I am now taking 50mcg Levothyroxine and 25mcg Liothyronine (the latter split into 2 doses approximately 12 hours apart).
Before the trail I was taking 75mcg and 100mcg Levothyroxine on alternate days.
My FT4 level has dropped from 10.6 (September 2023) to 6.6pmol/L. (Range 8.0 - 17.0)
My TSH level has risen from 1.12 (September 2023) to 1.64miu/L. (Range 0.38 - 5.33)
My FT3 levels were not measured this time but were 5.8pmol/L in September this year. (Range 3.8 - 6.0)
(I follow the recommended testing protocol from this forum.)
Occasionally I think that my symptoms, particularly fatigue, may have very slightly improved, However, the difference is so minimal, I'm not entirely convinced there has been any improvement.
My surgery called me this morning to arrange a discussion with my GP next week.
Presumably I should press for an increase in medication? T4? T3? Or both?
Is it to be expected that my FT4 will have fallen as I'm taking less Levothyroxine?
Written by
Ogbourne
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It will have fallen because you're taking less thyroxine, yes, but also because you're taking T3, which does lower FT4 levels. But, there was really no need to reduce your levo at all. Your FT4 wasn't high. Endos insist on doing this without having the slightest idea why they're doing it, they've just been told that's the protocol so they stick to it doggedly, whether they need to or not. And often it adversly affects the patient. So, if I were you, I'd insist they put the levo back up to where it was.
My FT3 levels were not measured this time but were 5.8pmol/L in September this year. (Range 3.8 - 6.0)
Obviously that’s useless
You may need less T3 and more Levo
Suggest you test privately first BEFORE changing dose
Recommended that all thyroid blood tests early morning, ideally just before 9am, only drink water between waking and test and last dose levothyroxine 24 hours before test
This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip)
On T3 - day before test split T3 as 2 or 3 smaller doses spread through the day with last dose 8-12 hours before test
Private tests are available as NHS currently rarely tests Ft3 or all relevant vitamins
Testing options and includes money off codes for private testing
Interestingly at my consultation yesterday, my endo told me that as I am now on combination therapy (T3 and T4) the only result which is relevant is my TSH. She was not at all concerned that my T4 had dropped below the reference range.
My GP practice has made an appointment for me to see my GP tomorrow re my recent thyroid function test. I'm expecting him to tell me that my T4 is now too low.
Anyway, as a result of my consultation, I am now taking an extra 25 mcg of Levo per day and will be re-tested in 4 weeks time. At which point, if I am not feeling better, I will change my dose to 40 mcg T3 per and 50 mcg T4. She seemed OK with my experimenting with different doses as long as I was tested regularly to ensure that my TSH did not drop below 0.38 miu/L.
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