Once on T4 - Levothyroxine we generally feel best when the T4 is up in the top quadrant of its range at around 80% with the T3 tracking just behind at around 70 % through its range and at around a 1/4 ratio T3/T4.
Currently your T4 is at around 41% with your T3 tracking at around 17% through the ranges:
Once on thyroid hormone replacement the TSH should be kept under 2 - likely under 1 and with most people feeling improved when the TSH is towards the bottom end of the range.
No thyroid hormone replacement works well until your core strength vitamins and minerals are optimal so it would be a good idea to have your ferritin, folate, B12 and vitamin D run.
Your physical symptom of feeling a bit better and now feeling tired again is your body adjusting to the thyroid hormone and telling you that you are still hypothyroid and needing a further dose increase.
How much T4 you will actually need is anyone's guess - we need what we need -
T4 is a pro-hormone and needs to be converted in the body into T3 which is that active hormone that runs the body - much like fuel runs the car - you need a full tank to go, come back, and do it all again the next day while your body resets, restores and repairs itself overnight - and what is important is to ensure your T3 remains at a high enough level in the range to give you back your health and well being - with your brain and heart needing T3 in order to function well both mentally and physically.
Conversion of T4 into T3 can be compromised by non optimal levels of core strength vitamins and minerals as already detailed + any physiological stress ( emotional or physical ) inflammation, depression, dieting and ageing :
Increases are low slow, by 25mcg and you might like to check your blood pressure, pulse and body temperature AM and PM as you go through this process -
I found whilst my pulse and blood pressure remained stable my temperature slowly rose from 35.4 to 36.6 - so I knew I was going in the right direction and felt I had some control of what was happening within my body.
HI, Looks to me that you should be taking another 75mg taking you up to 100mg. But doctors are advised to make incriments of 25mg each month, he will probably up your dose by another 25 mg next month and again for the following 2 months aby another 25mg then see what your readings are showing.
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