Looking for recommendations regarding dosage.

[Clara62]

After increasing my T4 dose from 75 mcg to 87.5 mcg while keeping my T3 at 10 mcg, these are the results I got… I find them a bit odd. Could the drop in T3 levels compared to a few months ago be due to switching from Liothyronine Sodium Roma (tablet) to Liotir (liquid)? :

TSH 0,015 µUI/ml 0,270 - 4,200

FT3 2,50 pg/ml 2,00 - 4,40

FT4 13,5 pg/ml 9,3 - 17,0

Previous results ( 2 months ago).

TSH: 0.033 µUI/mL (Range: 0.270 - 4.200)

- FT3: 3.10 pg/mL (Range: 2.00 - 4.40)

- FT4: 11.1 pg/mL (Range: 9.3 - 17.0)

Thank you🙏

Main symptoms include weight gain, acid reflux at night, and challenges with temperature regulation, frequently experiencing sensations of being too cold or too hot.

[SlowDragon Administrator]

Were both tests done as recommended

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

T3 ….day before test split T3 as 2 or 3 smaller doses spread through the day, with last dose approximately 8-12 hours before test

Free T4 (fT4) 13.5 pmol/L (9.3 - 17) 54.5%

Free T3 (fT3) 2.5 pmol/L (2 - 4.4) 20.8%

What vitamin supplements are you taking

What are most recent vitamin D, folate, ferritin and B12 results and ranges

Is your hypothyroidism autoimmune

Liotir (liquid)?

Never heard of this?

Have you tried Thybon Henning 20mcg tablets (cut in half to get 10mcg)

Or Teva 20mcg

[Clara62 in reply to SlowDragon]

Hello SlowDragon, First of all, thank you for your response. Yes, the tests were done according to the recommendations. Unfortunately, I can't split the T3 because now that I live in Italy, the only T3-based product I can find is a liquid form (with alcohol) called LIOtir. I need to look for other sources. I still have an old box of expired Thybon Henning, so I might use that in the meantime.

As for my hypothyroidism, I’ve never really understood whether it’s autoimmune or not. My antibodies have always tested negative, even though they’ve been measured many times. However, based on several thyroid ultrasounds done because of nodules, my thyroid appears as if I had Hashimoto’s. I’ve been told it might be a case of seronegative autoimmune thyroiditis? I don’t know, I’m not sure.

Recent blood values:

Vitamin B12: 584 pg/mL (Reference range: 197 – 771)

Vitamin D (25-OH): 48.7 ng/mL (Optimal range: 40 – 60)

Ferritin: 74 ng/mL (Range: 13 – 150)

Folate: 601 (Range: 340 – 1474)

I take D vitamin supplements.

I’m thinking of increasing the T3 dose to 10 mcg in the morning and 5 mcg in the afternoon (the old box of Thybon Henning 10, which can be split), while keeping T4 at 87.5 mcg. Do you think it’s a good idea?

[SlowDragon Administrator in reply to Clara62]

I’ve been told it might be a case of seronegative autoimmune thyroiditis

Sounds likely. 20% of Hashimoto’s patients never have high TPO or high thyroglobulin antibodies

I’m thinking of increasing the T3 dose to 10 mcg in the morning and 5 mcg in the afternoon (the old box of Thybon Henning 10, which can be split),

Yes sounds good idea. Going forward see if you can get an EU doctor/endocrinologist to give you a new prescription for Thybon Henning. You can send prescription to Germany and get Thybon posted to you in Italy

Are you on gluten free diet and/or dairy free….or tried them

Italy has high levels of coeliac/gluten intolerance. They test all school age children, so diagnosis is picked up.

Apparently it’s not too difficult to be GF there

[Clara62 in reply to SlowDragon]

I hadn’t thought about getting Thybon Henning from Germany, this is a very good idea. I ‘ll ask my doctor here in Italy, fortunately she is open minded . I know I should go gluten free ( not celiac but with Hashimoto I know it’s helpful ). Thank you very much SlowDragon for your help. ( As usual )🙏🙏