Any ideas where to go from now please?

or what it could be?

TSH 11.4 ( range 0.40-4.00), Free T3 6.01 ( 2.76-6.45), Free T4 11.86 ( 11.60-22.70) taking 0.75 g of NDT (Thiroyd) every morning

Also, haemoglobin 122 ( 117-155) ferritin 38 ( perimen 10-140, post 25-250) but iron 35.57 ( 4.10-24.00)

Vit d ( 25-OH) 29.7 ( 30-100) even though 4 weeks prior to the test had spent a week in the sun; zinc, vit E, magnesium all below the range

Many thanks in advance.

12 Replies

  • You are on too low a dose of thyroid medication and should increase. The aim should be a TSH of around 1. Some of us need a lower TSH to feel well.

    Someone who is knowledgeable about vitamins/minerals will respond but you are seriously low on Vitamin D. Did GP not prescribe for you? This is a link and you need to bring vits/minerals towards the top of the range.

  • Hi Shaw, thank you very much for your response, i am concerned that if I increase the dose T3 will get above the range ?!

  • Before blood tests were introduced patients were medicated with NDT according to their clinical symptoms until they felt well.

    Nowadays the emphasise has been put more on where the point in the blood test lands than on 'is the patient feeling well'. This is an excerpt from a doctor and some of his patients took T3 only.

    "For someone taking 100 mcg of T3, we expect your pattern of lab results—a low TSH and high T3. However, your TSH and T3 levels are irrelevant to whether you're overstimulated or not. Two studies we just completed confirm other researchers findings: these tests are not reliable gauges of a patient's metabolic status. Many patients taking T3 have TSH and T3 levels like yours but still have severely low metabolic rates. Their metabolic rates become normal only when they increase their dosages further. Their metabolic rates become normal and they have no detectable overstimulation.

    In some cases such as yours, the patient's Cytomel dose may need to be reduced. But symptoms such as occasional heart pounding and anxiety are usually not due to a patient's Cytomel dose. I say this because when Cytomel is solely responsible, symptoms of overstimulation are consistent, not occasional."

    The first question on the following page was his method of treating patients. I, myself am on T3 only and because I feel great I have no interest in the whereabouts of my T3 blood level. I am happy on my dose at moment, if I feel 'off' I will adjust my meds and I will have a blood test in March.

    Do you leave 24 hours between your dose of NDT and your blood test?

  • Yes, Shaw, i had 48 hrs, i did try T3 only last summer but also, one of my biggest problem is sleep ( waking up by obsessive persistent thoughts / dreams) , and whatever i try i always watch how it affects my sleep patterns...

    i am so grateful for your help! regards

  • Tsh is way too high

    you need to incease your thyroid meds every 3 to 4 weeks until you feel well and then your tsh is likely to be below 1

  • Thank you !

  • Helen, increase your NDT by half a grain and do the same two weeks later and hold on that dose for 4 weeks. Have another thyroid test at the endo of the 4 weeks to see what your TSH is and to make sure your FT3 hasn't gone over range.

    See if your GP will prescribe vitD, vitE, zinc and magnesium as all are deficient (below range). If not, you should supplement yourself until they are good in range.

    Ferritin is in range, but low as optimal is 70-90, so supplement ferrous fumarate and take each iron tablet with 500mg-1,000mg vitaminC to aid absorption and mitigate constipation.

  • Thank you Clutter for your reply, i anticipate that my T3 will get above the range if i increase my dose as now its at the top of the range ?!

    Also, if i will be supplementing with Ferrous fumarate for ferritin wouldn't it affect iron which is already significantly elevated?

    i do buy good quality vits/minerals myself, take them maybe not every day during the summer months but regularly but certainly wouldn't except the deficiency in vit D only a month later after the beach holiday!

    Other strange things: glucose in blood always normal but now have glucose in urine, insulin in blood well below the range as well as gluco haemoglobin...kindest regards

  • Helen, I'm surprised your FT3 is so high with TSH 11.4 and would expect it to be considerably lower. FT3 does lag behind TSH though so it may drop. If increasing by 1 grain makes your FT3 go over range you may need to drop 1 grain and add in an equivalent amount (75-100mcg) of T4 only.

    You're right, I overlooked iron being over range so you shouldn't supplement iron.

    As all your vits and minerals are deficient it indicates you aren't absorbing micronutrients from food and need to supplement. 1 week of sun isn't enough to correct vitD deficiency. You need 35-40,000iu vitD3 weekly until April/May and should retest.

    Hypothyroid patients often have low stomach acid which makes it difficult to break down and absorb micronutrients. You can raise stomach acid and improve digestion by taking Betaine Pepsin or 2 tsp of raw apple cider vinegar in fruitjuice or honey sweetened water before meals.

  • Your Free T3 is amazingly high given how bad (how high) your TSH is.

    I happened to notice this thread :

    and wondered if it might be of relevance. There are suggestions that high cortisol may be a factor in raising FT3, or possibly taking SSRIs?

  • Also your sleep patterns are consistent with adrenal fatigue/insufficiency which in turn will be linked to your low magnesium.

    Although supplements will help relatively quickly, in the long term you need to sort out your digestion. Stomach acid (there is an article on the TUK site about that), digestive enzymes and really good probiotics are all called for.

    They say the gut is at the root of so much!

  • Even more, they say the gut is the second brain so I tried to investigate it too, endoscopy & colonoscopy done, indication of atrophy of some areas and low stomach acid, have been taking Betaine Pepsin, very good enzymes and probiotics for a while now.

    Also, I had suspicions myself about low cortisol during the nights and had 2 saliva tests done a few months ago, one from Genova but they don't do during the night so had another test done from another company, i think it was Verisana, i specifically agreed with them that i needed the night test, it was a week or 2 between those tests and the results were quite contradictive so couldn't work out any logic from them whether the cortisol drops or rises at 3-4 am which both would rise the adrenaline....( tested sugar though which was and is ordinary 5 )

    Thank you ever so much everyone for your help!!

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