Latest round of bloods since being on T4+T3

[dexterholland91]

Hey everyone,

I like to post my latest round of bloods on here each time so people can give me a better insight into what’s happening surrounding my Hashimoto journey.

My 13th December bloods were with me taking 175 mcg T4 only and the latest round of bloods is with me now taking 162.5 mcg T4 along with 10 mcg T3. I have been on this ratio for roughly 8 weeks or more.

My free T3 has come up to 58.3% through the range, but me being on 12.5 mcg lower T4 has brought my free T4 down to 51% which seems quite drastic for such a small drop in T4?

I am still up and down very much symptom wise, I don’t seem to be able to get on top of the illness as of yet ☹.

Do the bloods suggest I should add back in the 12.5 t4 I dropped? And, could it be wise to up the T3 slightly too? I would love to know your thoughts.

Thank you 😊

28/2/24 results:

162.5 mcg T4

10 mcg T3

• TSH 0.62 mU/L (0.30 - 4.20) 8.2%

• Free T4 (fT4) 14.1 pmol/L (9.0 - 19.0) 51.0%

• Free T3 (fT3) 4.4 pmol/L (3 - 5.4) 58.3%

• T4:T3 Ratio 3.205 

• Folate - Serum 13.5 ug/L (3.0 - 20.0) 61.8%

• Vitamin B12 580 nmol/L (180 - 900) 55.6%

• Vitamin D 122 nmol/L (50 - 250) 36.0%

• Ferritin 90.1 microg/L (30 - 336) 19.6%

13/12/23 results:

175 mcg T4 only

• TSH 0.74 mIU/L (0.30 - 4.20) 11.3%

• Free T4 (fT4) 17.6 pmol/L (9.0 - 19.0) 86.0%

• Free T3 (fT3) 4 pmol/L (3 - 5.4) 41.7%

• T4:T3 Ratio 4.400 

• Folate - Serum 14.3 ug/L (3.0 - 20.0) 66.5%

• Vitamin B12 566 nmol/L (180 - 900) 53.6%

• Ferritin 90.1 ug/L (30 - 336) 19.6%

[TiggerMe]

I'd agree that you need to add back the 12.5mcg as your Dec results at 86% suggest there was no need to reduce... also adding T3 often knocks fT4 levels down

I'd adjust the T4 first and wait 8 weeks, then if you think you want to raise your T3 do it in 2.5mcg so you don't miss your sweet spot... you may find adding back in the T4 will do the trick

[SlowDragon Administrator]

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)

T3 ….day before test split T3 as 2 or 3 smaller doses spread through the day, with last dose approximately 8-12 hours before test

Is this how you do your tests

[dexterholland91 in reply to SlowDragon]

Yep, this isn't my first rodeo haha. I've been on this forum long enough now to know the do's and don'ts of blood testing protocol. Thanks

[SlowDragon Administrator in reply to dexterholland91]

So yes…..perhaps small increase of 12.5mcg back up in Levo

Retest in 8 weeks