Blood results help please

[susiebow]

Hi nhs bloods taken, just tsh 1.62. So I got finger prick test done tsh 2.12 range 0.27-4.2, t4 16.6 range 12-22 , t3 4.1 range 3.1-6.8 .Taking 87.5 mcg thyroxine and 5 mcg t3 daily for few months now.Pain and stiffness short of breath going upstairs.I do'nt know if to raise t3 ,as this would bring t4 down more,and prefer that higher,or to raise thyroxine dose,as that will hopefully t3 and t4.Any help.I feel hyper in my head but hypo in my body .

[SlowDragon Ambassador]

was test done as recommended early morning, ideally just before 9am, only drink water between waking and test and last dose levothyroxine 24 hours before test

This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip)

T3 ….day before test split T3 as 2 smaller doses spread through the day, with last dose approximately 8-12 hours before test

Assuming yes…

Free T4 (fT4) 16.6 pmol/L (12 - 22) 

FT4 only 46.0% through range

Free T3 (fT3) 4.1 pmol/L (3.1 - 6.8) 

Ft3 only 27.0% through range

Suggest you increase levothyroxine to 100mcg as next step

When did you last test vitamin D, folate, ferritin and B12

Exactly what vitamin supplements are you taking

[susiebow in reply to SlowDragon]

Yes to first question 7 am blood test.Taking vit d .Ferritin and b12 taken a while back but always been good.aThanks for your advice again.Just do not want to go overmedicated as felt so unwell then.

[susiebow in reply to SlowDragon]

Yes to first question 7 am blood test.Taking vit d .Ferritin and b12 taken a while back but always been good.aThanks for your advice again.Just do not want to go overmedicated as felt so unwell then.

[Buddy195 Administrator]

We all have our personal ‘sweet spot’ where we feel most well. I’m a fan of low and slow adjustments, so personally would add either 12.5mcg Levo or 2.5mcg Lio to your current dose. I certainly wouldn’t adjust both at the same time, as it’s hard to work out what is advantageous otherwise. Going super slowly stops me having anxiety symptoms (and physical symptoms like palpitations/fast pulse).

Personally, I’d try a daily dose of 87.5mcg Levo and 7.5mcg Lio as a first step.If you add 2.5mcg Lio and feel this hasn’t alleviated adverse symptoms after a few weeks, look to increase by an additional 2.5mcg (ie dose of 87.5 Levo and 10mcg Lio)

Remember to retest 6-8 weeks after being on a consistent dose.

[susiebow]

So ,I have raised my thyro xine dose from 87.5 and 5 of t3 daily to thyroxine 100 one day and 87.5 the next and 5 of t3 daily,after bloods as above.5 days in and I feel really bad ,done in ,sleepy and pain in knees worse.Dose raising thyroxine dose a little always raise t3 and t4 levels ? Any ideas why I feel so bad ?