Oops on Lio dose - should I reduce?

[Decant]

Hi,

I posted my latest results from 12th June here: healthunlocked.com/thyroidu...

I stated there that I'm taking 125 mcg T4 and 15 mcg T3 (3/4 of one pill), approximately 185 mcg at a 4:1 ratio. However I've just spotted that my T3 pills are 25 mcg, not 20, so I've been taking 18.75 mcg T3 which gives an approximate 200 mcg. I started ADHD medication 3 months ago and TRT last week so maybe I no longer need so much thyroid meds to give me mental clarity and physical energy?

I'm feeling well but I am feeling very hot at times (yes I know it's been hot weather!), vet hot at night, sweating heavily (and more than colleagues) whilst wearing my full length and heavy choir robes at church.

Should I reduce my dose?

Results from 12th June:

TSH 0.02 mIU/L (0.27 - 4.2) -6.4%

Free T4 (fT4) 14.2 pmol/L (12 - 22) 22%

Free T3 (fT3) 5.84 pmol/L (3.1 - 6.8) 74.1%

T4:T3 Ratio 2.432 

Thanks!

[greygoose]

approximately 185 mcg at a 4:1 ratio

so I've been taking 18.75 mcg T3 which gives an approximate 200 mcg.

No, this is wrong. You can't make comparisons like that because there are so many variables - not least, how well you convert. And, if you're taking T3, presumably you don't convert very well. Besides, T4 and T3 are two different hormones, they do different things. They are not interchangeable. So, forget all that.

You have been taking 125 mcg T4 - fine, although your FT4 could be higher, but maybe that's the right level for you. But, the difference between 15 mcg and 18.75 mcg is so small that it really doesn't matter that much. If you feel good then don't reduce anything. Your FT3 is not that high.

And, forget ratios. They're not useful when on thyroid hormone replacement. You need what you need, not what a euthyroid person needs. Ratios are for healthy people, not hypos.

[Decant in reply to greygoose]

Cool, many thanks, I'll stick where I am. There's enough changing already!

[greygoose in reply to Decant]

You're welcome.

[SlowDragon Administrator]

was test done early morning and last dose levothyroxine 24 hours before test

Last 1/4 tablet T3 approx 8-12 hours before test

Do you always get same brand levothyroxine at each prescription

some members find they need BOTH Ft4 and Ft3 at least 50% through range

You might need slightly more levothyroxine - eg add another 12.5mcg 3 days a week

Retest in 6-8 weeks

See what results show…..you might then need small reduction in T3

When were vitamin D, folate, ferritin and B12 last tested

[Decant in reply to SlowDragon]

Bloods were drawn exactly as per protocol. My linked post has all the details and the wonderful answers from yourselves.

I'll stick to 3/4 of the T3 pill, which gives 18.75 mcg not 15 mcg as I thought.

I'll be having more NHS bloods in July (to see if my TSH will rise - it won't) and full private bloods in September to check everything.

I'll have to come clean about the sneaky T3 after the NHS bloods as they think I've only just reduced T4 from 150 to 125 mcg after recent bloods, but it's really been months. I will use the GP's note from 2007 saying how well I was doing on the previous T3 trial.

Thanks!