Help with blood results

[Busyfish]

Hi just curious to hear what peeps think about my recent bloods. I've been on 100mg levothyroxine since April 2021 after docs told me I poss had Hashimotos. I had the TPO antibody at a low level I think circa 150. So my October bloods came back last wk as follows:

TSH: 1.64 range: 0.27 - 4.2

T4: 15.8 range: 10 - 22

T3: 3.8 range: 3.1 - 6.8

Should I increase my dose? I feel my T3 is low - should it not be sitting much higher? and should my TSH sit under 1?

Thanks

[Lalatoot]

Yes I would try an increase if those were my results.

[Busyfish in reply to Lalatoot]

Thank you. I used econsult and the response from the docs today is that it is OK to up dose to 125mg. In an ideal world where do you think my t3 should be?

[Lalatoot in reply to Busyfish]

Let the increase do its work first and give the body time to adapt before thinking where your ft3 should be.At this stage too you need to be looking, if you haven't already, at your vitamin levels as they need to be good for efficient t4 to t3 conversion. B12, folate, ferritin and vit d. As a rough guid the results should be in the top third of the vitamins range. If there is only a higher than number for the range your result should be double that.

Another boost to conversion for some is to split the levo dose. Some have found that this improves thyroid hormone levels.

Adding liothyronine t3 to levo is not a quick fix as it can take years to settle on doses. It cannot be readily had on NHS prescription so many rely on private prescription or importing it for their personal use . It is much simpler to be on levo only so I'd advice anyone to explore all the levo possibilities first making sure you are on a high enough dose and all cofactors are optimal before considering t3 combo.

[Sexyfish]

It depends. You would need to test your reverse T3 which in the UK can only be done privately and it’s not cheap. Equally testing for the dodgy DIO2 gene is helpful also. This is to see if you have a conversion issue. If you don’t, then a slightly higher dose of T4 might be ok. If you do have a conversion issue, increasing T4 won’t help (it will send most of it to reverse T3 which will make you feel worse) and you will need to get some T3.

TPO antibodies at 150 definitely suggests Hashis - all of this just means you need to monitor your symptoms more closely Hashis sufferers generally benefit from higher T3 levels (ie second half of range). This is more important than what your TSH level is.