Latest blood results

[Axleg]

I'm currently on 20mg of T3 Liothyronine in the morning and 100mg of T4 Levothyroxine in the evening and have been for the last 3 or so years with no real dramas.

My TSH has been pretty static for the last 3 years at 0.03 - 0.05 with my free T3 & T4 levels being OK, in the mid range. I've been feeling pretty tired lately with little energy and was due my 6 monthly blood test which I had a few weeks back. Annoyingly they only did my TSH but this has gone up to 2.9 which is quite a jump on my normal 0.03.

Could this be the reason for feeling lethargic and what is the best way to get this down a bit, would I need more or less T4/T3 to try and reduce this?

Thanks for any advice on this.

Alex

[Lalatoot]

To know whether to increase levo or lio t3, you need to know what your levels of ft4 and ft3 are. So step 1 is to get them tested. Then you will be basing your decision on facts rather than guesswork.

[jimh111]

I find taking T3 at bedtime helps tiredness and cognitive function a lot. I would try taking half at breakfast and half at bedtime before adjusting the doses. You can have the blood test before or after this change but try to have the blood taken half way between T3 doses.

[SlowDragon Administrator]

essential to test vitamin D, folate, ferritin and B12 too

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

thyroiduk.org/testing/

Medichecks Thyroid plus antibodies and vitamins

medichecks.com/products/adv...

Blue Horizon Thyroid Premium Gold includes antibodies, cortisol and vitamins

bluehorizonbloodtests.co.uk...

Only do private testing early Monday or Tuesday morning.

Link about thyroid blood tests

thyroiduk.org/testing/thyro...

Link about Hashimoto’s

thyroiduk.org/hypothyroid-b...

Symptoms of hypothyroidism

thyroiduk.org/signs-and-sym...

Tips on how to do DIY finger prick test

See detailed reply by SeasideSusie

healthunlocked.com/thyroidu...

Medichecks and BH also offer private blood draw at clinic near you, or private nurse to your own home…..for an extra fee

[FallingInReverse]

Could this be the reason for feeling lethargic

Generally TSH under 1 is where hypothyroid people feel the best.

Since TSH is what your pituitary gland sends out to tell your thyroid that it need more T4/T3, when we are on optimal dosing of Levo and/or Lio, your pituitary knows it doesn’t need to send out more TSH.

So increased TSH is an indicator that your T4/T3 levels have decreased and are no longer enough.

That would indeed be a reason hypo symptoms have popped up - tired, fatigued, low energy.

But without the right blood tests - you really have no way of knowing anything for sure.

and what is the best way to get this down a bit, would I need more or less T4/T3 to try and reduce this?

A nuance but important, you are not trying to get your TSH down. You need to optimize T4 and T3 and once you do, your pituitary will in turn decrease how much TSH it sends out.

That being said, as   Lalatoot says above, there is no way to know whether you should increase or decrease Levo or Lio and by what amount , until you test these all things at the same time:

- TSH

- Free T4

- Free T3

It’s essential to follow consistent test protocol as Slowdragon detailed. If you can get all these tests from the NHS, follow slowdragon’s links to get privately.

Further, T4 and T3 also need vitamin D, folate, ferritin and B12 to work, and therefore you should test these vitamins at the same time. Even when your T4 and T3 are corrected, if you are sub-optimal in these 4 things you will also need to bring those up for full thyroid health and feeling well. Further, as your thyroid hormones optimize, that will positively impact your vitamin levels.

So your very first next step is to get those test results, then come back here, start a new post and share them here and the collective wisdom of the forum will help!

Ps, T3 split dosing

Also just seeing what  jimh111 said - do you keep a symptom journal? I did, and noticed that I was getting tired 7-8 hours after my morning T3. So I split the dose (2.5 at 6:30 am and 2.5 at about noon) and voila! I stopped falling asleep in the afternoon ! Jim said “ try taking half at breakfast and half at bedtime before adjusting the doses.” T3 splitting strategies are countless and all comes down to tuning in to the subtleties and timing of how you feel.

Nonetheless, your high TSH indicates the full bloods are an absolute must.