SeasideSusie Dear Seaside Susie and forum members. You have given me such wonderful advice for some time and I’m back again. I’d appreciate your input. I’m not sure what to do next and I need to see the endocrinologist soon. I’m not sure my conversion is good enough to be T4 only.
Please advise on my latest test results:
112.5mcgT4 and T3 5mcg Feb 23 (been on dose for 6 months)
TSH 0.33 0.27-4.2
T4 16.92 12-22
T3 4.10 2.8-7.1
100mcgT4 and 10mcgT3 May 22
Same reference ranges as above
TSH 0.06
T4 15.16
T3 6.36
Many thanks for taking the time to read this post and comment.
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LynLyn
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Did you feel better on one of those dosing regimes than the other?
May 2022 - 100mcgT4 and 10mcgT3
FT4: 31.6% through range
FT3: 82.79% through range
February 2023 - 112.5mcgT4 and T3 5mcg
FT4: 49.2%
FT3: 30.23%
Do you know if you are OK with a low FT4 and higher in range FT3 or do you need them both balanced?
It really is a case of no-one can tell you what's right for you, we're all different so need to experiment to find the right balance for us, only you will know where you feel best.
If those were my results the February 2023 FT3 would be far too low for me and I'd need FT4 over half way through range and fairly well balanced with FT3.
With the May 2022 results the FT4 would be far too low for me and I wouldn't need FT3 that high.
For me, I would leave Levo at 112.5mcg and increase T3 initially to 7.5mcg and retest in 8-10 weeks, see where FT4 and FT3 lie and tweak again if necessary.
Dear SeasideSusie Many thanks for your excellent advice.
I’m ok but not ‘quite right’. In some ways I felt better last summer but again wasn’t ‘quite right’. I’ll try and persuade the endocrinologist to let me try 7.5mcg of T3. He’s not keen when my TSH becomes suppressed although he does look at T4 and T3 and knows I’m not over medicated.
I’ll try and persuade the endocrinologist to let me try 7.5mcg of T3.
You could be a little crafty here. Ask for 10mcg and if he refuses then ask him to compromise on 7.5mcg. If you get the 10mcg just take 7.5mcg.
He’s not keen when my TSH becomes suppressed although he does look at T4 and T3 and knows I’m not over medicated.
But as he's prescribing T3 he really ought to know that taking T3 does lower TSH often to the point of suppression. Is he banging on about suppressed TSH will cause osteoporosis and atrial fibrilation? If so that's only relevant in hypERthyroidism where a suppressed TSH and over range FT3 can cause problems. Suppressed TSH in hypOthyroidism is not the same. See:
The link between TSH, FT4 and FT3 in hyperthyroidism is very different from taking thyroid hormone (T4) in therapy. In hyperthyroidism, FT4 and FT3 are usually well above range and TSH is very low or undetectable. In therapy, FT4 can be high-normal or just above normal, TSH can be suppressed but FT3 (the important hormone that controls your health) will usually be in the normal range. FT4 and TSH are of little use in controlling therapy and FT3 is the defining measure. A recent paper has shown this graphically:
Heterogenous Biochemical Expression of Hormone Activity in Subclinical/Overt Hyperthyroidism and Exogenous Thyrotoxicosis
February 2020 Journal of Clinical and Translational Endocrinology 19:100219
DOI: 10.1016/j.jcte.2020.100219
LicenseCC BY-NC-ND 4.0
Rudolf Hoermann, John Edward M Midgley, Rolf Larisch, Johannes W. Dietrich
Dear SeasideSusie I’ve been to see the endocrinologist and he agreed to 7.5mcg of T3! I have to go back in June for blood tests. Thank you SO much for all your guidance and support - I’m forever grateful.
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Third blood test in 4 months
Bloods advice on dosage please 
T3 taken away, looking for a new source please :)
Why are FT4 and FT3 stuck at the bottom of the range despite increasing Levothryoxine? 
