Next step to try with dosage of levo and T3

[Zazbag]

Hello,

Since April this year I've been trying to adjust my dosage of levo and T3. The last time I felt properly well was about 1–2 years ago – I was on 150mcg levo and 25mcg T3, and at that time, this put my T4 at around 19–20 and my T3 around 6.8.

I have been on 175mcg levo and 25mcg T3 for the past two months. (Before this I was on 150mcg levo and 37.5mcg T3 and did not feel well).

I had a blood test last Friday following the recommended protocol (9am, fasted, with my last dose of levo 24 hours before, last dose of T3 (12.5mcg) 12 hours before):

TSH: <0.01 (0.30 – 4.20)

T4: 22.0 (12.00 – 22.00)

T3: 8.0 (3.10 – 6.80)

I posted a couple of months ago when I was taking 150mcg levo and 37.5mcg (12.5mcg x3 per day) T3. I was fatigued a lot, excessively hungry (had gained weight) and I kept losing my temper over things that I'd usually be able to stay calm about. My blood pressure was also higher than usual and I noticed a racing heart/heart palpitations on the odd occasion.

My blood test results then (following the same protocol) were:

TSH <0.01 (0.30 – 4.20)

T4 15.8 (12.00–22.00)

T3 8.1 (3.10 – 6.80)

Ferritin 65 (13 – 150)

Folate 9 (2.99 – 26.80)

Vitamin B12 576 (197 – 771)

Vitamin D 100 (50 – 250)

I've continued to supplement iron, folate, B12 and vitamin D since these results so they should still be at a good level if not higher.

I'm quite surprised that lowering my T3 by 12.5mcg (back to a dose of 25mcg) and increasing my levo by 25mcg (to a dose of 175mcg) has increased my FT4 level from 15.8 to 22 and kept my FT3 around the same level as it was when I was taking 37.5mcg T3 and 150mcg levo.

I feel much better than I did when I was on 150mcg levo and 37.5mcg T3 as I was very fatigued then but also had symptoms of over-medication. I also feel much better than I did when I was on 150mcg and 25mcg (my dose up until I had my blood test in April when I was having hypo symptoms).

Would really appreciate any advice on how to tweak my dose level now. I'm guessing I might need to lower my levo to 162.5mcg and see if that brings my T3 down into the normal range but would like to hear your thoughts on this. Many thanks!

SlowDragon

helvella

[SlowDragon Administrator]

Well I would agree try reducing levothyroxine to 162.5mcg daily

Retest in 6-8 weeks

Do you split your T3 as 2 or 3 smaller doses everyday or just before test?

Possibly reducing T3 by 1/4 tablet after next test …..if FT3 still high

[Zazbag in reply to SlowDragon]

Thanks so much for the fast reply!

I always take T3 in 2 doses, 12.5mcg 2x per day. I have 50mcg tablets so I split them into quarters. I have some 5mcg tablets on the way though so if I end up needing to fine tune my T3 dose after trying 162.5mcg levo it shouldn't be too much of an issue. Thanks again!

[Noelnoel]

“Since April this year I've been trying to adjust my dosage of levo and T3. The last time I felt properly well was about 1–2 years ago – I was on 150mcg levo and 25mcg T3, and at that time, this put my T4 at around 19–20 and my T3 around 6.8”

Sorry, I’m unfamiliar with your history but I’m intrigued to know why, with the above test results and feeling properly well you began changing your dosage?

[Zazbag in reply to Noelnoel]

"I also feel much better than I did when I was on 150mcg and 25mcg (my dose up until I had my blood test in April when I was having hypo symptoms)."

I felt well on that dose until about a year ago. Then I started to develop hypo symptoms again. I had a blood test in April this year and it showed my FT4 and FT3 had dropped to below the levels they were before I added T3 two years ago (when I felt terrible). Hence why I'm trying to tweak my dose of both to get my levels back to where they were when I last felt well (FT4 19/20, FT3 top of range seems to work well for me).