Outdoor temps sudden rise,air hunger,weakness back,test results in.Do i reduce NDT and add T3,any advise gratefully appreciated.

[Gillybean1]

,Ive been taking 3/4grain Armour NDT sublingually in the morning,having upped the dose from 1/2 grain to this amount 10weeks ago, these are most recent results done 3weeks ago.

TSH     0.13    (0.40-4.00)                        previous Nov 2015 TSH  3.29 (0.27-4.2)

FT4      18.4   (11.5-22.7)                              "            "       "     FT4  16.3 (12.00-22.0)

FT3      5.3     (2.8-6.5)                                   "            "        "    FT3  4.2   (3.9-6.7)

T4         98     (58-161)

RT3      0.48   (0.14-0.54)

TG        <20    (<=40)

TPO      212    ( <35)

Folate  >20     (5.00-10.00)

B12     1058    (190-660)

Ferritin    33    (13.00-150.00)

Iron Saturation  38%   (15.00-50.00% )

Transferrin BC    60     (50.00-85.00)

Transferrin          2.39  (2.00-3.60)

Iron        23    (14.00-30.00)

My Vit D was 115 (75-200) last year, no reason to think its changed as ive adjusted it through winter too.

Cortisol due to be redone (shortly via saliva) this was elevated last Dec due to personal circumstances and i think that might have elevated my HDL at the time for the first time ever in my lifetime. Interestingly my GP was not familiar with raised HDL only LDL.

As the majority of my issues sit around complex  chronic gut pain ,malabsorbtion,nausea and fatigue, should i try lowering the NDT and adding 5mcg of T3? Especially as i cant cool down and i cant heat up.

I can see a glaringly obvious low Ferritin level, its better than it was, I take with the disaproval of the Gastroenterologist Floradix GF Iron once a day, on a day when my guts not too painful and its rising very slowly, but really irritates my liver if i take more. A iv of iron is absolutely out of the question with him as he believes anti depressants is the answer, need i say more..... !

Any thoughts or comments greatly appreciated please, best wishes to all G.

B12    

[shaws]

I'm sorry you are having unpleasant symptoms. I note you are taking Armour sublingually and I do know that some people do so. I'd just mention that NDTs are made to be taken with 1 glass of water as the molecules within them are too large to be absorbed by the tongue and therefore the possibility is you may not actually be getting the amount of hormones you believe.

(I am not medically qualified I will point out).

This is from the company that produce Nature-throid and WPure:

A: Both medications were formulated to be swallowed whole on an empty stomach with an 8oz glass of water. Use as directed by your doctor.

and

A: No thyroid drug is FDA approved for sublingual usage. Both tablets were formulated to be swallowed whole on an empty stomach with an 8oz glass of water. Use as directed by your doctor.

getrealthyroid.com/the-real...

3/4 gr of Armour is around 75 mcg of levo (quite a small dose). Usually when beginning NDT (if you've been on levo previously) you just switch straight over to an equivalent dose. However, if you are taking NDT you increase dose by a small amount every two weeks till symptoms are relieved and you feel better. Also you should be making a record of pulse/temp too when not on an optimum dose.

[Gillybean1 in reply to shaws]

Hi Shaws, Thanks for your reply, only started with NDT at 1/4grain 18mths ago and working up very slowly its been tricky because of the difficulty of low ferritin. Now on 3/4 grain.

I know i should swallow with water but i found i had less symptoms when taken sublingually, whether thats is because i took too much water and pushed the crushed tab beyond stomach bag and into small intestine, or whether sublingually im getting more overall into the stomach im not sure.

Ive done temps and pulses everyday, moved up from 35temps -60 pulse to 36.5/ 36.8 temps - 70pulse. Ive been DFree and Gfree 4years, following FODMAPS .

My question is would lowering NDT to 1/2 grain and adding T3 to say 5mcg help with the air hunger in these hot weather days ?

I dont understand conversion figures my tabs say 1grain 60mg= levo T4 38mcg/ T3 9mcg, but you said 3/4 grain=75mcg levo. Sorry if im being thick here,but im totally confused.

Kind regards G.

[Hidden]

Hi, I am not an expert on adding T3 to NDT, but your rT3 looks as if it is a bit high.  It is my understanding that to deal with high rT3, T4 needs to be reduced and T3 increased so there is less T4 around to convert to rT3.  Hopefully someone else could confirm that adding a little T3 could help.

When taking Vit D, you should be adding some magnesium with it.  Vit D uses mg to convert to is active form.  Sometimes this can uncover a problem with low mg.

[Gillybean1 in reply to Hidden]

Hi Jan4363, Thank you for your reply, yes i thought the Rt3 was heading up the highway, but Shaws reminded me of Dr Lowes notes, when my heads not foggy i will have another go at understanding it !! Its still just in Genova D's ranges.

I guess with all this stuff we have to suck it and see ! Im not sure why im so scared of adding the T3 even at a small amount say 5mcg, i think it may be ive still got in my head the Endo saying what a silly woman i was to even think of self medicating and that even taking 5mcg T3 would make my heart race and that i would not like the overall feeling!

I just thought T3 might help with the hot weather.

Yes i do take Mg /Ca (great gut soothers). plus Selenium/.ACES/B,s/Zinc/C/ProB  all at the recommended intervals. Irons the tricky one.

All good wishes to you,and thanks G.

[shaws]

Reverse T3 is no problem and this is an excerpt from a specialist:-

Dr. Lowe: Some readers will not be familiar with reverse-T3, and I know from experience that many others harbor misconceptions about the molecule. Because of this, I have summarized in the box below what we know about reverse-T3. I've answered your question below the summary.

Conversion of T4 to T3 and Reverse-T3: A Summary  

The thyroid gland secretes mostly T4 and very little T3. Most of the T3 that drives cell metabolism is produced by action of the enzyme named 5'-deiodinase, which converts T4 to T3. (We pronounce the "5'-" as "five-prime.") Without this conversion of T4 to T3, cells have too little T3 to maintain normal metabolism; metabolism then slows down. T3, therefore, is the metabolically active thyroid hormone. For the most part, T4 is metabolically inactive. T4 "drives" metabolism only after the deiodinase enzyme converts it to T3. 

Another enzyme called 5-deiodinase continually converts some T4 to reverse-T3. Reverse-T3 does not stimulate metabolism. It is produced as a way to help clear some T4 from the body.

Under normal conditions, cells continually convert about 40% of T4 to T3. They convert about 60% of T4 to reverse-T3. Hour-by-hour, conversion of T4 continues with slight shifts in the percentage of T4 converted to T3 and reverse-T3. Under normal conditions, the body eliminates reverse-T3 rapidly. Other enzymes quickly convert reverse-T3 to T2 and T2 to T1, and the body eliminates these molecules within roughly 24-hours. (The process of deiodination in the body is a bit more complicated than I can explain in this short summary.) The point is that the process of deiodination is dynamic and constantly changing, depending on the body's needs.

web.archive.org/web/2010103...

[Clutter]

Gillybean,

Thyroid peroxidase antibodies are positive for autoimmune thyroid disease (Hashimoto's) which causes 90% of hypothyroidism.  100% gluten-free diet may improve symptoms and reduce antibodies and may improve painful gut, nausea and malabsorption.  @Humanbean found ferritin improved markedly after she went g-f.

chriskresser.com/the-gluten...

thyroiduk.org.uk/tuk/about_...

Thyroid results are good but there is scope for a small increase in NDT to raise FT3 a little to see whether it improves symptoms.

B12 and folate levels are good. Ferritin remains too low.

__________________________________________________________________________________________

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.

[Gillybean1 in reply to Clutter]

Hi Clutter, thank you for your reply.

Would raising NDT give me more problems with cooling down to present hot weather because or the T4 content ? Is it the T4 that warms us ? Hence asking if T3 would help the hot weather issue.

Ive been Gfree/Dfree 4years now and the antibodies have risen in that time, still working out which food is pushing it.Going through FOODMAPS this year,which i was introduced to 4years ago when i was only able to eat liquid vit/min meals so it was impossible to apply then. Its a bit complex but i can see the crossover links to thyroid/gut and immune attack.

Thank you for the links, i really like Chris Kressler info and explanations.

All best wishes to you, G.

[Clutter in reply to Gillybean1]

Gillybean,

You aren't over medicated so it's unlikely reducing dose will improve heat intolerance.  There is T3 in NDT so I can't see the point in reducing NDT dose and taking T3 separately.  T3 causes heat intolerance in some people but the 7.5mcg in 3/4 grain is unlikely to be responsible.

Low iron/ferritin can cause air hunger.

_______________________________________________________________________________

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.

[Gillybean1 in reply to Clutter]

Hi Clutter ,many thanks for your response. I had the heat intolerance, and inability to heat up air hunger 6 years before i got myself diagnosed with Hashis, that said as soon as i started Armour last year, there has been a massive improvement, but not to hot weather. So maybe as im still undermedicated increasing my NDT up to 1grain may help.

I didnt know T3 can cause heat intolerance as well as eliminate heat intolerance, i guess i just have to take some, suck it and see.

I thought adding more T3 alone might also help my gut as that has been a major problem. Just afraid.

All best wishes to you, G.

[greygoose in reply to Gillybean1]

T4 doesn't do anything much, it's a storage hormone. It's T3 that causes symptoms when it's too high or too low. You should really get the FT3 tested when you're on any replacement containing T3, because the TSH and FT4 will naturaly be low.

[Gillybean1 in reply to greygoose]

Hi Greygoose,

Thank you for your reply, im still on 3/4grain Armour giving me a  FT3 of 5.3  (2.8-6.5)  and  FT4 18.4 (11.5-22.7)  TSH  0.13 (0.40-4.00) so i can move up now to 1grain and see what happens.

I think i was hoping that extra T3 might be the magic bullet for the gut issues, i knew Dr Lowe talk about T3 reducing heat intolerance. i did not now that too much of it can cause it as well, so thank you for that information.

Guess i need to stop being such a wuss and try it if the upping to 1grain doesnt do it.

All good wishes to you , G