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Dose increase?

Do I need an increase in meds please. I take thyroxine 175mcg and 20mcg T3, I was diagnosed with hypothyroid in 2012 and given T3 in 2015 because I am a poor converter. Symptoms are

Dry skin
Tiredness
Low heart rate (under 50 beats per min)
Constipation
Weight gain
Dizziness
Puffy eyes
Breathlessness
Pins and needles
Heavy periods
Loss of appetite

Thank you

Serum TSH 3.87 mIU/L (0.2 - 4.2)
Serum free T4 16.1 pmol/L (12 - 22)
Serum free T3 4.2 pmol/L (3.1 - 6.8)
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Avatar universal
A good thyroid doctor will treat a hypothyroid patient clinically by testing and adjusting Free T4 and Free T3 as needed to relieve symptoms, without being influenced by resultant TSH levels.  Symptom relief should be all important, not just test results, and especially not TSH results when already taking thyroid med.  I say that about TSH because scientific studies have shown that it is frequently suppressed when taking adequate thyroid med, which does not mean hyperthyroidism, unless there are hyper symptoms caused by excessive levels of FT4 and FT3.  

Many of us have found that we needed FT4 at least at mid-range, and FT3 in the upper third of its range, or as needed to relieve symptoms.  Your FT4 is a bit low but the main problem causing those symptoms would be your FT3, which is only at 30% of a range that is far too broad.  So being in the low end of the range is frequently inadequate.  FT3 is the thyroid hormone used by all the cells of the body to produce needed energy.  

Hypo patients are also frequently deficient in Vitamin D, B12 and ferritin.  If not tested for those you should make sure to get those done and then supplement as needed to optimize.  D should be at least 50 ng/mL, B12 in the upper end of its range, and ferritin should be at least 100.
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