Advice required

[Carlax]

My visit to the Endo was again very painful and unhelpful. It is supposed to be one of the best hospitals in the country but yet again failed to be very helpful. Not only that, the dr. got wrong the info re my current medication twice so the level of listening and engagement was not 100%, obviously. I understand that they may be under a lot of pressure but you errors are not acceptable when you are talking about people's health.

I was a bit frustrated and sad to feel that despite all the money I pay via taxes, I do not get the need I require health wise. Thankfully, I have you and that makes me more positive and hopeful about the future.

I followed all the advice given on this site before taken the blood test. No supplements for a week and 12 hrs break on T3 and 24 on T4 and test done at 8 am without any food.

Based on my current medication of 100 Levo and 15 Lio these where blood test results are as follows:

T4 - 0.05 (0.30-4.20) (-0.6%)

Ft3 - 4.9 (3-5.4) (79%)

Ft4 - 13.5 (9-19) (45%)

What shall I do? Shall I reduce my Levo and if so, by how much? Also, it is worthwhile having my Levo dosage for the day split in the am and pm for a more physiological absorption?

For the records, I take Vit B Complex and Magnesium and I follow the rules around the time gap with food, iron and supplements .

Many thanks in advance

Carla

[SlowDragon Administrator]

How much levothyroxine were you taking BEFORE adding T3

Ft4 is low

you might need higher dose levothyroxine

When were vitamin levels last tested

Not taking any vitamin D?

Which B complex?

[Carlax in reply to SlowDragon]

Hi SlowDragon, I hope that you are well.

How much levothyroxine were you taking BEFORE adding T3? It had been recently reduced to 125 mcgrs from 150mcgrs that I had for years. I am 65kgs and 173cms, female and mid-forties. My level of activity is medium to low.

Ft4 is low. you might need higher dose levothyroxine The Endo is suggesting the opposite hence my confusion. Based on the TSH, she wants me to go to 75mcgrs. So I am very confused.

When were vitamin levels last tested? I just checked, it was 26 of November 2021

Not taking any vitamin D? I am taking 1 pill of 20,000 iu every 4 weeks

Which B complex? Thorpe. I am also taking B12 injections every 2 - 3 months by a private doctor.

[SlowDragon Administrator in reply to Carlax]

Ft4 is low. you might need higher dose levothyroxine 

The Endo is suggesting the opposite hence my confusion. Based on the TSH, she wants me to go to 75mcgrs. So I am very confused.

We see this ALL THE TIME

Endocrinologist should know adding T3 results in low TSH

Many, many people on levothyroxine plus SMALL dose T3 find they need BOTH FT4 and Ft3 at least 50-60% through range

so dose levothyroxine has been reduced from 150mcg to 100mcg and now endocrinologist wants to reduce to 75mcg ….despite Ft4 already being on low side

Suggest you try increasing levothyroxine to 112.5mcg

Retest in 6-8 weeks

You might, after next test, need to reduce T3 a little ….perhaps by 2.5mcg or 5mcg

All four vitamins need testing at least annually

What were TSH, Ft4 and Ft3 on just 150mcg levothyroxine

Were vitamin levels optimal when on just levothyroxine

[Carlax in reply to SlowDragon]

just a clarification, I was on 125 mcgrs before I started T3 but 3 weeks before that, I had been on 150 mcgrs for years. Does it make sense?

[SlowDragon Administrator in reply to Carlax]

so what were results on 150mcg

Why was dose reduced?

[Carlax]

I had hyper symtoms, mainly palpitations and nervousness. The TSH was 0.08. This was done before I joing healthunlooked so I did not know any better.

I went along with what the specialist told me.

I worry that increasing Levo will make me more anxious and have palpitations.

But I wilm go ahead with your suggestions here. I will be nonitoring it really regularly.

Many thanks again.

Carla