Latest thyroid results after reducing Levo

[TiredMummy]

Hi everyone,

I’ve got my latest results after reducing my Levo from 150mcg daily to alternating between 125mcg and 150mcg (effectively 137.5mcg daily).

Latest results after being on above meds for 6-7 weeks:

TSH <0.005 (0.27-4.2)

Free T3 5.9 (3.1-6.8)

Free thyroxine 29.4 (12-22)

Blood test results from September:

TSH <0.005 (0.27-4.2)

Free T3 5.88 (3.1-6.8)

Free thyroxine 33.5 (12-22)

Comments on the above really appreciated but on the face of it my T4 has come down a bit with the dose reduction but my T3 has held well with a slight improvement. I’m also starting to feel better so wondering if I should reduce again to 125mcg daily and then re-test after 6 weeks…

Any suggestions very welcome 🤗 🙏

Thanks!

[OudMood]

Maybe reducing to 125mcg daily and see how you do is not a bad idea.

However, I just read this from an older post.

This was from SeasideSusie. I don’t know how to link that comment or I would..

If she needs a slightly over range FT4 to achieve a reasonable FT3 level then so be it, and here is the evidence that says this is fine:Dr Toft, past president of the British Thyroid Association and leading endocrinologist, states in Pulse Magazine (the professional magazine for doctors):"The appropriate dose of levothyroxine is that which restores euthyroidism and serum TSH to the lower part of the reference range - 0.2-0.5mU/l. In this case, free thyroxine is likely to be in the upper part of its reference range or even slightly elevated – 18-22pmol/l. Most patients will feel well in that circumstance. But some need a higher dose of levothyroxine to suppress serum TSH and then the serum-free T4 concentration will be elevated at around 24-28pmol/l. This 'exogenous subclinical hyperthyroidism' is not dangerous as long as serum T3 is unequivocally normal – that is, serum total around T3 1.7nmol/l (reference range 1.0-2.2nmol/l).*"*He confirmed, during a talk he gave to The Thyroid Trust, that this applies to Free T3 as well as Total T3 and this is when on Levo only. You can hear this at 1 hour 19 mins to 1 hour 21 minutes in this video of that talk Not working as expected?You can obtain a copy of the article by emailing ThyroidUK:[e-mail] it and highlight question 6 to show your doctor. From the British Thyroid Foundation:btf-thyroid.org/thyroid-fun...Occasionally patients only feel well if the TSH is below normal or suppressed. This is usually not harmful as long as it is not completely undetectable and/or the FT3 is clearly normal.There are also certain patients who only feel better if the TSH is just above the reference range. Within the limits described above, it is recommended that patients and their supervising doctors set individual targets that are right for their particular circumstances.I would argue that her FT4 is only 1 point above range and that as her FT3 is well within range there is no problem and she is not overmedicated.

[OudMood in reply to OudMood]

this is the post

healthunlocked.com/thyroidu...

[SeasideSusie Remembering]

TiredMummy

With regard to OudMood 's reply above, the "slightly over range" FT4 in that case was 23 (12-22). I would not consider your FT4 to be "slightly over range" at 29.4 (12-22), I would consider it to be considerably over range and an FT4 level that high is not good in the long run.

You need to get your FT4 down to range so I would reduce your Levo again and if that lowers your FT3 too much then perhaps you're looking at poor conversion of T4 to T3.

[OudMood in reply to SeasideSusie]

thanks for clarifying!

Sorry if I misquoted you 🙃

[TiredMummy in reply to OudMood]

thanks OudMood, it was a good thought in any case and much appreciated 🙂

[TiredMummy in reply to SeasideSusie]

thank you for those wise words as ever SeasideSusie, I think I will try waiting it out a little longer and re-test to be sure as I’ve climbed a very steep mountain to be where I am right now. But will keep a close eye like you say on what happens with T3 conversion! Ultimately, I will reduce if over a bit more time the T4 remains so elevated.

[pennyannie]

Hello :

Glad you are feeling a little better :

Yes you are correct, your T3 has held up very well, and in fact, improved a smidgeon !

You need to try and get down into the range so a further dose decrease in T4 logical - maybe just try 12.50 T4 -and save all the fuffing about with cutting the tablet ?

Well done, and glad you feel improved :

[TiredMummy in reply to pennyannie]

Hello Pennyannie and thank you so much for your lovely words of support.

[tattybogle]

My Twopenneth ...

personally . i'd wait until spring on the 137.5mcg dose to see what happens.

yes i do agree with the others .. ie . you don't want to be running fT4 at that level 'for life' ,.... but .... in your case , i'd wait a bit ... you've made the mistakes before of making your mind up too quick /or increasing /or reducing dose by too much at a time ... (we all have ,so i'm not having a go ... just saying )

allow your body some time to settle down .

6/7 weeks is the bare minimum to see effect on blood results and symptoms .. it's quite possible those numbers/ symptoms will change if stay on same dose for another couple of months . (see my old reply to your last post re. what happened to my fT4 and how long it took to come down)

you've started to feel a bit better .. so allow your body a bit of consistency to see of the improvement in symptoms continues.

Don't rock the boat just as winter is about to become extremely cold and difficult . if it turns out that 125 is "a reduction too far" , you'll be sinking your boat in a rather icy river. Wait till spring , then if you do 'take a dip' it won't be so grim.

re -test bloods when winter is on the way out and if fT4 is still at this sort of level, then reduce to 125mcgand see how that goes till summer .

while i do agree that high fT4 is not a good idea 'long term'. i really don't believe that a few more months of it is a dealbreaker ... not when compared to the 'other' risks involved ..ie. whole body suffering instability from constantly changing doses.. and the risk of crashing if 125mcg is too low dose and then being off work in winter...

here endeth my two penneth .. actually that was more like 50p's worth.... sorry x

[TiredMummy in reply to tattybogle]

Thank you Tattybogle…..you are absolutely right, I do make decisions too quickly! Thank you for pointing out again your story, hugely appreciated. I’ve decided to wait a little longer and see how I go. I don’t want to upset the apple cart at the moment, not when I’ve clawed my way back from suicidal thoughts to having a sense of humour again! Im not there yet at all in terms of stability, still got quite a way to go, but goodness me I’m in a better place than I was….so I’m at last I’m encouraged 🙂