Blood test results

[stephensmith]

Male, Age 60, Medications – Atoravastatin 40mg, Tostron injections and NDT. Retired 2013

Hypothyroid and Hypogonadism 2013. Under private Endocrinologist

Have tried Levothyroxine, T3 and NDT. Unable to tolerate a high enough dosage to get blood test levels within reference range (in particular TSH), Very jittery anxious, waking at 4 am itchy face and neck, extreme tiredness in afternoon, max 50mg Levothyroxine or 20mg T3 or ½ grain NDT (tried 3 types of NDT).

Currently managing 5 days ½ grain with 2 days of none medication (3 days of non medication gives numbness over left eye and top of head

TSH – 10.5 (0.55 – 4.8)

T4 – 11 (9.0 – 23.0)

T3 – 5 (3.5 – 6.0)

Others

B12 – 350 (211 – 911) - OK

Vitamin D 76.3 nmol/L - OK

FBC, ESR, Rheumatoid Factor, ANTI CCP, Glucose, all OK

Calcium - OK

Ferritin – 181 (22 – 322) - OK

CRP <5 (0.0 – 5.0)

SCK - 218 (40 – 320)

Blood Pressure 145/90

Serum Follicle stimulating hormone level <0.3 (1.0 – 18.0)

Serum LH Level <0.1 (2.0 – 9.0)

Serum Sex Hormone binding gobulin level - 27.9 (10.0 – 57.0)

Any advice ???

[Poshpenny]

Does your private endocrinologist believe in adrenal fatigue, because I think that is something you should explore. If he doesn't then please consider finding one who does.

[stephensmith in reply to Poshpenny]

Will ask on my next visit, although I think he is running out of options !!

[Clutter]

Stephensmith, you definitely need more thyroid hormone to bring up FT4 and reduce TSH. Why are you only taking medication 5 out of 7 days?

Ferritin is okay which rules out low iron making it difficult to tolerate thyroid hormone dose increases. Has cortisol been tested to rule out adrenal issues which can make tolerating thyroid hormone difficult?

B12 is low in range, 1,000 is optimal. Supplement 1,000mcg methylcobalamin sublingual lozenges, spray or patches and take a B Complex vitamin to keep the other B vits balanced.

VitD is just in the 75-200 replete range. I recommend supplementing 2,500iu D3 daily to maintain levels until April.

[stephensmith in reply to Clutter]

Hi Clutter, Had private tests last year. Morning and lunch readings were just below range, afternoon and evening mid range. Strangley I feel better on a morning than an afternoon. Thanks for the advice on Vitamins, have never been a strong believer in them, however I guess when your immune system is buggeredthen it needs all the help it can get

[Clutter in reply to stephensmith]

Stephen, I was very dismissive of vits/mins until VitD and folate deficiency and low B12 meant I needed to supplement. After a few weeks I found it made an enormous improvement to my well being.

[stephensmith in reply to Clutter]

Thanks Clutter, reckon it's a man thing !!!

[stephensmith in reply to Clutter]

I only take NDT 5 or 6 days out of a week as I gradually build up to being hypo, one or two days seems to settle me down

[Clutter in reply to stephensmith]

Stephen, you lose the benefit of T3 in NDT dosing that way. It would be better to take a lower dose over 7 days.

Disclaimer: I am not medically trained. My advice is based on my personal experience &/or research and is not given in my capacity as an Admin of Thyroid UK or endorsed by TUK. Information on the forum is not intended to be a substitute for medical guidance from your own doctor.

[stephensmith in reply to Clutter]

OK, thanks for that Clutter. Get the tablet cutter working!!

[PaulB]

Stephen

Multiple endocrine problems are a nightmare, I know personally. US Endo I saw warned me of high ICA levels and so have watched glucose levels, but on his advice had HbAIc checked and while challenge and spot checks of glucose were normal HbA1c has shown positive.

Ask your GP to check it

Keep well

Paul

[stephensmith in reply to PaulB]

Thanks Paul

[shaws]

I'm sorry you are having problems with your thyroid hormone replacements.

Others will respond to your other blood tests. I note you are taking a statin and have read that statins interfere with the uptake of thyroid hormones. Cholesterol lowers when we take thyroid hormones as usually it is hypothyroidism which causes an increase.

All other medications should have a gap between thyroid hormones and other medications - some need about 4 hours.

This is an excerpt:

If you have an underactive thyroid (hypothyroidism), treatment may be delayed until this problem is treated. This is because having an underactive thyroid can lead to an increased cholesterol level, and treating hypothyroidism may cause your cholesterol level to decrease, without the need for statins. Statins are also more likely to cause muscle damage in people with an underactive thyroid.

nhs.uk/Conditions/Cholester...

[stephensmith in reply to shaws]

Hi Shaw's, I did go without stations for two months to see the effects. There was no change. I have hereditary high cholesterol, my father died at 54 of furred arteries. I take statins on a night and ndt on a morning. Thanks for your reply

[shaws in reply to stephensmith]

With hereditary high cholesterold that obviously makes a difference. Have you tried nature-throid as it is hypo-allergenic (just a thought).

[stephensmith in reply to shaws]

My current NDT is Naturthroid

[shaws in reply to stephensmith]

I think you've tried all of the main replacements. What about compounded ones. See link. I know in the USA they do compounded ones but in the UK you'd have to pay unfortunately. I have no idea what they consist of.

thyroiduk.org.uk/tuk/treatm...

[stephensmith in reply to shaws]

Will look into the compounded type I currently pay for my NDT thanks

[shaws]

These are two links re the same doctor regarding the importance of cholesterol by :-

I first heard this doctor when I was at a conference:-

drmalcolmkendrick.org/2015/...

drmalcolmkendrick.org/books...

[Teuchter]

Hi Stephen, I'm sorry to hear you are still struggling.

I'm not sure I have any answers for you, just sharing a few thoughts which sprang to mind as I read your post.

Im a 47 year old male, was diagnosed hypothyroid in 2001, prescribed thyroxine, it did'nt really cure me, and each time my dose was increased, I felt worse. Going on a hunch, I asked for testosterone to be checked: it was fine, as was SHBG: but Estradiol E2 was too high. The NHS offered me no treatment for this, but I have since found that danazol, anastrazole and particularly letrozole have helped me tolerate a higher dose of thyroxine. I have concluded that my body converts too much testosterone to oestrogen. Having this problem, exogenous testosterone would probably not help me, since my body would probably just convert the excess to oestrogen, making things worse. I would suspect that many men with my body type (well built, but slightly prone to belly fat and gynaecomastia) would benefit from these aromatase inhibitors, which prevent this conversion.

Re: statins: don't believe the hype: there is enough evidence out there to suggest that statins are of limited benefit (one study suggests they might make you live two or three WEEKS longer), and are not worth the side effects. I suspected simvastatin was making me feel worse, aggravating my response to thyroxine, so I stopped taking it.

I'm no expert, just sharing my experiences, in the hope it helps you or someone else.

All the best

Geoff.

[stephensmith in reply to Teuchter]

Hi Geoff, interesting post. I think I need more testosterone, but will need to check levels after a week following injections. Thanks

[Glynisrose]

Any doctor worth their salt would not prescribe statins alongside thyroid meds.

[LindaC]

Any doctor... would not prescribe statins!