Hello – Hopefully, others will chime in here. I do think it’s normal for levels to fluctuate somewhat and for dosing to need some tweaks over time. Although you definitely need to take action if certain levels are going out of range.
It’s also helpful to have labs drawn at the same time of day each time, as TSH levels can fluctuate throughout the day.
I have not taken replacement hormone (and obviously I’m not a doc), but my thought would be that if your T4 is too high, a T3/T4 combination might make you feel worse, not better. This would definitely be a great question for your doctor!