There isn't a "best". What is best is what's right for you.
When on combination thyroid hormone replacement some people are fine with a lowish FT4 as long as FT3 is in the upper part of it's range . Some need FT4 and FT3 to be fairly well balanced, usually over half way through range .
Of course, how you feel is important too.
By the way, the ratio is irrelevant when taking combination thyroid hormone replacement.
Thank you. Sorry, I didn’t word my post very well, it was to get a rough idea of what generally works for most as a guide.
I guess I’m wondering if my T4 is a bit high compared to T3. It’s hard for me to know how I’m feeling “thyroid” wise because I have low calcium currently which gives some similar symptoms,
I thought I would try to get my ft4 and my ft3 both somewhere in the 60% maybe up to 70%as I'd read about folks feeling good on that. Bad idea as those levels are right for those individuals and not me. After altering doses for 2 years I found that my ft4 tends to sit at 50% and my ft3 at 72%and that works for me.
I feel optimal when my TSH is around 1.00 (0.35-5.50 range). My T4 is generally low midrange and my T3 also just under midrange. This is without taking medications on blood draw morning. I’m on liquid levothyroxine plus liothyronine. I split my doses of T3 5mcg then 5mcg 8 hrs later. I’ve split my levothyroxine dose also but the past week have been trialing taking levothyroxine going to bed. So far so good but that could easily change. I can’t cope with symptoms if my TSH is suppressed or too high. I get similar symptoms either way. So for myself if I keep to my regimen and keep my TSH around 1.00 I feel very well indeed. My endocrinologist explained that a TSH above 2.5 is in hypo territory and you’ll be symptomatic. NHS ranges are too wide he said.
My Endo is extremely pleased I’ve managed to keep my TSH hovering around 1.00. Me too as I feel so good. I take T3 5mcg twice a day 8hrs apart. I reduced my levothyroxine by 10% down from 75mcg a day to 68mcg a day. I also split my levo dose. I’m on liquid levothyroxine so it’s easy to fine tune your dose. I don’t think everyone needs to be suppressed on T3 although I know many are. I’ve had an issue lately obtaining my liquid levo due to National stockout. I went a bit haywire on tablets. Back on liquid now and things have settled back down. Sometimes you need to address the levo rather than lio doses to keep your TSH not suppressed.
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