You have a problem with your blood count from the Carbimazole dose. Usually happens at higher doses, but not at low doses. Your Free T3 and T4 are at the higher end of the range. Ideally you want to keep it at mid range or higher. You need to take at least the Regular L-Carnitine along with Vit D and Magnesium. When you take Acetyl-L-Carnitine it is like doubling your dose of Methimazole as far as the effects it is going to have on your results. With the Regular L-Carnitine, it will raise your levels only slightly but should keep you stable. It is a very fine balancing act. I would tell your doc that just because you have Graves does not mean you don't also have Hashimoto's. Many people on other Boards I have been on have both Graves and Hashimoto's. You test for Hashimoto's with TGAb and anti-TPO levels. People who have both do better with natural supplement treatments like Bugleweed instead of Carbimazole along with other supplements. But you need to know. I would not worry about the TSH for now. You need to keep your Free T3 and Free T4 levels stable. Once stable, you can increase the TSH with the carnitines. However, Acetyl will really send you hypo if you do not monitor and adjust it frequently. You were lucky you went no higher than 4.0 on your TSH. When that happens, stopping the Acetyl and staying on the Regular L-Carnitine along with a low dose of Carbimazole (10 mg or under) should keep you steady. Your doc raised your dose when you went higher because she does not know you are taking the carnitines. You probably could have lowered your TSH by stopping both carnitines for a week, and then adding back the regular l-Carnitine at a dose of 3,000 mg per day. When taking Acetyl-L-carnitine, it is a very fine balancing act. I was off both carnitines for a year on 2.5 mg of Methimazole and my levels are all normal. I am now on 2.5 mg every other day and take 500 mg of Regular L-Carnitine on the off days.