Monitoring my bloods with medichecks, I am taking 15mcg Lio in two doses and 125mcg levo daily.
Results:
T4 7.1 range 3 1-6.8
T3 21.1 range 12-22
My numbers are a little high but I definitely do not feel high, however when I next see my endo (4 months) if these numbers don't change he will almost certainly want to reduce my meds.
Thought I may lower my Levo too 100 a day but wanted some advice?
Many thanks
Free T4 (fT4) 21.1 pmol/L (12 - 22) 91.0%
Thats quite a high % of T4 when you are taking T3. I think your gut feeling is right to drop the Levo a little.
What are your latest results for key vitamins - ferritin, folate, B12 & d3? It is essential to get these levels to OPTIMAL.
What are you supplementing with?
Haven't done any supplement test for a while, I have found when I take supplements I am quite ill (but quickly feel better when I stop (and I have mixed up what I stop and when to see if it's one particular supplement causing it) (I mostly use "clean British" brand) I also probably have fibro (not sure if that matters) so I was taking vit C, D, Bs, omegas 3,5,7, 5http (I don't sleep well) but now just take magnesium at 8pm.
Low vitamin levels mean our thyroid hormone doesnt work well.
Were the B vitamins you were taking in the active/methyl form?
Being over replaced can make you feel hypo.
I suggest you get your vitamin levels checked which is essential.
Private tests are available, see link for companies offering private blood tests & discount codes, some offer a blood draw service at an extra cost. thyroiduk.org/help-and-supp...
You have ft4 and ft3 mixed up on the results.
We need to know how many hours you left between your last dose of each hormone and the blood draw. That way we can interpret the results.
If you left 24 hours between last levo dose and blood draw then that ft4 result is about the lowest level for ft4. If you left 2 - 4 hours after your levo then you are looking at the highest your ft4 gets in general.
Likewise ft3 if you took blood 2 - 4 hours after a dose then that is the peak level you have measured. If you left the same number of hours as you normally have between doses between your dose and blood draw then you are looking at the lowest level.
Thank you - rookie mistake, good catch 🙄I took last (only) dose levo 06.30ish previous day and did blood test 03.00ish so almost 21hrs.
Last dose of lio was 15.00ish previous day so about 12 hrs.
personally….then looking at timings…..I would try reducing T3 by 5mcg
Or retest
Last dose levothyroxine 24 hours before test and split T3 as 10mcg x 3 doses spread through the day…..last 10mcg dose T3 approx 8-12 hours before test
Definitely test vitamin D, folate, ferritin and B12 too
Thank you, ferretin usually high but iron ok - gp doesn't seem to worry about this. I will get a range test done.I will retest thyroid in a couple of weeks once adjustments take effect.
High ferritin
Are you pre or post menopause
healthunlocked.com/thyroidu...
We have received further information the lab about ferritin reference ranges. They confirm that they are sex dependent up to the age of 60, then beyond the age of 60 the reference range is the same for both sexes:
Males 16-60: 30-400 ug/L
Female's: 16-60: 30-150
Both >60: 30-650
The lower limit of 30 ug/L is in accordance with the updated NICE guidance and the upper limits are in accordance with guidance from the Association of Clinical Biochemists. ‘
Post, and over 60. I will take a look at the updated numbers.Thanks 😊
So you are looking at ft4 near the lowest it gets and and average level for ft3.Next possibility is a hashis flare. Do you have hashis? Do these latest results reflect other results so not a hashis flare?
If these were my results and I thought they were not driven by a hashis flare I would definitely be looking to reduce my levo and or lio, one thing at a time.
I would reduce levo first by 25mcg daily. Reducing levo will reduce both ft4 and ft3. It will take a while for things to settle. So 6 to 8 weeks then blood tests again. Then be guided by thee next set of results as to any further changes. Reducing my levo by 25mcg caused my ft3 to drop by 0.5 so you may not see a big drop in ft3 away from the top of range. You might wish to consider a change in t3 dose then depending on what the next results show.
If you chose to lower your t3 dose first rather than levo, this would bring your ft3 down into range quicker but lowering your t3 dose will slightly increase your ft4 levels which you don't need.
Thank you, I do have hashi not sure it's a flare - what does that look/feel like? Looking at medichecks graph it's a very gentle increase in nothing T3 and T4. I was thinking of reducing levo to 100 daily at first, loath to reduce T3 as it took a long fight to get it prescribed 😊.
Well you don’t need to tell endocrinologist you have reduced T3 …..or T4
It frequently takes months/years to fine tune mix of T3 and T4
What size T3 tablets are you prescribed?
which brand of T3 are T4 you taking
Do you always get same brand
Easy to cut 20mcg tablets into 1/4’s
I would suspect reducing levothyroxine by 25mcg is too much. If you’re going to reduce levothyroxine try reducing by 12.5mcg daily or even only 4 days per week
OKI have 5 and 10s T3, take a 10 in am and 5 in pm
Yes have same brand - I can't tolerated T4 teva so assume same for T3, uts on my notes.
I will do as you say re T4, as I have 100s and 50s (teva only company make 25s) I can easily adjust.
I am taking 15mcg Lio in two doses
and 125mcg levo daily.
I read that as taking 15mcg twice a day
(ie. 30mcg in total)
So yes if only on 15mcg in total……try reducing levothyroxine……initially to 112.5mcg daily …..cutting 25mcg in half to get 12.5mcg
(or 100mcg/125mcg alternate days)
T3
Are you getting Roma capsules or tablets
If tablets it will be Morningside Liothyronine as they are only ones licensed in U.K. currently for 5mcg and 10mcg tablets
It’s much, much more expensive to get 5mcg and 10mcg tablets than getting 20mcg tablets and cutting into 1/4’s
Up to date prices discussed in this post
healthunlocked.com/thyroidu...
Currently NHS pay - April 2023
Liothyronine tablets
28 x 20mcg = £50.60 - Morningside or Mercury Pharma or Teva brand available
28 x 10mcg = £152 (single supplier)
28 x 5mcg = £120.50
Liothyronine capsules
28 x 20mcg = £55
28 x 10mcg = £65
28 x 5mcg = £55
So currently in April 2023
20mcg tablets are CHEAPER than capsules
So if only on 15mcg per day …….
Perhaps consider…..As a separate change…..NOT at same time as reducing levothyroxine
Suggest trying 3 x 5mcg ……roughly equal 8 hour intervals……waking, mid afternoon and bedtime
5mcg at bedtime often improves sleep
Or if 5mcg at bedtime keeps you awake….waking, noon and 6pm
I have Morningside tablets. I did speak with my gp some time ago about the cost and he wasn't bothered so ....I used to take the 5mcg in the early evening but it did keep me awake.
I will try reducing my levo 1st.
Thanks 😊
Teva levothyroxine contains mannitol as filler instead of lactose. It’s mannitol that upsets many people
Teva T3 doesn’t contain mannitol, but is still lactose free
Mercury Pharma and Wockhardt also make 25mcg tablets
Which brand levothyroxine are you taking
Easy to cut 50mcg in half to get 25mcg ….or into 1/4’s
Use pill dispenser to save spare pieces
Yes I would reduce levo first as you suggest.
If after the next set of bloods ft3 is still at top of range I'd reduce T3 by 2.5mcg maybe so half a 5mcg tablet.
Re your fight to get T3 - any endo looking at your current results would say you are over medicated so you may have to reduce your T3 if your results remain high. Otherwise you risk your whole dose being withdrawn rather than just accepting a reduction.
Thank you.
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