Thank you in advance for all your advice. I live in a small town, no endo close by, have to depend on GP for care. She is great and works well with me (I have some of a medical background).

Diagnosed in 2013, treated with MMI for 7 years, went into remission for 10 years.
6/29/2023 to ER with afib, labs:

TSH 0.03 0.40 - 4.50
T3, Free 5.1 2.3 - 4.2
T4, Free 1.6 0.8 - 1.8
Started MMI 5mg qd

9/12/2023
TSH 0.35 0.40 - 4.50
T3, Free 3.0 2.3 - 4.2
T4, Free 1.0 0.8 -1.8
Continue MMI 5 mg

1/12/2024
TSH 5.36 0.40 - 4.50
T3, Free 2.3 2.3 -4.2
T4, Free 0.9 0.8 - 1.8

Question: What now? Continue 5mg, cut in 1/2, ?? Thanks for any advice.

Hi Rosie,
According to guidelines, since FT4 was never elevated, you shouldn't have been put on MMI right off since it can cause FT4 to fall too low for your body's needs. Your elevated TSH shows that this has happened. You want to lower your dose to 2.5 mg daily or if you have hypo symptoms lower to 1.25 mg daily. Having levels too low prevents remission. It's also possible that your original FT3 was incorrect since many things, especially Biotin in B vitamins, falsely increase this result. Best to you, Elaine