I was diagnosed with Hashimoto's in January by a fantastic American GP, who picked it up in the very early stages. My TSH was 4.07, total T3 0.68, FT3 1.62, total T4 7.1 and FT4 0.97. I went on 25mg Thyroxine.
My TSH gradually came down to 1.40 in April, at which point I was still not feeling 100% so she upped my dose to 100mg.
Then I moved to another country (I'm an expat in the Middle East) and had to find a new endocrinologist.
I've been feeling absolutely AWFUL since we moved, but this new doctor won't increase my meds. He tested my morning cortisol levels to check for adrenal issues, but they were normal, so now he says I just need to carry on as I am. I am completely stuck.
My latest blood results at the end of August were:
TSH 1.63 (ref range 0.27 - 4.2)
FT3: 3.40 (ref range 3.1-6.8, so this is bottom end of range)
FT4: 21.90 (ref range 12-22, so this is top end of range).
He is refusing to do anything other than keep me on 100mg based on my bloods, whereas I am SURE I am feeling hypothyroid still. I feel worse than I did in April - weight is going up rapidly, hair is falling out, I'm having to use hand cream all the time again because my skin is so dry, and I literally cannot function in the afternoon - I always fall asleep.
I have made an appointment with a different endocrinologist in another city in October, as I think my T3/T4 results point to a possible issue with T4 conversion, and I know this guy can prescribe T3 meds (they're very hard to get hold of over here).
But in the meantime, I have just increased my own meds from 100mg to 125mg as you can buy it over the counter here - from my blood results above, please can anyone advise if this is a stupid idea? I am really worried about doing it, but I am desperate to feel better again.
Well, not a stupid thing to do, but I doubt it's going to help. You do indeed have a conversion problems. So, the only thing to do, really, is add T3.
You would have to have your FT4 very much over-range to get your FT3 up to a level where you felt well. And, whilst that wouldn't exactly make you over-medicated, it would bring problems of its own. Having a lot of unconverted T4 sloshing around in the blood is not recommended.
So, the sooner you get to see that T3 doctor, the better. However, in the meantime, you could get your vit D, vit B12, folate and ferritin tested, and supplement any sub-optimal results. That might help your conversion a bit.
But, I'm curious, how do you know that you picked up your Hashi's at an early stage? It has nothing to do with the TSH, nor the antibodies, because they bother fluctuate. Did you have an ultrasound that showed minimal damage?
greygoose good point on the ultrasound... i ignored my health for probably couple of years that i know of!! my thyroid apparently has shrunk to a tiny size with nodules on it...
greygoose no i didnt.. with respect read my post again.. it was Hidden that said that .. i was merely agreein that an ultrasoundscan can show whether early or late stage.. mine is late because i had ignored my symptoms and my thyroid shrunk x
Oh, lord! It gets so complicated when people jump in. I thought you were the OP. One doesn't always go back to the beginning to check, takes so much time.
OK, my bad. I see amy777 has reposted, without clicking on any of the green reply buttons, so no-one will know she's replied! lol
Thanks both of you, I'm glad you confirmed what I was thinking about T3.
In answer to grey goose, the reason I know I caught it in early stages is because (a) the same doc had checked my thyroid levels just 2 months earlier and they were 'normal' - it went downhill VERY rapidly over Christmas, which I think was possibly due to me eating carbs again (I normally avoid them and I am beginning to suspect a gluten intolerance, as I feel awful when I eat them) and also I think because I went on Sertraline for a short time and I think that is what really messed up my thyroid.
Also my new doctor took some convincing at first that I had ever been correctly diagnosed in the first place - he said my bloods looked fine even as far back as January, and when he tested for antibodies, they came back negative. It was only when he performed an ultrasound and saw damage that he finally believed my diagnosis!
Like I said, he's a pretty old school doctor and I need to ditch him ASAP and hopefully this new one will be better (and I hope the rumours that he can prescribe T3 are true).
If he can't prescribe it, does anyone know of any UK doctors who will? I am going back to the UK for Christmas and I am willing to pay to see someone privately.
Very, very unlikely that you'd find an NHS doctor to prescribe T3 and most private ones also work within the NHS as well. The suggestion generally comes from an endo, they may add a very small amount to Levo (eg 150 Levo/5 or 10 T3). But the cost has to be borne by the GP's surgery. Due to the extortionate cost of T3 (something like £250 for a box of 28 I think) then GPs are unwilling to bear the cost. Local CCGs are clamping down, are not allowing new prescriptions, and even taking T3 off people already prescribed it.
You could email louise.roberts@thyroiduk.org.uk and ask for the list of thyroid friendly doctors/endos and ask for feedback from members of they know anything about them, you might just drop lucky but even with a private prescription the cost will be extortionate.
Many of us who take T3 self source it and self medicate.
Amy, Hashi's does not come on over-night. If your thyroid is shrunken, then you have had it for a long time. The fact that your bloods were normal a few months before, proves nothing, because with Hashi's, they all fluctuate - TSH, antibodies, etc. Which is why one negative test proves nothing.
Sorry, amy, totaly confusion, ignore what I just said.
But, if you want someone to know you've replied to them, you have to click on the green 'Reply' button underneath their post, and then they will get notification. You cannot just say 'thank you, both of you', because neither of us will know you've replied! lol
But, as I said, the fact that your bloods were normal a few months before, proves nothing, because with Hashi's, they all fluctuate - TSH, antibodies, etc. Hashi's takes years to get to the point where it's noticeable. It happened long before you ate carbs over Christmas, and long before you took Sertraline. It's very difficult to catch Hashi's in the early stages, unless routing tests are done regularly - which they aren't.
I've been struggling with Vitamin D for a year now - I think that's what caused all my issues in the first place. It's 44 at the moment and I am taking 50,000 iu every week to try and bring it back up - while I was in the middle of moving here I kept forgetting to take it, which hasn't helped, so I am making more of a concerted effort now. I am also taking Ferroglobin liquid iron with B12, zinc etc. My ferritin levels are Ok, by the way.
Are you also taking K2-MK7 along with your D3? Vit D aids absorption of calcium from food and K2 directs the calcium to bones and teeth rather than arteries and soft tissues. Magnesium is another co-factor when taking D3.
Did you have your B12 level checked before starting the Ferroglobin? If your ferritin level is optimal (half way through range) but your B12 was sub-optimal then you'd be better supplementing with methylcobalamin and a B Complex.
I've never had my B12 levels checked - I will request it. (It's easy here, you can basically walk into any clinic and pay and they will run whatever tests you want!). If it was to be low, would that explain the low conversion to T3.
I've just started taking Caltrate Minerals, which is 400iu of vitamin D3 (in addition to my weekly 50,000 iu) which also contains calcium and magnesium, but I don't know how much. I have recently taken a lot more interest in magnesium deficiency, as it was causing my son's constipation, so have started to become more aware of the need to supplement it.
Hidden I've just looked at Caltrate Minerals but can only see 600-D3 and it says 800iu D3 plus 600mg calcium carbonate and 50mg magnesium oxide.
I assume yours is something similar to this but to be honest it's a waste of your money. Both the calcium and magnesium contained in the supplement are the cheapest and least bioavailable form and are the ones to avoid. See
Also, you shouldn't supplement with calcium unless you've been tested and show a deficiency.
You would be better just getting a decent form of magnesium to go with your D3 (as well as K2-MK7).
K2 is a co-factor when taking D3. Vit D aids absorption of calcium from food and K2 directs the calcium to bones and teeth rather than arteries and soft tissues. (This is why supplementing calcium is not a good idea unless you know you're deficient.)
There are two forms - K2-MK4 and K2-MK7. MK4 can be a natural form which comes from animals (grass fed dairy is a source of MK4). It's difficult to get enough K2 from the MK4 natural sort, you'd need to eat an awful lot of it. So the MK4 in supplements is synthetic and is made from the extract of tobacco plant and the therapeutic value of it only lasts a few hours in the blood.
MK7 comes from bacterial fermentation such as Natto. This form stays in the blood much longer than the MK4 sort so a better choice for supplementation.
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Managing my own medication
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