Latest Blood Results from BH...should I raise T4 even if I can't convert it?

[KT304]

Latest Bloods from Blue Horizon, on a daily night time dose of 100mcg T4 and 25mcg T3 (Tiromel), I had the DIO2 test and have limited function to convert T4 to T3. I was prescribed T3 by my Endo but refused to pay the £300 per month, so source my own supply for a heck of a lot cheaper, and I am due to see him next week. My GP refuses to supply any T4 til I've been to the hospital next week so I had to buy some T4 online too as I would have run out  

My questions would be should I check RT3, and should I increase T4 even if I can't convert it well? And I can never seem to raise my folate, what can I take?

Results are:

Biochemistry

:

CRP 1.90 <5.0 mg/L 

Ferritin 74.0 20 - 150 ug/L 

Thyroid Function: 

TSH L <0.005  - 0.27 - 4.20 IU/L 

T4 Total 77.8  - 64.5 - 142.0 nmol/L 

Free T4 12.71  - 12 - 22 pmol/L 

Free T3 6.16  - 3.1 - 6.8 pmol/L 

Immunology:

Anti-Thyroidperoxidase abs 29.7 <34 kIU/L 

Anti-Thyroglobulin Abs 31.3 <115 kU/L 

Vitamins:

Vitamin D (25 OH) 72 

Vitamin B12 471 

Serum Folate 13.55 10.4 - 42.4 nmol/L 

Jan 2016 (NHS): On 100mcg T4, no T3. 

TSH: 0.28 (Range 0.34-4.6)

T4: 10.7 (range 7.5-21.1) 

T3: Not Done 

Vit D: 53 Lower end of the range is 50

I take 10000 D3 with a Super K and Calcium/Magnesium supplement and Jarrows B12 1000 but not religiously, so I could make sure I do that daily and raise levels?

To report, I've never felt better (apart from some god awful lurgy I picked up on Sunday which has flattened me) and I've also started running 3 times a week, my Paleo diet has worked and is working, I've dropped 18lbs (plenty more to go), my hair is growing back, I don't have joint pain, I sleep like a baby! The only niggly things left are the hives, even being gluten free I have many things that trigger terrible hives, and if I'm not in bed by 10.30pm my feet are ON FIRE.  

Hope everyone is well and thank you for reading  

[greygoose]

My personnal opinion, from all I've read, is that no, you shouldn't increase your T4 dose. If you're taking T3, then you Don't need lots of T4, so the body doesn't hang on to much, so it's expected to be low in range.

And your FT3 looks great - and you say you feel well - so, if I were you, I'd leave things where they are.

I think you ought to start getting more serious about taking your B12. Optimal for B12 is 1000, so yours still has quite a way to go.

What have you been taking for your folate? If i were you, I'd get a B complex, with methylfolate - not folic acid - and see if that will bring it up. You need to take a B complex with B12, anyway, to keep the Bs balanced.

Why are you taking calcium? Did it test low? Taking vit D3 should bring your levels up, anyway, because it increases absorption of calcium from food. Maybe you should get it tested again.    

[KT304 in reply to greygoose]

Thanks greygoose, much appreciated. 

Noted on the B12, I've just brought a weekly pill holder, which I had been meaning to do, so no excuse now. I'll also order some Jarrow 5000 and take for a month, then revert back to 1000. Also will add methyl Folate to the basket and B Complex too. 

I was taking Solgar Gentle Iron (iron Bisglycinate) but it was random, not daily. 

Was told by my GP a while ago Calcium was low but have no result. I read somewhere about calcium being taken with Vit D, I might have read it here, or in some Kindle book about a guy who took mega doses of Vit D3 that you should take Super K with the Vit d. I use Life extension tablets.  I'll get a full Vitamin panel done next month to check on all of the levels.

I also take Q10, Selenium and Zinc with B complex I brought from tesco!!! 

I stopped the Betaine HCL as it was repeating badly on me, after going through a great period where it really helped, and have just finished a course of Probio 7 Advanced Formula too, this really did help with my IBS. And so did running help my IBS too, last time I had an "Episode" was when I was glutened at the Albert Hall a few weeks ago and nearly came a cropper (lord knows what I would have done should I have not made it to the lav in time) but the running has really, really calmed my bowels, as well as the T4/T3 and I find I'm doing ok inside. 

Sometimes, I eat my dinner then take my tablets, and there are at least 8-10 I take, my kids look at me like I'm crazy, whilst shoving B12 at them to help with brain function and Uni degrees! 

Thank you so much gg, and I've ordered the Jarrows bits now. 

xx

[greygoose in reply to KT304]

The methylfolate should be in the B complex.

Well, vit D3 and calcium work together, but that doesn't necessarily mean you have to supplement it. Calcium suppléments are very well absorbed, and the vit D3 should raise calcium levels anyway. You're right to take the K2.

Good idea to get them all tested again - although not much point in retesting B12 because if you're supplementing, the results will be skewed - unless you can manage to get a... can't remember the name of it! lol The new type B12 test.

[KT304 in reply to greygoose]

Thank you  

I'm hoping the endo keep the dose the same, I'm loathe to change it now I feel well. 

[greygoose in reply to KT304]

Is he one of those that are ruled by the TSH? Just tell him you feel well and you know that if he reduces your dose you'll feel bad again. Your FT3 isn't over-range, so there's no logical reason to reduce your dose.   

[KT304 in reply to greygoose]

No, I don't think so, he is pretty good. I saw him privately at first, then my GP referred me to him via the NHS. My GP would not take his written instructions on what meds I should have and prescribe accordingly,  the practice manager instructed my GP to refer me to this endo via NHS. All round a good result, I get to see who I want to, and when I've been to see him next week, he can write on NHS letter headed paper instead and give the same instructions. 

You hear (read) a lot of stories about the TSH, how they like to keep it around 1, and mine is quite low, but I'll fight to stay on the same dose. It's taken a long time to get this well!

[greygoose in reply to KT304]

Yes, a lot of them are afraid of a suppressed TSH. They think you'll get osteoporosis and heart attacks. But none of it is true.

Just stand your ground. It's your body, after all. He is there to advise you, not to dictate to you.