As you can see I now have my bloods back and looks like I need to increase my Thyroxine as both TSH and T4 are and issue? My test was in the morning and I had not had any medication for around 30 hours. The Cortisol is also elevated.
Any pointers would be good.
Thanks
Alex
looking at previous posts
You’re on 100mcg levothyroxine and 20mcg T3 ?
Which brand levothyroxine and which brand T3
Anything changed recently
what vitamin supplements are you taking
B12 and folate low
The only vits I take are Borroca! Not sure that covers what I'm needing.
Suggest you get a good quality separate B12 and a good quality daily vitamin B complex
Low B12 symptoms
b12deficiency.info/signs-an...
methyl-life.com/blogs/defic...
With serum B12 result below 500, (Or active B12 below 70) recommended to be taking a separate B12 supplement and a week later add a separate vitamin B Complex
Then once your serum B12 is over 500 (or Active B12 level has reached 70), you may be able to reduce then stop the B12 and just carry on with the B Complex.
If Vegetarian or vegan likely to need ongoing separate B12 few times a week
Highly effective B12 drops
natureprovides.com/products...
Or
B12 sublingual lozenges
uk.iherb.com/pr/jarrow-form...
cytoplan.co.uk/shop-by-prod...
B12 range in U.K. is too wide
Interesting that in this research B12 below 400 is considered inadequate
healthunlocked.com/thyroidu...
Low folate
supplementing a good quality daily vitamin B complex, one with folate in (not folic acid)
This can help keep all B vitamins in balance and will help maintain B12 levels too
Difference between folate and folic acid
healthline.com/nutrition/fo...
B vitamins best taken after breakfast
Thorne Basic B recommended vitamin B complex that contains folate, but they are large capsules. (You can tip powder out if can’t swallow capsule)
Thorne currently difficult to find at reasonable price, should be around £20-£25. iherb.com often have in stock. Or try ebay
Igennus B complex popular option too. Nice small tablets. Most people only find they need one per day. But a few people find it’s not high enough dose
Post discussing different B complex
healthunlocked.com/thyroidu...
IMPORTANT......If you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 7 days before ALL BLOOD TESTS , as biotin can falsely affect test results
endo.confex.com/endo/2016en...
endocrinenews.endocrine.org...
In week before blood test, when you stop vitamin B complex, you might want to consider taking a separate folate supplement (eg Jarrow methyl folate 400mcg) and continue separate B12
Post discussing how biotin can affect test results
My T3 is Aristo currently. Thanks
You mean your levothyroxine
T3 in U.K. on NHS
Teva, Morningside or Mercury Pharma
NHS.
So you are getting a bit of a false low by leaving it 30 hours rather than 24 but you are absolutely in need of an increase of 25mcg and retest in 6-8 weeks, you'd also benefit from improving your folate and B12 levels and Vit D ideally needs to be 100-150... do you already take any supplements?
EDIT!... I see you are on combined T3 & 4 so leaving 30 hours after T3 means this reading is totally inaccurate as T3 has a short life, I would say you are ok to increase your T4 but keep your T3 the same until you have retested leaving 24 hours after last T4 and 8-12 after last T3 having split your dose into 2 the day before, pre 9am test nothing but water before
3 weeks after part thyroidectomy follow up appointment 
Follow-up blood test result - without medication
Update from follow up
Follow up from T3 seized post earlier this year
My follow up blood tests, what do they show?
