My symptoms have returned - do I need additional Levothyroxine?

[bristolboy]

Lots of info in my Profile/Biography. I have been on T4 for many years. After adding privately-sourced T3 to my prescribed T4 around 2019 I have been jogging along reasonably well until a year or so ago, when symptoms started to return. Extreme tiredness, inexplicable weight gain, bad brain fog, and feeling cold.

Two sets of blood tests this year (both done according to our protocol) show FT3 to be good, but FT4 has been dropping. The tests, in Feb 2024 and July 2024, show FT3 at 94% and 73% through range respectively, but FT4 has dropped to 37% and 34% through range (it used to higher).

I have been on 150mcg of Accord T4 for a few years now, and a year or two ago finally settled on 25mcg of Tiromel T3. What could be the reasons for my symptoms reappearing? As FT3 looks reasonably good, I’m assuming the drop in FT4 is the reason? Or is that too obvious, and have I missed something? Instead, maybe a tiny increase in T3 is the answer?

I have accrued a “reserve” supply of T4 tabs, so I’m thinking of adding some more T4 to my current 150mcg (+ the 25mcg of T3). Would an extra 50mcg of T4 be too much of a jump, maybe just 25mcg, or less? I’m male, 69 years old and weigh 80kg

If extra T4 turns out to be the answer, then I shall have to bite the bullet and ask my GP for an increase. And hold my hands up to the T3 ☹

[TiggerMe]

Certainly for me if my fT4 drops below 50% regardless of fT3 level I feel awful so I'd agree with you that a small increase to your T4 would be a good idea, I'd be inclined to suggest adding an extra 12.5mcg daily and see how you go, could be enough and help eek out supplies 🙃

[bristolboy in reply to TiggerMe]

Thanks. Yes, you’re probably right, I should know to start gently - 12.5mcg it’ll be then 😀

[TiggerMe in reply to bristolboy]

Sneaking up on the elusive sweet spot is better than boom and bust 🙃

[bristolboy in reply to TiggerMe]

Absolutely 😀!!

[olgadimitri]

I reduced my Levothyroxine intake when I started taking Selenium regularly. I moved to a hot tropical country, this could also help my thyroid, but proper vitamin supplements are very important. I found a lot of useful tips researching on this site, but it's different for individuals.

[bristolboy in reply to olgadimitri]

After taking advice from this site I have been taking good supplements, and my levels are now very good. But I have taken a rest from Selenium for many months now - so maybe it’s time to think about starting taking it again. Thanks 😀