These are my most recent results. Blood was taken first thing in the morning, fasted and before I took my medication. The lab ranges are also shown above. How can my tsh be so low and my t3 still be so low/not optimal? I'm on 150 levothyroxine. Am I right that I might need some t3? And if so, would I reduce the levo slightly?
Many thanks for your help!
You would be right, yes. Your TSH is so low because your FT4 is so high, and your FT4 is so high because you're not converting it to T3 very well, and your FT3 is too low.
Probably not necessary to reduce levo. Adding T3 will lower the FT4, anyway.
Thank you. Would 25 t3 be a good dose to start?
Before considering adding T3 have you tested vitamin D, folate, B12 and ferritin
Can you add most recent results
What vitamin supplements are you taking
Looking at your forum name you are presumably already on gluten free diet
Are you also on dairy free diet
which brand levothyroxine are you taking
Do you always get same brand
Would 25 t3 be a good dose to start?
Definitely NOT
Far too high to start on
Maximum starting dose is 5mcg …..perhaps initially as 2.5mcg twice a day
But if only got 20mcg tablets…5mcg waking
After week or so add second 5mcg dose 10-12 hours after morning dose
Wait 8 weeks at this dose and then retest
Oh OK. Yes gluten free but not currently dairy free. My vitamin labs were pretty optimal. I take vitamin d with k, omega 3, magnesium, glutathione and b12. Always the same brand of thyroxine
Can you add most recent vitamin results and date last tested
You aren’t taking any vitamin B complex or folate?
Important to test ferritin too
Vitamins
Exactly what B12 supplement are you taking and how long before test did you stop taking it
B12 is low, and especially low considering you have been taking B12
Ferritin
Ferritin is ok,
You don’t want it to drop under 70
Eating iron rich foods like liver or liver pate once a week plus other red meat, pumpkin seeds and dark chocolate, plus daily orange juice or other vitamin C rich drink can help improve iron absorption
List of iron rich foods
Links about iron and ferritin
irondisorders.org/too-littl...
davidg170.sg-host.com/wp-co...
Posts discussing why important to do full iron panel test
healthunlocked.com/thyroidu...
Good iron but low ferritin
healthunlocked.com/thyroidu...
healthunlocked.com/thyroidu...
Chicken livers if iron is good, but ferritin low
healthunlocked.com/thyroidu...
Shellfish and Mussels are excellent source of iron
healthline.com/nutrition/he...
Iron deficiency without anaemia
healthunlocked.com/thyroidu...
Ferritin over 100 to alleviate symptoms
healthunlocked.com/thyroidu...
healthunlocked.com/thyroidu...
Great research article discussing similar…..ferritin over 100 often necessary
ncbi.nlm.nih.gov/pmc/articl...
If ferritin drops under 50 get a full iron panel test for anaemia. Never just assume that iron is also low
It’s possible to have low ferritin but high iron
Test early morning, only water to drink between waking and test. Avoid high iron rich dinner night before test
Medichecks iron panel test
medichecks.com/products/iro...
retest full iron panel 3-4 times a year if you start on iron supplement
If taking any iron supplements stop 5-7 days before testing
Confusing Iron Results
Confusing first results on T4/T3 
Confusing advice from Endo
Confusing blood test results
