Do you know the cause of your hypothyroidism - is it Auto Immune ?
We generally feel best when our T4 is up in the top quadrant of its range with the T3 tracking just behind at around 60-70% through its range.
So your T4 is at 26.10 and around 119% with your T3 at 4.60 and around 40% through ranges.
The accepted conversion ratio when taking T4 only is said to be 1 / 3.50-4.50 - T3/T4 - with most people feeling at their best when they come in this ratio at 4 or under:
So if I divide your T4 by your T3 - I'm getting your conversion coming in at around 5.7 - showing your body struggling to convert and utilise the T4 thyroid hormone replacement.
It could be that with a dose reduction in T4 to bring your level down to around 20 and 80% through the range you may find your T3 and T4 hormonal balance restored to around a 1/4 ratio T3/T4 which is where we tend to feel better
There is a fine balance between T3 and T4 hormones and they need to be able to respond to each other - much like 2 children of even weight can on a seesaw - but if their weight disproportionate - one's stuck in the mud - with one stuck high in the air - and with little fun.
T4 - Levothyroxine is a pro-hormone and needs to be converted in your body into T3 which is the active hormone that runs the body and said to be around 4 x more powerful than T4 :
No thyroid hormone replacement works well until your core strength vitamins and minerals are up and maintained at optimal levels - I now aim for a ferritin at around 100 - folate around 20 - active B12 125 ( serum B12 500++ ) and vitamin D around 125.
So I take it you have ben on this dose of 175 mcg daily for the past 5 years and the exhausting has been creeping up on you over time, as do all the insidious symptoms of hypothyroidism.
So I'd first start off improving your core strength vitamins and minerals - though they are not dire, though we haven't a folate reading - are you taking any supplements at the moment and did you leave these off a week prior to the blood draw so we measure what the body is holding rather than what has been recently ingested ?
How do you take your T4 - empty stomach and wait an hour before eating or drinking anything ?
When you took the blood test was it an early morning appointment - fasting overnight and just taking in water and did you leave around a 24 hour window from your last dose of T4 -
or did you take the T4 before the blood draw ?
I have read that starting HRT can affect one's thyroid hormones and a dose increase in T4 needed by some to maintain optimal T3 and T4 readings but with a T4 over the range - I doubt very much your doctor will do this, as first off s/he will need your T4 back in it's range.
P.S. The range is just that - and some people do run with their T4 slightly over range if this relieves the symptoms of hypothyroidism being tolerated - and we would then expect their T3 to be up at around mid 6s and towards the top of the T3 range -
and not down at just 40 % through the range which is clearly too low a level of T3 for you , or anybody really, to be able to function well and restore health and well being.
Content on HealthUnlocked does not replace the relationship between you and doctors or other healthcare professionals nor the advice you receive from them.
Never delay seeking advice or dialling emergency services because of something that you have read on HealthUnlocked.
Thyroid Blood Results
Thyroid Test Results - Thriva
Thriva advanced thyroid test results - advice please!
Thyroid panel blood test results 
Cholesterol and thyroid test results
