Some help and advice please with my results.

[DoodleMoo]

I would be really grateful if someone could advise me where to go next please.

Here are my latest results 11/04/23:

TSH 0.01 mIU/L (0.27 - 4.5) -6.1%

Free T4 (fT4) 15.1 pmol/L (11.0 - 23.0) 34.2%

Free T3 (fT3) 5.77 pmol/L (3.1 - 6.8) 72.2%

T4:T3 Ratio 2.617 

Folate - Serum 4.3 ug/L (2.0 - 18.7) 13.8%

Vitamin D 77 nmol/L

Ferritin 235 ug/L (20 - 260) 89.6%

Vitamin B12 516 ng/l (197 - 771) 55.6%

I am currently taking 100mcg Levo and 20 mcg T3 (all AM). Test was done at 8:50 AM with the last dose of Levo 24 hours before and T3 split in half (1/2 taken 24 hours before and 1/2 taken 12 hours before).

Actually, I feel okay, but some days slightly under-medicated (cold, tired, shaky, and pins and needles in my feet). I think you are going to tell me folate is low! I have started this week back on my daily green smoothie (incl. a handful each of Spinach and kale), is that enough?

TBH I got lazy with taking my vitamins too, so I am now as of this week back on Vit D, selenium, magnesium, Vit C, Igennus B12, zinc. I am strictly gluten free and have been on and off with dairy (now off!).

My previous results - Feb 2023 - were (taking T3 15mcg AM, T3 10mcg PM and Levo 87.5mcg AM):

TSH 0.01 mIU/L (0.27 - 4.2) -6.6%

Free T4 (fT4) 12.8 pmol/L (12 - 22) 8.0%

Free T3 (fT3) 4.9 pmol/L (3.1 - 6.8) 48.6%

T4:T3 Ratio 2.612

If you are able to advise me as to where to go next, I would be really appreciative. I have an appointment with my endo on Tuesday.

Thank you so much.

[Jaydee1507 Administrator]

I have started this week back on my daily green smoothie (incl. a handful each of Spinach and kale), is that enough?

In a word, no. A B complex is always recommended here to keep all the B's in balance. It also contain folate. The whole reason we use supplements is that we cannot get enough vitamins from our food and I personally would be needing to eat several buckets full of greens to get enough folate to keep my folate at optimal levels.

This B complex has all the right vitamins at a not unreasonable cost for 90 days supply. amazon.co.uk/Liposomal-Soft...

T4:T3 ratio is only relevent on Levo only.

Some people do need their FT4 & FT3 to balance more at around 70% of their ranges. Your FT4 is still pretty low.

[DoodleMoo in reply to Jaydee1507]

Thank you very much for your answer.

My B Complex (Igennus - sorry I said it was only B12 above) includes folate. Thank you for your alternative suggestion. I will look at it when this runs out.

In terms of T4/T3 what would your suggestion be please? Keep T3 on 20mcg and increase Levo by 12.5mcg or 25mcg?

[Jaydee1507 Administrator in reply to DoodleMoo]

You've only had a week back on supplements so perhaps that explains some of the lower levels. When you have been back on them a few months then retest to see if any need adjusting.

The Igennus B Complex is deceiving as full dose is 2 tablets a day and many only take 1. So you would save money and get more bang for your buck buying the one I mentioned.

Your FT3 is at 72% which is a good place to be. Perhaps try adding 12.5mcgs Levo as that does need bringing up a bit.

[DoodleMoo in reply to Jaydee1507]

Thank you so much. I do take 2 tablets of the B complex but as you say, it hasn't been long since I went back on them. I will try increasing Levo by 12.5 mcg and see how that goes.

Again, thank you for your advice.