You'll occasionally see both prescribed on extreme cases but a good many endocrinologists feel the T4 to T3 conversion is sufficient. (I think it clips off an iodine molecule or something).
My wife is on name brand 225mcg. She doesn't respond to the generics for some reason We even made a trip for her to see a thyroidologist (they are out there), and they stated that at such a low dosage increment any variation affects some people, so name brand it is.....and no, they don't make a 225mcg. You have to buy 200mcg and 25mcg dosages, and they both cost the same. 
Edit: If I recall correctly, she started @ 150mcg around 7 years ago +/- .
Last edited by almostgone; 06-21-2020 at 11:42 AM.
There are 3 loves in my life: my wife, my English mastiffs, and my weightlifting....Man, my wife gets really pissed when I get the 3 confused...
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