Finally on medication and latest results

[Joell]

Hi Everyone....I haven't posted on here for quite a while but I have been following all your posts trying to learn as much about this condition as I can as I found it all very frustrating and confusing at first...still do but am getting there slowly. Firstly, I am wishing everyone good health and success with their treatments. After a long struggle with GP, thanks to advice on this website, I fought for a referral and finally saw an Endo and he started me on minimal 25mg of Levo daily ( due to previous heart palpitations) and then had a 2nd appointment 8 weeks later after another blood test where he has upped my dose to 50mg and then said he didn't need to see me again as my results were normal from this test and advised that I have another blood test at GP's in 3 months time . My weight hadn't changed but he told me to be patient as it will take a few months for the levo to get into my system. I still don't feel brilliant and suffer from insomnia etc but am trying to be objective and give it a good few months. I was just hoping for advice regarding my latest results and wanted to ask do I still carry on taking my supplements as normal. I am currently taking Selenium, Folate, Kelp and Vitamin D but have recently realised that I should have been taking D3 as saw discussions here saying that this was more effective. My latest test results are as follows, HOWEVER the test was not done in the morning on an empty stomach ..despite trying , I could only get an afternoon test before my 2nd endo appointment was due and I had also taken my levo that morning as I didn't realise you were also supposed to skip the meds before a test.

Free T4 of 14.4

T3 of 4.4

TSH 2.62

FSH 85.7

LH 35.8

Testosterone 0.5

Cortisol 408

B12 of 1199

I had asked for testosterone as my initial appointment , an age ago now it seems, with GP was for lack of libido and whether to start taking HRT purely for this reason ( I had early menopause at 40..took nothing for it and am now 50) before being told I was borderline Hypo and then all this took over and HRT idea went on the back burner. I read that HRT should not be taken with levo but endo said that I can. I am reluctant to do so at the moment though as feel it's early stages of just getting my head around this and my body used to this medication. I know a lot of people on here are here because levo did not work for them and am just wondering how I will know if it is helping me. Is it just a matter of time and do I judge it by results of 'normal range' in further tests? Any general advice for next steps to help myself would be really appreciated. Thanks all.

[Clutter]

Joell, TSH 2.62 is slightly high for comfort, FT4 14.4 a little low and FT3 4.4 a little low. Most people will be comfortable with TSH just above or below 1.0, with FT4 in the upper range and FT3 a little higher. If dose was raised to 50mcg after the 2nd blood test I think you'll be on target. Symptoms can lag behind good biochemistry by a couple of months so you should feel more improvement.

You judge how well Levothyroxine is working by how you feel and by blood tests. Levothyroxine probably won't cause weight loss but should make you feel well enough to increase activity and exercise to help weight loss.

For maximum absorption Levothyroxine should be taken with water on an empty stomach 1 hour before, or 2 hours after, food and drink, 2 hours away from other medication and supplements, and 4 hours away from iron, calcium, vitamin D and oestrogen.

FSH >40 confirms you are menopausal which you know already. Women do take HRT and thyroid replacement but take the tablets at least 4 hours apart. There's less likely to be interference with absorption of Levothyroxine if transdermal HRT patches are used.

How much iodine is in your kelp supplement? Iodine supplementation is controversial in patients taking Levothyroxine as it may exceed your RDA.

[Joell in reply to Clutter]

Thanks so much for your helpful reply Clutter. I will print that out so I remember what to take and when as I have been taking ALL my supplements about 2 hours after the levo thinking that was ok. My kelp supplement contains 150 pg of iodine per tablet....shall I ditch them now do you think ? I guess I will just wait a couple of months before proceeding with HRT and see how I get on with the levo. Really don't want to take anything else if I can help it but will seek GP advice and ask for the patches if I decide to go ahead. I was so desperate before I finally got the Endo appointment that I was about to start self medicating with Thyro Gold which I had read good reviews about. The appointment came through as the Thyro Gold arrived so I didn't start it but just out of interest, do you have any knowledge of this medication? Once again, thanks for all your help.

[Clutter in reply to Joell]

Joell, 150mcg iodine is the max RDA. Could you halve the dose? On top of the supplement you are getting iodine from Levothyroxine and diet.

ThyroGold contains thyroxine (T4) and T3. Some members have found it beneficial, others not. I think the smallest dose is 150mg which is equivalent to something like 75-100mcg Levothyroxine.

[Joell]

OK thanks Clutter. I'll stop the kelp as I didn't realise that levo contained iodine so I guess I shouldn't need it now. And thanks for the info on the Thyro Gold. Am just trying to get my head round the T4 and T3 thing and why some people with hypothyroidism only need one and some need both, or just T3. Is the difference that levo is only T4 whereas Thyro Gold contains both T3 and T4 ? Really appreciate all this information as I am trying to make my own notes of the basics that I need to understand. You have been an amazing help already.

[helvella Administrator Thyroid UK in reply to Joell]

T4 is called T4 because each molecule of T4 contains 4 atoms of iodine. (That works out to be around 66% by weight. So 100 micrograms of T4 contains about 66 micrograms of iodine.)

T3 is called T3 because each molecule of T3 contains 3 atoms of iodine.

[Clutter in reply to Joell]

Joell, Levothyroxine (T4) converts to T3 via the thyroid and major organs. People's ability to convert differs. Thyroidless patients lose the ability for thyroidal conversion and often need T3 in addition to enable sufficient T3 levels, while others may convert less efficiently, sometimes due to DIO2 gene impairment, and also need T3. Some people don't tolerate T4 and need T3 only.

[Joell]

Thanks Clutter and helvella .. I feel like I am having a biology lesson. It's so complicated and such a long discovery process for each person of what is right for them. Am wondering how one finds out if they are unable to tolerate T4. I guess it's if the symptoms continue or get worse. I try to read as many posts as I can but am thinking that all I do is confuse myself with too much information because there are so many variations and sometimes terrible degrees of this condition. Because of my lack of knowledge, and desperation to start off on the right path with my medication, I get too caught up with individual posts and start thinking ' I should be on NDT' because somebody said that levo was useless and they only lost weight and felt better once they were on NDT ! However I actually feel grateful that I have at least started taking Medication and whether this one is right or wrong am hopefully on the path to managing my health. I was going to say I am a shadow of my former self but more accurate would be a fat, fed-up, insomniac, zombie version who can't remember what someone has said to me just two seconds ago and has to ask them again, lol. Here's hoping for some improvement and I will post my next blood test results in a couple of months. Thanks again , I really am so grateful for your responses.