Am I missing something!!

Hi everyone

Would love your thoughts on my latest blood results. At present I'm taking 4 grains of ndt which I buy myself but I still don't feel good, I have no energy, no motivation, breathless when climbing stairs, and a new one on me ...no appetite!

TSH 0.04 range O.40 - 4.90

T4 10.7 range 9.00 - 19.00

T3 4.9 range 2.60 - 5.70

B12 600 range 187 -883 (supplementing)

Folate 4.7 range 3.10 - 20.50 (started to supplement two weeks ago)

From what I can gather T3 looks fine so why do I feel rubbish?

When. Saw Dr peatfield last year he said my adrenals are struggling so I take adrenal cortex as I felt nutri adrenals didn't help so I have just purchased adrenal cortex.

I had a 24 hour saliva test done last year and my cortisol levels are low throughout the day. Could this be related to how I feel or do I need to tweak my NDT.

Thank you so much in advance

Maro xx

31 Replies

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  • maro I'm not an NDT expert as I take Levo/T3 combo but I would have thought there was room for improvement with your FT4, it does seem low, and your FT3 could come up a bit too.

    But what about Ferritin? Have you had that tested? Thyroid hormone of whatever type can't do it's job properly unless ferritin is at least 70, better even higher. Low ferritin can cause fatigue and shortness of breath. If not already tested I would be doing that. I'd also do an up to date adrenal test as well.

  • Thanks for replying susie. GP didn't test for ferritin this time but it was done last October...85 range 5.00 - 204 is that high enough? In October my T4 was 11.2 so it is lower now but I thought low T4 was ok when on NDT. It's so difficult to know if it's thyroid related or adrenal, have suffered with depression in the past so could be that I guess.

  • maro Your ferritin isn't bad, 70 is the minimum it should be but as that is a wide range then half way would be better, I'd be aiming for at least 100, just my personal opinion, that is what I would do. Do you like liver? A helping of liver once every week or two could probably be just the boost needed.

    Your B12 and folate aren't yet optimal, you may find that once you've reached optimal levels (1000 for B12, half way through range or higher for folate) then that will help.

    As I said, I'm not an expert on NDT so not really sure whether your FT4 is OK where it is. I know the ratio is about 38mcg of T4 and 9mcg of T3, but I'm not sure whether one would expect to see a higher FT4 in test results. Hopefully someone will come along who knows a lot more than me.

  • Thanks susie, yeah I do like liver...haven't had it for years when mom would do it for tea (memories) I will give it a go. I realise folate is low so I'm supplementing and also taking B12 but I see there is room for improvement. I read your profile suzie...you have been through the mill health wise plus the usual uphill struggle of dealing with incompetent and arrogant GPs. I hope you are feeling well these days. X

  • maro Oh, as you like liver (most people go 'bleugh') then if you eat it regularly that should help keep your ferritin topped up.

    I popped into the butcher's whilst walking the dog this morning and picked up two lovely slices of Welsh spring lamb's liver (I live in Wales). Got me a big onion here too so I know what I'm having for tea tonight - yum!!! I've only just started eating it again after many, many years. I was a non-red meat eater (just chicken, turkey, fish) for a very long time. I've had to force myself to eat liver but have found it rather nice :) . I just do it plain, thinly sliced, onions and liver both fried in butter, a few roasted tomatoes then whatever else fancy with it.

    I did see you were supplementing B12 and folate, so hopefully those will start improving soon.

    Thanks for your good wishes. I can't say I'm well but there has been an improvement since I started consulting with a holistic hormone specialist regarding adrenals and sex hormones a few months ago and using supplements for those, plus the tweaking of the thyroid meds has made a difference. There's still some way to go but my lungs have been a big problem this year (pleurisy, pneumonia and pseudomonas) which has made things difficult.

  • Thanks suzie that sounds quite tasty. I'm in Birmingham but I'm sure I can get hold of some nice lambs liver. I was wondering weather I should get my sex hormones tested I'm 54 and going though menopause so I guess that's not helping matters. Sorry to hear of your ongoing problems with your lungs.. Thank you for taking the time to advise me.

    X

  • Oooh maro I'm originally from Birmingham! I'm sure you'll get some decent liver from a butcher. Mine was rather tasty :) .

    My hormone test was through Genova, I think they do 3 or 4, I had the menopause plus because I am well past menopause now.

  • Thanks suzie it may be helpful to know state of hormones. Liver is on my shopping list lol. Thanks suzie for your advice. Btw bet you don't miss brum .

  • maro "Btw bet you don't miss brum ."

    No, not at all, wouldn't go back if you paid me LOL! The only thing I miss is going to the theatre, there were always good shows with big names and if ever a musical came I would be there. I live in a very small seaside town now (where mountains come down to the sea, and I have the loveliest view of both :) ) and we are devoid of 'proper' shops (but there's always the internet :) ) and we have just a very small theatre which does show films and has amateur shows occasionally but it's not the same.

    It's a very laid back lifestyle, always someone to say hello to when walking the dog. And I'm very selfish because I dislike it intensely at holiday time when our resident population expands 10 fold and it gets very crowded. We get a lot of Brummies at holiday time but I don't get homesick LOL!!!

    I haven't been back for about 6 years now, since before my husband died but there's no need now. My mother passed away two years ago and I have one brother there who really only has time for his own family so, as I don't drive and he does, he could visit me but he doesn't. I don't lose any sleep over it though.

    My daughter and her family live in Stourbridge, my son and grandaughter live in the same place as me.

  • Suzie it sounds wonderful I'm about done with city life I long to live by the sea. We have a caravan in bewdley so at least I can escape the madness. I do love the sea tho. Going to Pembrokeshire in August so at least I'll see the ocean. You're not missing anything suzie x

  • When taking NDT, the TSH is likely to be suppressed, and the FT4 low. It doesn't matter. However, your FT3 is only just over mid-range, so there's plenty of room for an increase.

  • Oh thanks greygoose I'll try going up to 5 grains. Am I converting ok? Was summoned into see G.P as result for TSH was deemed "abnormal" I am amazed at their ignorance and patronising attitude . Anyhow I only go for my bloods then I hot foot it out of there before they inflict any damage!

    Thanks again greygoose

  • Impossible to tell if you are converting well once you are on any form of T3. Because, obviously, you won't be converting as much.

  • I'll try to remember that greygoose , I'm not well up on FT4 when on NDT, just know TSH is usually suppressed and FT3 should be in range, so I didn't want to give wrong information. Glad it got cleared up for Maro.

  • It's the same when taking any form of T3. The body only holds on to as much of the T4 as it needs, and it doesn't need so much when you're taking ready-made T3. :)

  • Ok see what you mean, just wasn't sure weather to try T3 instead of NDT to see if I feel any better...any thoughts?

  • It's perfectly possible that NDT doesn't suit you. If doesn't suit everyone. But, it's all trial and error. I had to try just about everything possible before I found out that I was best on T3 only.

  • Thanks greygoose I've been on NDT for a year or so. Just fed up of feeling rubbish so maybe it's time to give t3 a shot.

  • maro,

    Results are good. TSH and T4 are often low when medicating T3 as the pituitary gland senses thyroid hormone and secretes less. T3 is good... you just need to get it working so if this were me I wouldn't tweak NDT dose yet..

    Vit B12 is optimal @ 1,000 according to PA Society. If you supplement, methylcobalamin is best for Hashi sufferers. Take with Methylfolate (B9) & a B Complex because they work together to regenerate red blood cells and make iron work properly. You are low in folate and a deficiency can make you breathless similar to iron deficiency.

    Dr P says adrenaline found in high cortisol levels shouldn’t be a problem and so the whole adrenal glandular may be used as is considered more “complete” . He also emphasises the need to keep DHEA (which initially rises with cortisol before becoming exhausted) and cortisol in balance.

    However, LOW cortisol levels tolerate adrenal cortex much better than the whole glandular. The HPA axis regulates many homeostatic systems in the body and our own adrenal cortex produces cortisol (amongst others) in response to stimulation by ACTH. Glucocorticoids in turn act back on the hypothalamus and pituitary (to suppress CRH and ACTH production) in a negative feedback cycle. Therefore low cortisol will impact thyroid hormones by reducing conversion and possibly uptake in the cells. This is when we have good results like yours but still have symptoms but also remember symptoms often follow on for up to several weeks//months after good biochemistry. Everything just has to catch up ! ! ...

    Low thyroid hormone and low cortisol will impact blood sugar levels. Eating well and including protein, healthy fats and carbs will aid adrenal health. Unbalanced cortisol also causes inflammation that is known to reduce TSH secretion so down regulating thyroid hormone production.

    So all in all ... probably your low cortisol and low folate making you feel still hypothyroid... and what about Vit D and ferritin levels ? ? ......

    I can't tolerate NA or NAX either. Hope you feel better soon.

  • Hi radd thank you so much for that very informative reply. So do you think after a time on adrenal cortex I may improve? My total cortisol was 19 when it was done last year I'll try and send image. Ferritin done in October 2015 was 85 range 5.00 - 204 Vit D has confused me it 163nmol says normal or is it high? The loss of appetite is new also I'm always hot. So would you advise to stay on NDT or try T3.? Sorry radd for all the questions . Many thanks

  • Maro,

    Haha .... Vit D confuses me too ! ! .... but I would say yours is high as blood levels of 40 ng/ml – 50 ng/ml or 100 nmol/L – 125nmol/L are considered a safe optimum level ..

    I read it is safer to supplement higher readings with Vit K2 to control calcium in blood vessel but some specialists would consider this elevated level may cause excess calcium absorption. If you are supplementing it may be best to leave off for 3-6 months considering it is the sunny summer months ( or supposed to be ! .. ) .. I don't supplement from May - October.

    Ferritin should be half way through range but is the stored iron so variable and not always indicative of reduced iron unless massively low. Are you supplementing to build stores ?

    I don't know about the loss of appetite but it is important to eat well as missing meals will stress the adrenals further. It can be counterproductive to keep switching meds and if low cortisol is the culprit, this would apply to any thyroid med.

    If this were me, I would stay on NDT and concentrate on optimising folate, etc and improving adrenal health. As you are hot I certainly wouldn't increase dose but concentrate on getting that 4.6 of T3 to activate within the cells to achieve wellbeing.

    Cortisol level of 19 doesn't sound good so this isn't just a case of supplementing adrenal cortex but incorporating rest and down time ( yoga ? ) .. that will reduce stress hormone output. I take 3 grams daily of Vit C to support adrenals, ideally taken in 2 or 3 smaller doses taken throughout.

  • Thanks radd. Yeah think I overdone the Vit d, I was taking a high strength supplement , will leave it till October. I do believe my low cortisol affects how I feel so hopefully the adrenal cortex will help. I take 2 grams of Vit c but didn't know it helps adrenals so I'll up it. Thanks again radd for taking the time to reply it's much appreciated.

    Maro x

  • maro,

    The highest concentration of vitamin C in the body is stored in the adrenal glands.

    adrenalfatiguerecovery.com/...

  • Thanks radd, very interesting .

  • T3 is the active thyroid hormone which controls the metabolism and therefore the symptoms. You are right, your Free T3 is just above the mid point of the normal range so you should not have hypothyroid symptoms.

    As you are still having severe symptoms one possible cause is Impaired Sensitivity to Thyroid Hormone (more often known as Thyroid Hormone Resistance). It is genetic and requires very high T3 levels in the body to overcome the resistance.

    If there are other family members with fibromyalgia, CFS, ME, Coeliac Disease, MS, Heart Disease, thyroid or depression this would further support this.

  • Hi sandy that is interesting..not heard of it. I do feel that I should be better than I am..every day is like wading through mud. I also have lost confidence from a quite outgoing person I now want to stay home with my family and not see anyone! My 3 sisters have under active thyroid , one also has fibro. Depression and alcoholism also run in my family not sure if there's a connection, my late father, 2 brothers and 1 sister are alcohol dependant. Is there a specific test I can take to see if this is the case. Many thanks for your reply sandy.

  • Your family history points very strongly to this condition. Depression is very common and people can turn to alcohol as a coping mechanism.

    There is no specific test for the condition.

    Hypothyroid symptoms with good Free T3 and a family history are the indicators. If T3 reduces or clears the symptoms that is confirmation that you have the condition.

    I will send you a personal message about a book on this.

  • Thanks sandy I've just read your profile and read about he book...I would be very interested to read it. Do you think I should start t3 instead of NDT?

  • I would recommend T3.

  • Just to clarify is there a test to find out if I hav impaired sensitivity to thyroid hormone.

  • No the condition is confirmed if your symptoms improve or disappear with a high dosage T3 treatment.

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