Drop in frees despite increase in medication

[Thywotsit]

Hi there,

I have results today 10 weeks after a small (37.5mg week) increase in levothyroxine.

With the last blood test I imagined I was getting to the fine-tuning stage - symptoms were improving along with range percentages being something like in line.

However, both FT4 and FT3 have dropped significantly since then.

The test was done as per protocol and nothing else has changed in the way I take the medication so I’m struggling to understand why this might be..

Could it be a lab error?

Should I retest now or should I wait again?

Results

13.01.25

FT4 14.9 (12-22) FT3 4.8 (3.1-6.8)

04.11.24

FT4 17.0 (12-22) FT3 6.1 (3.1-6.8)

I do still feel under-medicated - several symptoms have returned, but I am much less tired these days so these latest results are very confusing.

Would very much appreciate any thoughts.

I thank you.

[GlowCoach Administrator]

Lab results can still be settling 3 or even 4 months following a dose change either way.

It may well be that your body has been doing further healing and requires more Levo now your dose has settled more.

How much are you taking and how much do you weigh in kilos?

What supplements are you taking and what are you supplementing with?

[Thywotsit in reply to GlowCoach]

Thanks,

Yes, good point, I did consider that I might just need more now after further settling of hormones, although I am already taking more than my size would suggest I might need on average.

I am 58 kilos

Taking Eutirox (850mcg week)

125 x 6 days and 100 for 1 day

Tiromel 15.6mcg daily split dose.

Supplementing with

3 arrows iron 1 per day

Vitamin D K2 3000 per day with Magnesium 384mg elemental.

Cheers

[GlowCoach Administrator in reply to Thywotsit]

You need what you need. We all absorb levo & T3 slightly differently. Different brands can make a difference too.

125mcgs a day is a not unreasonable amount to take in a combination dose, so try that next perhaps.

Most people need a really good B complex. What were your last B12 & folate results?

[Thywotsit in reply to GlowCoach]

Thanks.

Yes, indeed, you need what you need although

Back in July I was taking 125mcg daily and my FT4 was 20.3 FT3 6.1.

Although in range I was feeling distinctly over medicated- it was pretty awful, sweaty and couldn’t keep still etc

I think perhaps it’s just swinging about all over the place.

It’s hard to know what my ball park amount might be in this instance.

[Thywotsit in reply to GlowCoach]

I am a bit sporadic with folate and B complex but I do take them a few times a week.

Results

[GlowCoach Administrator in reply to Thywotsit]

Those results look good but be careful not to stop it altogether.

Swinging results in the early stages of thyroid disease are not uncommon, so that another possibility as well as just numbers settling over time.

[Thywotsit in reply to GlowCoach]

Thanks.

Yes, it’s all to easy to let a few things slip altogether..

[SlowDragon Administrator]

How much Levo are you taking

Which brand

How much do you weigh in kilo

Are you taking Levo well away from any vitamin supplements or other medication

What vitamins are you taking

[Thywotsit in reply to SlowDragon]

Thank you for the reply.

Eutirox 850mcg week

Tiromel 15.6 daily

Same brand of medication consistently.

58 kilos

3 Arrows

3,000 D K2 spray

Magnesium

Sporadic B complex and folate.

[tattybogle]

are you taking T3 as well ?

time of last doses is needed to interpret fT4 / fT3 results sensibly.

what TSH doing now ?... it's not the most important result , but it's easier to figure out what's happening if we have the full picture.

lots of possible reasons for lower T4/T3 levels now . unlikely to be an error as such. much more likely to be eg. hashimoto's fluctuations (assuming have positive TPOab ?) , ie unrelated to dose change. thyroid relaese of T4/T3 wobbling up and down as it's being damaged .

or it could be you've overshot slightly and deiodinases have increased conversion of T4 to Reverse T3 /reduced conversion of T4 to T3/ speeded up recycling of T3 to T2 etc as a consequence.

[Thywotsit in reply to tattybogle]

Thanks for replying.

Yes, taking a combination.

Last Levo dose taken 25 hours before test and Tiromel split 3 doses, last dose 8 hours before test.

TSH result similar to last test in November -

13.0.05 TSH 0.01

04.11.25 TSH <0.01

So probably not a processing error, that’s what I wanted to know thank you.

What I didn’t understand was why both FT4 and FT3 would lower together.

I’d have imagined one or the other.

Perhaps I’m in some sort of balance lag.

Cheers

[tattybogle in reply to Thywotsit]

body's thyroid hormone balancing system is fiendishly complex , so sometimes fT4 / fT3/ TSH don't seem to make any sense with just one snapshot .

When unsure what's going on , its good idea to wait a few more wks without making any changes and retest ~ a longer view sometimes helps make sense of what went on .

my fT4 / fT3 do inexplicable things from time to time .and sometimes bear no relation to symptoms . my TSh is usually a bit more in line with dose changes / symptoms , but just for fun it seems to lag behind what's happening by 6 months , sometimes i swear it's "answering the question before last" like that Two Ronnie' sketch .

but sometime to be honest , we just don;t know why, ... best we can do is keep observing consistently and adjusting carefully in response to what we observe .

"if in doubt ,wait a bit longer than you want to , and adjust by a bit less than you think" is the best way to stay out of too much trouble .

[Thywotsit in reply to tattybogle]

Yes, exactly, it seems like my symptoms do not correlate with my results at the moment.

That’s a great reply, and I know that sketch - its comic genius.

Many thanks for the advice. I was thinking about giving it a bit longer and testing again, otherwise I could get in a muddle..

That’s what I will do.

[Thywotsit in reply to tattybogle]

Positive for antibodies.

[Thywotsit in reply to tattybogle]

Ah yes, I have just re-read that properly and see what you mean about increased conversion of T4 - RT3 then reduced conversion of T4 to T3.

That makes sense.

Thank you.