Another 8 weeks on. Advice, please

[WaystarRoyco]

Hi everyone.

Background: I was diagnosed with hypothyroidism some years ago, but only discovered last November (2023), thanks to the forum, that I have an atrophied thyroid. Also, upped my dose of Levothyroxine in early October from 100 mcg Levothyroxine 3 times a week and 125 4 times a week plus 10mcg Lio a day to 125mcg Levothyroxine 7 days a week, Lio unchanged at 10mcg a day.

The last time I checked in here after a blood test I was feeling somewhat better than I had been. This time, I'm still feeling better than when I began increasing last autumn. I have more energy and have even been able to start doing a little exercise again. But I can at times feel slightly wired and restless and have bouts of diarrhoea.

Here are the results of my Medichecks test this week. I did it as per guidelines here, EXCEPT for T4 which I took about 26 or 27 hours before the test. Long story. Got up for a pee around 3am and took it on autopilot. The point is, I think the FT4 result is lower than it might have been?

CRP HS 0.4 mg/l (0 - 5)

Ferritin 144 ug/L (13 - 150)

Folate >20.0 ug/L (>2.9)

Vit B12 256.0 pmo/L (25.1 - 165)

Vit D 183 nmol/L

TSH <0.01 mlU/L (0.27 - 4.2)

FT3 5.1 pmol/L (3.1 - 6.8)

FT4 19.2 pmol/L (12 - 22)

Thyroglobulin antibodies 13.7 IU/mL (0-115)

Thyroid peroxidase antibodies <9.00 IU/mL (0-34)

What would you recommend from here?

[Jaydee1507 Administrator]

Free T4 (fT4) 19.2 pmol/L (12 - 22) 72.0%

Free T3 (fT3) 5.1 pmol/L (2.4 - 6) 75.0%

On paper these look like optimal results but of course there are variables and we are individuals.

If you think your FT4 might have been a little higher you could try dropping 12.5mcgs Levo a day or even a small amount less by alternating doses.

Vitamins are looking good, well done.

Vit D is a tad on the high side. Vitamin D should be around 100 - 150.

How much are you taking? Could do with being reduced a little.

[WaystarRoyco in reply to Jaydee1507]

Thank you. How are you calculating percentages? I get FT3 to be 54% through range. I did wonder whether a tiny drop of T4 and a tiny increase in T3 might be appropriate. So hard to get my head round it!

I'm taking Solgar Vitamin D3 1000 IU.

[Jaydee1507 Administrator in reply to WaystarRoyco]

Apologies I hadn't changed the range value correctly so you are right on the Ft3 being 54%.

Your FT4 doesn't need to drop any so a small T3 increase should help.

How are you taking your 10mcgs T3?

If on 15mcgs you can split it 3x so morning, late afternoon & bedtime.

Thats a very small amount of vit D for such a high result. Are you sure there isn't vit D in anything else you take?

[WaystarRoyco in reply to Jaydee1507]

Okay. Thanks for double checking! I usually take T3 in two doses: 8am and 5pm. If I was going to try a third dose, should I bring the second one forward?

I don’t think there’s D3 in anything else but I will check. What amount do you think I should be taking, if any, given my current result?

[Jaydee1507 Administrator in reply to WaystarRoyco]

Ideally T3 doses should be evenly spaced approx 8 hour apart, hence suggesting adding a bed time dose which would leave your current schedule unchanged.

You do need to experiment yourself and could also try 10mcgs morning then 5mcgs at 5pm. See what works for you.

Looking at your current D3 level you don't need to take any if you really are only taking 1,000iu a day which is a pretty low amount.

[WaystarRoyco in reply to Jaydee1507]

Okay. I could maybe try 6am, 2pm, 10pm.

And I’ll drop the D3.

Will do another test in another 6-8 weeks. Actually I have to for my endocrinologist but it’ll be interesting to see where and how I am then.

Thanks so much for your help and support. I really appreciate it.