I picked up my lab results yesterday morning, and I would like your opinions in this issue.
I am living in Spain and here there is no much knowledge about NTD or T3 treatments.
In 2013 I started using thyroxine until 75 mcg having really bad results with it so I stopped it. Then I used Erfa and was horrible too, then the last thing I used T3 alone only 10 mcg per day and feeling better but I had tachycardia and my head was like a carnival... heavy thoughts, fast thinking, paranoia..., and I had diffult breathing and ezcema... so I stopped too.
I have been with any medication since June 2015.
I have low B12, low Vitamin D and low Ferritin. I have never have any cortisol test yet.
My lab work results are:
TSH 8.00 (0.3-4.5)
T4 0.82 (0.85-1.8)
TPO >1000 (0-35)
FERRITIN 40 (15-150)
My GP told me that I cant be with any thyroid medication, so she wants to start with levo again, 50 mcg and retest in 3 months...(thats sounds crazy)
So I would like to try to add any T3 to my dose...
What should I do?
Should I increase my vitamins level first and then start again with the treatment?
Which dose of levo and T3 should I start to be equal to 50mcg of T4?
How long should I stay in that dose?
Many thanks in advanced for all your kind help
Regards
Written by
Cavalli13
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When you are taking one thyroid hormone and wish to switch over, you just switch to another in an equivalent one dose.
It is serious to stop thyroid hormones once diagnosed as it can lead to other more serious illnesses.
You might have taken too low a dose when you tried NDT and T3. Low doses can also give us bad symptoms as our body struggles to cope. i.e. breathlessness etc anxiety, palpitations and the list goes on and on.
When we are prescribed after the initial diagnosis we get a blood test after six weeks with an increase, usually about 25mcg each time until we are well and the TSH is around 1 or lower. Some of us need it suppressed particularly those who've had thyroid cancer they must definitely have a suppressed TSH.
i.e. your starting levo was 75mcg and should have been increased after six weeks. Some doctors make the mistake of thinking if we are 'in range' that we are on sufficient but we have to be low or below range - not towards the upper part of the range.
Your last dose of T3 was 10mcg - a pitiful dose as it is equal to around 30mcg of levo. Our body cannot function with such low doses and that might have resulted in your suffering the consequences of tachycardia.
Occasionally some people have a 'reaction' to the fillers/binders and that can be tested by taking 1 antihistamine tablet 1 hour before the thyroid hormones. If no reaction a change of brand is required till we find one that suits us.
T3 (which converts from T4 to T3 (sometimes not efficiently) or T3 only is the active hormone which is required in all our receptor cells.
Your doctor is wrong - they cannot just prescribe the basic 50mcg and tell you to come back in 3 months. It is six weeks. If we don't increase when needed we can have a rebound effect.
Make an appointment now for six weeks, and have the earliest possible appointment, fast also although you can drink water. Leave about 24 hours from your last dose of levo and the test and take levo afterwards. (so you don't make a mistake after your ast dose put your tablets elsewhere so you don't accidentally take the dose before the test). Also ask for B12, Vit D iron, ferritin and folate to be tested as we can be deficient. Always get a print-out of your results, with the ranges, and you can post if you have a query.
I wouldn't add T3 yet till you are on a stable dose of levo. That will take a few months. Afterwards if you don't feel well (of course your dose would have to be optimum) you can then add T3 with a reduction in T4.
The following is advice from one of our Medical Advisers:
Personally I think that, to know exactly what the equivalence is between two regimens of treatment (i.e. switching between T4 or T3 products, or between different regimens of T3/T4 versus NDT etc) it's essential to test for TSH, FT4 and FT3 before switching and again immediately afterward. In the simple case of T4 only treatment it's well known that different brands of pills show different bioavailability for the same dose. How much more likely is this for more complicated switching. Getting accurate data for switching outcomes is a cardinal rule for best results.
Shaws ,i believe that your quote is from a clinical scientist not a medical doctor. Good advice which i have realised i am ignoring ,switched to Thyroid S three days ago but i suppose i should wait until i have increased dose from one grain before testing.
Cavalli13, 10mcg T3 is equivalent to 30mcg T4 so you could start with 25mcg T4 + 10mcg T3 which is equivalent to 55mcg T4. You should start T4+T3 as soon as possible and you can supplement B12, iron and vitamin D at the same time.
Take T4 and T3 on an empty stomach 1 hour before food and drink or 2 hours after, 2 hours away from other medication and supplements, and 4 hours away from iron, vitamin D, calcium and oestrogen.
TPO antibodies are positive for autoimmune thyroid disease (Hashimoto's) which has caused your hypothyroidism. Many members find a 100% gluten-free diet can reduce Hashi flares, symptoms and antibodies.
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.
Cavalli,
I am sorry to hear you have felt so unwell but it is very important you take your thyroid meds.
Your TSH is high and T4 is too low. The aim of any thyroid meds are to restore the patient to euthyroid status and for most people that means TSH just above or below 1.0 and T4 in upper third of range.
Levothyroxine takes 7/8 days to be absorbed before it starts working and up to 6 weeks to initially saturate the body which will only tolerate small increases at any one time. Your doctor should retest your thyroid hormone levels after 6 weeks and adjust the dose according to results.
Leave 24 hours between last dose and blood draw and have the blood drawn early in the morning whilst fasting (only water) when TSH is highest. Symptoms can lag behind good biochemistry by 6-8 weeks.
It is important to take your pill on an empty stomach with a glass of water, 1 hour before food, 2 hours before supplements and 4 hours before calcium, iron or Vit D supplements.
People with thyroid issues often have vitamin deficiencies (as you have) and these will need to be addressed in order that your body will utilise the thyroid meds properly.
I wouldn't recommend medicating NDT or T3 until your nutrients and iron are optimal as I have read it is not as flexible as T4 alone (Levothyroxine.)
If you wanted to medicate T3 you could add some to your T4 as advised by Clutter above.
Your thyroid antibodies are very high and to reduce inflammation and feel better you need to reduce these. Members have found a gluten free diet to be beneficial and supplementing selenium helps lower TPOAb's as well as helping thyroid meds to convert.
For further advice on the best individual supplements to address your deficiencies post a new question with the subject in the title.
Disclaimer: 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.
Thank you very much for all your quick replies,. I am gluten free since June and my tpo were 1500 but now they have dropped to 1000 so I guess the diet is helping.
I am pretty scared to start with the levo again because I started to have really bad diziness last time all the day.
I am working in an optician shop selling all day and dealing with clients so I dont really want that my symptons will interfere in my job...
At the moment I am not having a really good time, get out of the bed is a big effort to deal. I know that I need to do something with my illness as I am getting worse day by day, but really scares me a lot..
Anyway is my resposanbility to get better so I will try to do my best and I really hope that I will be myself one day again..
Thank you again, because this forum is a great help for me every day.
I will keep posting and I will start with the 50 mcg take at night and retest in 6 weeks we will see how is going...
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