What to do about lower than expected test results?

[WaystarRoyco]

I’d value some advice about what to do regarding my most recent test results:

TSH: 0.02 (0.27 - 4.2)

FT3: 4.6 (3.1 - 6.8) 40.5 %

FT4: 18 (12 - 22) 60%

This was on 125mcg Levo five time a week; 100mcg twice a week and 10mcg of Lio a day. Test done per guidelines here.

I reduced it from 125mcg Levo seven days a week 8 or 9 weeks ago per suggestions from here. It has come down more than I’d imagined.

For info, I’ve had a hugely stressful last couple of months. Major relationship problems and a lot of ongoing uncertainty about life, work, money… My sleep has been wrecked and anxiety through the roof. I’m sure the stress is contributing to the thyroid results. Energy-wise, I’ve been worse (which isn the sleep situation), but my weight, which was slowly dropping, has stalled, my hair is falling out, incredible give and I’ve got more brain fog again. I’m thinking of going back to 125mcg Levo on a daily basis again. What do you think?

[SlowDragon Administrator]

Is your hypothyroidism autoimmune

When were ferritin, folate, B12 and vitamin D last tested

What vitamin supplements are you taking

Hair loss suggests low iron/ferritin

Which brand of levothyroxine are you taking

Do you always get same brand at each prescription

on almost any dose T3 it’s highly likely TSH will drop very low or suppressed

Do you always split your T3 as 2 x 5mcg

Was last 5mcg dose 8-12 hours before test

[WaystarRoyco in reply to SlowDragon]

Is your hypothyroidism autoimmune?

I believe I have Ord's, based on a thyroid scan last autumn, which showed atrophied thyroid. However, the usual antibodies that are tested (Thyroglobulin and Thyroid Peroxidase) have never come back as raised. (I went for years feeling like shit but being untreated...)

When were ferritin, folate, B12 and vitamin D last tested?

January this year, though obviously before all the stress kicked off:

Ferritin 144 (13 - 150)

Folate >20 (>2.9)

B12 >256 (25.1 - 200)

Vit D 183 (50 - 200)

What vitamin supplements are you taking?

I am taking Pure Encapsulations B-Complex Plus; Seeking Health Methyl B12 with L-Methylfolate; Seeking Health Magnesium Malate; Zinc 30. For info, these were all recommended by an FM practitioner on the Thyroid UK list.

I'm not currently supplementing Vit D.

Which brand of levothyroxine are you taking? Do you always get same brand at each prescription?

Currently taking TEVA and have been for some months now. I do try to get the same brand each time. I know TEVA disagrees with some people, but I seem to get on well with it usually.

Do you always split your T3 as 2 x 5mcg? Was last 5mcg dose 8-12 hours before test?

Yes, I usually split it like that. On the day before the test I split it 5mcg 6am; 2.5mcg 2pm; 2.5mcg 9.30pm. Test was taken at 7.30 am.

[SlowDragon Administrator in reply to WaystarRoyco]

Yes, I usually split it like that. On the day before the test I split it 5mcg 6am; 2.5mcg 2pm; 2.5mcg 9.30pm. Test was taken at 7.30 am.

So you need 5mcg dose increase in T3

Retest in 8 weeks

[WaystarRoyco in reply to SlowDragon]

Thanks, @SlowDragon. Would you split it into three, as I did before the test?