help with labs

[Marinaaa]

Hi again,

I am feeling a bit down and I think I might need to increase my lio meds a bit and would need some advice on how to do it. I wont see my endo until two months and he adviced to do it if FT3 went down sometime. I always feel better when my FT3 is around 3.6. never been over that however. Anything lower than 3 makes me feel really bad.

I am currently taking 88levo plus 25 lio.

I´m thinking of lowering o 75 levo and add 6extra lio? or maybe 12? will FT4 go down excessively? Is this important? Is it necessary to have good Ft4 as well? my endo said they should be balanced and both had some mechanisms in the body.

Perhaps adding just lio to the levo I¨m currently taking could be another posibility.

Well, these are my most recent labs: I¨m 45 and experiencing menopause sympthoms.

APRIL 2024

DAY 3 FSH 34.57 UI/l (previous labs FSH was 40(sept), 30(july) and 75(december 2023)

ESTRADIOL 25,3pg/mL

PROGESTERONE 0,45 ng/mL

TESTOSTERONE TOTAL 0,09 ng/mL

FREE TESTOSTERONE 0,57pg/mL

TSH 0,01

FT4 1.16 ng/dL (range 0.92- 1.68)

F T3 3.07 pg/mL (range 2-4.4)

Previous labs NOVEMBER 2023

TSH 0.02

T4L 1.01 ng/dL (range 0.92- 1.68)

T3 1.43

FT3 3.62 pg/mL (range 2-4.4)

My symphtoms are tiredness and waking up at night with sweats. Stomach noises and some pain. apparently a new endometrioma found which had been gone. I know some of them are mixed with perimenopausal sympthoms, but still FT3 isnt great.

Thanks for your priceless help. I would appreciate some advice here.

[SlowDragon Administrator]

Free T4 (fT4) 1.16 pmol/L (.92 - 1.68) 31.6%

Free T3 (fT3) 3.07 pmol/L (2 - 4.4) 44.6%

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 did your test?

Results suggest you might be best increasing levothyroxine to 100mcg

Retest 6-8 weeks later

You should see both Ft4 and Ft3 increase a little

[Marinaaa in reply to SlowDragon]

Hi Slowdragon, I take the all the dose in the morning before breakfast, I have been doing it like this for years, I tried the split option and it didnt work for me.

Also, in the past, my endo tried with 100 levo and that didnt increase Ft3 at all, it even went down, and created more resistance and I felt more hypo, thats why I started on T3, because I dont convert well.

He even tried with 125 levo and it didnt work at all, I can tell you. You can probably read it on my previous posts.

Should I then increase lio without increasing levo?

Is it important for FT4 to be in a good position as well or not? thanks

[SlowDragon Administrator in reply to Marinaaa]

But that experience was when on only Levo

It could/should be better now taking T3 as well

It would result in Ft4 and Ft3 being more in balance

If you try increasing levothyroxine…..retest 6-8 weeks later

If it’s no good, then reduce levothyroxine and try extra T3 instead

[Marinaaa in reply to SlowDragon]

Yes, but now taking 25mcg lio my Ft3 is low, because i¨m not converting well levo. In the past, when I converted better, it reached up to 3.6. Still not top of the range but I felt ok. So if I¨m at amoment of not converting well, i´m not to convert better with more levo, it is my guess and dont want to play around changing doses a lot and risk feeling crap. In the past even taking 100mcg levo or 125mcg levo my FT3 resulted in 2.3 and I felt very unwell.

I got this same values last summer and couldnt talk to my endo until november as he was on a leave, he advised that if this happened again I should be reducing to 75 levo and increasing 12 lio. Just wanted to check with you because 12 lio seemed like a lot to me, I thought 6 was more appropiate, but I¨m not going to increase levo as my RT3 increased in the past when I increased it over 88mcg, so its going to happen again.