Do I reduce to 50 or 62.5mcg Levo?

[Amber-sky]

Hi, could I have some advise please as to whether I should reduce to 50mcg or 62.5mcg of Levo?

My last two blood tests show a low TSH and high T3 (most recent below and previous ones on my profile).

TSH .01 mIU/L (.3 - 4.2) -7.4%

Free T4 (fT4) 15.4 pmol/L (9 - 19) 64.0%

Free T3 (fT3) 6.2 pmol/L (3 - 5.4) 133.3%

T4:T3 Ratio 2.484 

( I follow all the blood test guidelines on fasting, before 9am etc ).

I have been taking 75mcg Levo for just over a year and have been gradually experiencing more fatigue and anxiety. I initially thought I would need an increase but the tests show otherwise. My weight is a steady 50kg.

My GP suggests that I reduce to 50mcg but I read on here on that that is more of a starter dose - but is it be the right amount for some people?

Or should I ask to reduce to 62.5mcg? If so, is it better to alternative 50 and 75 each day or split a 25 in half and take it with 50? Does anyone know if GPs are happy to do this?

Also my GP always requests 3 months not 6/8 weeks between blood tests. Is this too long to wait, particularly if things aren’t quite right?

Below is GPs text comment.

“I'd like to reduce your thyroxine dose from 75mcg to 50mcg because your T3 is higher and your TSH is lower than last time - which tells me you are on slightly too much thyroxine. Your T4 remains normal. I have sent a prescription to Lloydsdirect so the new dose should come by post. Please can you do a repeat blood test in 3 months. to check the new dose?”

I have a telephone consultation booked with them later this week so any advice would be much appreciated, and is anyone else on just 50 mcg and find that OK?

Thanks

[SlowDragon Administrator]

Are you ONLY taking levothyroxine or also taking T3 (liothyronine) or NDT as well?

Was test done early morning, ideally before 9am, only drinking water between waking and test and last dose Levo 24 hours before test

NDT or 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

what vitamin supplements are you taking

Please add latest vitamin D, folate, ferritin and B12 results

[Amber-sky in reply to SlowDragon]

Hi there. Yes I’m only taking levothyroxine and tested early morning, only drank water and last Levo dose was 24 hrs before test.

Have been taking vitamin D3 and B Complex since last test results below from medichecks September 2023.

Folate - Serum 26.1 ug/L (8.83 - 60.8) 33.2%

Vitamin B12 150 nmol/L (37.5 - 188) 74.8%

Vitamin D 91.1 nmol/L (50 - 250) 20.5%

Ferritin 82.1 ug/L (30 - 150) 43.4%

[Cornwaller]

The doctor's advice seems reasonable. If you become hypo then you could nudge back up again - assuming you have squirrelled a bit of levo away!

[Minimol]

Hi Amber-sky, personally I’d want to see a consistent set of bloods (2 or more years) showing FT3 as over range before changing my dose of Levo. as it could be a blip of some kind that’s caused your FT3 result from Biotin in the B Vitamins you’re taking to a virus etc., 🤷‍♀️ However if you’re not feeling good it might be worth trying a lower dose to see if it helps. Maybe reducing 25mcg (a third of your usual dose) is too much to drop in one go and you might choose to take alternate daily doses of 50mcg and 75mcg at first?