Results back and I need some advice please

[11Ananke11]

Hi again. I reduced my Levo dose from 100mcg to 87.5mcg (as advised here) a few months back as I was a bit over medicated. I felt much better after a few days but as time went on my energy levels have dropped and I feel a wee bit rubbish.

I finally got around to re-testing this week and the results are in, levels are all within range but TSH and T3 are far from optimal.

PREVIOUS RESULTS:

TSH 0.794 mIU/L (Range: 0.27 - 4.2)

Free T3 4.6 pmol/L (Range: 3.1 - 6.8)

Free Thyroxine X 26.7 pmol/L (Range: 12 - 22)

NEW RESULTS:

TSH 3.440 mlU/L (Range: 0.27 - 4.2) 80.66%

Free T3 3.7 pmol/L (Range: 3.1 - 6.8) 16.22%

Free Thyroxine 19.7 pmol/L (Range: 12 - 22) 77.00%

TGA 52.8kiU/L (Range 0 - 115)

TPO 112.0klU/L (Range 0 - 34)

I self medicate and wonder if anyone could advise how I can get optimal levels. I felt quite over medicated when my T4 was high and I'd like to avoid that happening again. Should I try a small increase in Levo or I have T3 that I could take, would that be my best option?

Got my Vits done this time as well, they are as follows...

Ferritin 326 ug/L (Range 30 - 332)

Folate - Serum Sample error

Vit B12 - Active 70.5 pmol/L (Range > 37.5)

Vit D 71 nmol/L (Range 50 - 250)

I take Vit D3 + K2, Magnesium and B Complex (stopped for test)

Tests were done as per forum instructions, early morning, empty stomach and 24hrs since last dose of Levo.

Thanks for reading.

[Jackblack46]

It looks like that you are a poor converter and so adding in T3 would probably benefit you.

[11Ananke11 in reply to Jackblack46]

Thanks for the reply. That's what I was thinking too.

[SlowDragon Administrator]

what size tablet T3 have you got

Start SLOWLY adding max of 5mcg (or 6.25mcg if have 25mcg tablets)

[11Ananke11 in reply to SlowDragon]

Thanks SlowDragon, I have 25mcg ones so probably 6.25mcg would be easier.

[humanbean]

I reduced my Levo dose from 100mcg to 87.5mcg

You could try taking 87.5mcg 5 or 6 days a week and 100mcg on the other days, or some other combination.

I take two different doses of Levo. I take 2 days (non-consecutive) of 50mcg per day and 5 days of 100mcg per day. This is done because they are the only pill sizes I have. It averages out to 85.7 mcg per day.

[11Ananke11 in reply to humanbean]

Thanks humanbean. I alternate days with 100mcg and 75mcg so I suppose I could up the number of 100mcg days. Having said that, in my last post with the high T4 and 100mcg/day someone commented that my T3 was low then too.

It's a minefield.

[greygoose]

I self medicate and wonder if anyone could advise how I can get optimal levels.

Difficult when you have Hashi's, because levels are going to jump around frequently. And I very much doubt that those higher levels had much to do with your dose of levo, more likely to do with the Hashi's messing you around - and there's nothing you can do about that.

But, you definitely are a poor converter, no doubt about that.

[11Ananke11 in reply to greygoose]

Thanks greygoose. I lost weight and assumed that was the issue but here we are again lol so you're right about Hashi's messing me around.

[greygoose in reply to 11Ananke11]

You're welcome.

[DippyDame]

FT4 looks ok

But your FT3 is miserably low

Low FT3 with relatively high FT4 = poor conversion

Your T4 to T3 conversion is impaired, you need a higher FT3 leveml

So optimise essential nutrients to support thyroid function

Vit D recommended level 100 - 150nmol/L (40 - 60ng/ml)

Vit B12: 300pmol/L (145-569) = 406.5pg/ml

Folate: recommended to be at least half way through range

Ferritin: Optimal ferritin level for thyroid function is 90-110ug/L

Hashis causes the thyroid hormone levels to fluctuate so sometimes difficult to find one's optimal levels.

However, I'd be inclined to raise levo dose to 100mcg maybe twice a week....you have plenty room to do this, and add a daily dose of 5 or 6.25 mcg (a quarter of a 20 or 25mcg tablet)

T3 will reduce TSH and FT4

[11Ananke11 in reply to DippyDame]

Thanks DippyDame. Would you recommend increasing Levo and starting T3 at the same time or make one change then the other later on? I started taking T3 this morning.

[DippyDame in reply to 11Ananke11]

We only change one thing at a time...so go with the T3 and see how it goes.

How much T3 are you taking? You can increase by a further 5 or 6.25mcg after 2 weeks.

Repeat that up to 10mcg then test again

Depending on results and symptoms you may, or may not, want to change T4....or further increase T3

We are all different so it's basically trial and error I'm afraid

Listen to your body....symptoms are an important guide

Hopefully Hashis will settle down eventually once the thyroid is destroyed by a series of 'attacks', and you are on adequate replacement hormone(s)

We're all here to help....just ask

[11Ananke11 in reply to DippyDame]

Thanks again. I took 6.25mcg this morning so I'll stick with that for a couple of weeks.

[11Ananke11]

I started taking 6.25mcg of T3 this morning. I took it at 6:30am along with my Levo but I'm now just wondering is it ok to take them at the same time and do the same rules apply to T3 like taking on an empty stomach and only water for the next hour?

[Stourie in reply to 11Ananke11]

I take my t4 and t3 together when I wake and have done for years so you’re absolutely fine doing that. Jo xx