth logging symptoms & improvements so its easy to gauge how far you have actually come.