Not Sure I Trust My Endocrinologist Any Longer...

[Trademole]

....so i'm very interested to get feedback from the highly educated members of this forum.

I started seeing a Harley St endo at the beginning of 2015. He has sorted out one area of hormone-related problems (testosterone) but i'm not sure he is getting to the bottom of my thyroid.

I am a 52 year old male and have been taking levothyroxine for around 5 months - started on 75m mcg, then 100. There has been no change in my fatigue & cognitive impairment. My latest set of blood tests show no change in any thyroid metrics despite taking the thyroxine for 5 months which all seem to be at the bottom of the 'normal' range, although some of the others seem ok-ish?

TSH 0.77

Total Thyroxine 77

FT4 12.7

FT3 3.9

B12 553

Iron 17.4

Folic acid 9.8

Vit D 130

This week he told me to go up to 125mcg and come back and see him in 4 months! Can any of the smart people in here suggest any other ways of interpreting my situation?

Thanks

Mark

[greygoose]

Hi Mark. Do you have the ranges for those results, please? You'll get better replies if you give the ranges - anything else will just be guess-work.

[Clutter]

Trademole, Good news is that your endo isn't obsessed with keeping TSH in range as a dose increase will suppress it. Importantly, a dose increase will raise FT4 and FT3 levels which are low and probably why you are symptomatic. Recall in 4 months isn't unreasonable. It takes 6-8 weeks for a dose increase to be reflected in blood levels, and symptoms can lag behind good biochemistry by a couple of months.

B12 and folate are adequate. Optimal B12 is 1,000. Supplementing 1,000mcg methylcobalamin taken with a B Complex vitamin may improve energy.

VitD is optimal. I think iron's okay but can't be sure without the range (figures in brackets after result).

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I am not a medical professional and this information is not intended to be a substitute for medical guidance from your own doctor. Please check with your personal physician before applying any of these suggestions.

[Trademole in reply to Clutter]

wow!

that was quick, thank you.

[Trademole]

Thought it might be better to include the blood test ranges as well.

TSH 0.77 (0.3 - 5.0)

Total Thyroxine 77 (66 - 181)

FT4 12.7 (8.8 - 18.8)

FT3 3.9 (2.8 - 6.5)

B12 553 (179 - 1162)

Iron 17.4 (6 - 26.5)

Folic acid 9.8 (2.3 - 17.6)

Vit D 130 (>75)

[Marz]

Are you supplementing with anything ? B12 ? - VitD ?

[Trademole in reply to Marz]

Yes i have been taking 5000 IU of Vit D3 and a Vit B supplement but now realise it was the wrong type of B12 - should have been methylcobalamin not cyanocobalmin

[Marz in reply to Trademole]

...just wondered - as your results were not too bad considering

Cyanocobalamin is taken by some people - it's just that it has to convert into Methylcobalamin. You cannot overdose on B12 and once supplementing the tests become pretty useless. B12 is needed in the cells and only around 20% of the amount in your blood is available at a cellular level. Having it around 1000 should help with cognitive issues. Around 500 or below it can be a neurological condition....

b12deficiency.info/signs-an...

The above link will give you so much information about B12.

When taking B12 also take a GOOD B complex. Also take K2 with the VitD. D increases absorption of calcium and K2 directs it to the bones and teeth. Worth reading up on K2 - it is an interesting vitamin and does quite a bit in the body !

You may also wish to look up Folate v Methylfolate - the first is synthetic - the latter natural. Sometimes all this fine tuning can make a difference I have found

[LAHs]

Hi TradeMole, just a note you might want to bring to the Endo's attention. There are some meds which interfere with Thyroid meds and I believe Testosterone supplements are one of them. You might be building up reverse T3 (rT3) as a result, i.e. your (good) amount of T3 is not getting to your cells because

a) the testosterone is using the thyroid binding globulin (TBG) as "transportation" to get to the sites to do it's job and

b) all of the cell receptors may be occupied by rT3.

Just a couple of things your endo might want to look into.

[Heloise]

Hi Trade, so you don't know any of the ranges? The TSH range we all aim for 1.0. I was wondering if your FT4 stayed around 12 even after you began taking T4. What you are really hoping to do is raise the FT3 into the upper part of the range because this is what will raise your metabolism. You could compare these although they may not be the same for European testing.

stopthethyroidmadness.com/l...

Often they are not looking to get to the bottom of it but doctors like this functional medicine are trying to. He has more videos if you click the icon at bottom right.

youtube.com/watch?v=nZ_CP7l...(Not working as expected?)

[Trademole in reply to Heloise]

Thanks Heloise

Yes my FT4 has been unchanged at around 12 even since taking thyroxine. My FT3 is in the lower part of the range 3.9 (2.8 - 6.5).

Bizarrely i also have shakiness and anxiety which i read is a symptom of hyper not hypo?

I will check out the vidoes.

[Heloise in reply to Trademole]

If you were hyper, you would be "hot", you would possibly have palpitations and tremors BUT when you are hypo and very low your adrenals get involved. So if you have internal shakiness we used to think it was adrenaline that your poor adrenals use to keep you going, but I've also read another reason for that. Anyway, I'm pretty certain you are HYPO.

Yes, go to You Tube and check more of his videos as they briefly explain several situations. #1 serotonin #2 dopamine #13 low conversion (although both T3 and T4 are low so maybe not) #18 low testosterone.

#19 excess testosterone #21 high cortisol (might be you)

How did your doctor treat testosterone?

If you have time this man explains the hormones so well.

youtube.com/watch?v=T_Re4ja...(Not working as expected?)

[Trademole in reply to Heloise]

I had very low testosterone but have had Nebido injections every 10 weeks and that is now in the 'correct' range. He also put me on Hydrocortisone because my short synacthen adrenal test was suspect but this hasnt made any difference so has been discontinued.

I was also tested but there was no pituitary problem or tumour.

[Heloise in reply to Trademole]

When i first discovered Dr. Clark I found it interesting that the remedy for a deficient hormone is not necessarily to add the hormone, but to find out why it is deficient. There are two schools of thought on that I guess but the more I learn, I find I agree that it makes more sense to take a holistic view if you respect that the body is always trying to heal. I don't believe modern medicine goes along with this theory but the two doctors above do.

Not saying that you don't need substances to support your problem areas. For instance when you are under stress and your adrenals produce all that cortisol, they need more magnesium and more vitamin c if you aren't nutritionally sound which is also a problem. We really need to support our bodies but this area is often ignored by the profession. Even symptoms seem to be ignored if blood tests are "in range".