Need HELP with my recent Blood results

[vinsquet]

I am a new member and the first time posting but I have been reading these posts and appreciate all your good advices and experiences.
In Sept 2001, I was diagnosed Hyper and 2 month laters did a very low dose of RAI and become HYPO.  During that time I was still a smoker and was maintaining on .075MG Synthroid.  Did put on lots of weight and started exercising 2 year ago and was able to lose 1/2 the weight.  Recently quit smoking in Nov, 2009 and have not looked back since:) Now my thyroid is out of wack.  I am now very lethargic (mostly in the early afternoon 2 pm), and basically not motivated to do anything.  I did my blood work in April and doctor said everything looked good, but I was feeling horrible.  I asked to be changed over to Nature-Throid and am now on 1 1/2 grain/daily.  I'm still feeling lethargic in the afternoon.  Here are my recent blood results as of end of July.

TSH – 0.26 ( 0.4 – 4.50)
T4 Total = 5.5 (4.8 – 10.4)
Free T4 = 0.7 (0.8 -1.8)
T3 Total = 116 (76 – 181)
Free T3 = 274 (230 – 420)
T3 Uptake = 32 (22 – 35)
RT3 (Reserve T3) = 14 (11 – 32)
Thyroblobulin Antibodies = Less than 20 (<20)
Thyroid Peroxidase Antibodies = Less than 10 (<35)
Thyroglobulin = 0.2 (2 – 35)
In  April’s blood work my Vitamin D level was low 20 (range 20 – 100), since then I have been supplementing with VD3.  Now the current results is 40, which I do need more improvement and will continue and up my dosage.  My Vitamin B’s numbers were excellent, so problem there.  Iron was also good, no problem there either.
I think my Free T 3 and Free T4 and a bit low and I think I would be able to increase by 1/2 to 1 more NT grain.  Would really appreciate your thoughts and advice.  I won't be able to see the doctor until another month.  Thanks so much.  Desperately awaiting your feedback!

[vinsquet]

Thanks so much Laura for your reply.  In the beginning I did not split the dosage of 1 1/2 NT in the morning (7 AM) but since reviewing the recent results, I have added 1 more grain NT at about  2 PM starting yesterday.  I must say that I am feeling less fatigue, and will be closely watching for any palpitation and will report again in another week or two.  Thanks again.

[laura1967]

Your Free T4 level is way too low, and your Free T3 is also still low. You aren't on enough medication. You need to up your dosage. Your Dr cannot go my your TSH whatsoever, as any T3 med will supress the tsh greatly and make you look hyper.
When you are on a combo med or both meds, you can only treat by the Free's.
This why you are so fatigued. Also.....are you splitting your dosage 1/2 in morning and 1/2 in early afternoon???  You need to be spreading your dosage out in order to maintain proper blood levels of T3.