What should I do now?

[Jamima]

My latest thyroid test shows an improvement on my GP test (no t3) in July. Since July I’ve been using metavive I at 3 per day and for the past 6/7 weeks I switched to levo 50mcg and T3 3 moving up to 9mcg which I’ve since dropped back to 6 as I felt really unwell on 9. I’ve tried raising my levo but always end up feeling tired so I’m still on 50mcg. My bowels are definitely better as is my brain fog and I’ve lost a bit of weight without changing anything other than walking for longer., but I’m still tired a lot of the time, although no crashing episodes. Should I try to raise levo again?

21/7/23 - GP test

Tsh 2.5 (0.23-5.6)

FT4 13 (9-28)

[Jaydee1507 Administrator]

So how long have you been on a stable dose and what was the dose timing prior to the blood test? For levo 24hrs is recommended, T3 6-8 hours.

Free T4 (fT4) 16.9 pmol/L (12 - 22) 49.0%

Free T3 (fT3) 5.1 pmol/L (3.1 - 6.8) 54.1%

You're getting close to optimally medicated so could try a small Levo increase of say 12.5mcgs.

[Jamima in reply to Jaydee1507]

Stable dose 7 weeks, I followed all the timings, T3 was a 12 hour delay, levo 24hr. Should I try levo only and see what my own conversion is?

[Jaydee1507 Administrator in reply to Jamima]

You're so close to being optimally replaced that it wouldn't be wise to switch to Levo only at this point.

Have you ever tried Levo alone?

[Jamima in reply to Jaydee1507]

Thank you. Yes, I’ve tried levo solo a couple of times and it made me quite unwell, but I know my adrenals were in bad shape and are definitely better now. I’ll try a 12.5 levo increase. Thanks again.

[Jamima in reply to Jaydee1507]

Just out of interest, what is optimal? I know it’s like the proverbial piece of string, but just a ballpark.

[Jaydee1507 Administrator in reply to Jamima]

Proviso that this is a very individual thing, but speaking very, very generally, both FT4 & FT3 at around 70% of range is a place that some people do well. You are not too far off that at the moment.

I've just been reading some of your old posts and as you have tried a number of hormones and adrenal meds it would be a good idea to write your bio up with a brief summary of whats happened and what you are trying currently.

I wonder what if anything you have tried diet wise? Gluten/dairy free? Anything else? You have mentioned swelling up a few times and that can point towards histamine issues.

[Jamima in reply to Jaydee1507]

Thank you Jaydee - I will write up my bio, I’ve got some notes somewhere that I compiled to give pre medic visits, every single one of them ignored those notes! Aaanyway, I moved on and without this forum god knows what sort of state I’d be in. The swelling is pretty much gone now, I don’t know if it was a sex hormone or thyroid hormone issue, perhaps both, but I haven’t noticed it in the past couple of months so can only assume the self medicating has more or less sorted it. I had some really awful reactions to bug bites that I never experienced before and I wonder if that was due to low cortisol? I no longer use hydrocortisone as since introducing T3 my levels seem ‘normal’, but I will saliva test cortisol next week. Thanks again, it’s always good to have a reassuring voice when you’re flying solo.