My doctor says my t3 (liothyronine) and t4 levels are okay but the tsh levels are still off, what are the causes? i am taking .088 levothyroxine daily (from .150 to .112 to current dose) 10 + years ago had a radio-active iodine procedure.

This : This means you need an adjustment in your dose of levothyroxine. If your TSH is up still, you need an increase your T4 dose. Your pituitary gland that makes the TSH is not getting enough T4 and T3 (liothyronine) to be happy even if those are in the "normal" range.

It : It depends on what you mean by saying "off". If your TSH is high, you may be of need for increased thyroxine dosing and if low (i.E below the lower limit of normal), the opposite. Having abnormal TSH value soon after dose adjustment is not uncommon and generally, it will take up to 4-6 weeks for new dose adjustment to reflect on the blood test. I would suggest that you discuss this with your physician before any conclusion is made if the dose you are currently under is appropriate or not. Good luck. Cayce t. Jehaimi, M.D., faap pediatric endocrinology & diabetes the children's hospital of southwest florida fort myers, fl usa.