new blood test results, would appreciate comments- this is a follow up on a previous post

[HyHashi]

Hello everyone, and thank you for your time! this is my main source of info and help with hashi!!!

After getting back new test results I would appreciate some feedback. I have been diagnosed with Hashimoto's 14 months ago, after much trouble with trying to find the right doses of meds (and a string of unkind or unprofessional GPs) am now self medicating with 75mcg T4 and 20mcg T3. These are my main issues:

- Immune system very low- I have been ill almost constantly this year (which is totally unlike me) with 4 bouts of flu, colds, pneumonia and bronchitis.

- energy levels aren't too bad compared to a year ago but i still feel too weak most days to do any exercise.

- terrible brain fog, no memory or concentration!!! This is seriously damaging my work as I am an artist and rely on having ideas to make a living!

- very swollen breasts (this is a MAJOR annoyance, I have gone up 3 sizes and find it unacceptable)

Have been taking selenium, vit C and D supplements, and started last month on a good multivitamins that includes iron, vit K2, b12 (wellwoman 3-6-9). Gluten free for 10 months.

TSH 0.01 (0.3-5.0)

T4 13.6 (9.0-19.0)

T3 4.9 (3.25-6.21)

Ferritin: 53 (9-120)

serum b12 700 (200-1000)

serum folate 12.1 (4-18)

The GP has no advice for me. I am wondering if I should persevere or switch to some NDT and see how that works out? I am also trying to conceive...

many many thanks for your feedback, any pointers would be SUPER appreciated.

[Clutter]

HyHashi,

I think you could increase either Levothyroxine or T3 dose to raise FT3 which may improve symptoms. If you're planning to conceive you will be pressured to switch back to Levothyroxine for the duration of the pregnancy so it may be worth sticking with it for now.

It may be worth supplementing iron to raise ferritin >70. Take each iron tablet with 500-1,000mg vitamin C to aid absorption and minimise constipation. Take iron 4 hours away from Levothyroxine and T3.

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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.

[HyHashi in reply to Clutter]

Thanks Clutter, what would be a good level of of FT3 to aim for? I have noticed a direct relationship between my swelling up and how much T4 I am taking so would be more inclined to raise how much t3 i am taking.

[Clutter in reply to HyHashi]

HyHashi,

10mcg T3 may be sufficient. Do retest 6-8 weeks after raising dose to make sure FT3 remains within range.

[bluebug]

I presume you have had your vitamin D level tested and it is at or round 100nmol/L?

You need to get it tested to ensure you take supplements at a high enough level to raise it and to keep it in that range. Doctors generally advise too low a level of supplementation.

[HyHashi in reply to bluebug]

Hi Bluebug, yes i did- came back at 91 (80-150) but as my GP isn't saying anything I don't know if that's good or bad?

[bluebug in reply to HyHashi]

91 is good. You want it to be slightly higher.

How much vitamin D are you taking in terms of IU (international units) per day?

As some people need to take a higher dose over the autumn/winter months than in summer.

[greygoose]

You're wasting your money with the wellwoman 3-6-9, you won't get anything much out of it. You certainly won't get iron, because there's also magnesium oxide in it (which you can't absorb) which will bind with the iron and make it unusable. And they B12 is cyanocobalamin, which you can't absorb, either. Don't know what you're paying for it, but it's money down the drain.

[HyHashi in reply to greygoose]

That's good to know! waste of money indeed is there a multi vitamin you'd recommend? Would be so much more practical than taking 5 different pills (and that's not even thinking of costs, which add up like crazy)

[bluebug in reply to HyHashi]

Multi-vitamins aren't recommend due to the multiple interactions. Plus different people need different doses of vitamins to increase or maintain their levels.

You can get a B complex vitamin. Just make sure it has more of the RDA in it and is NOT gender specific.

For iron to raise your levels you really need to take ferrous fumarate or similar with a separate vitamin C supplement. You need to take one ferrous fumarate two times per day with water and vitamin C, 4 hours away from thyroid meds and 2 hours away from other food, drink and supplements to avoid interaction. You have to get this from a pharmacist as it's sold behind the counter. You need to use a pharmacy you DO NOT get your prescriptions from and need to say something like "I have low iron and my doctor told me to get this as it's cheaper off prescription" Alternatively buy it off Amazon. After the course of 84 wait a week and get your ferritin level tested. You must do the test to confirm everything is OK.

[bluebug in reply to HyHashi]

In regards to the costs ferrous fumarate is about £3.75. Once you get your level up you can cut down the number of times you take it per week.

While Solgar and Jarrows are the recommended brands for buying online as they use methylcolbalamine and methlyfolate. Some people do fine with generic vitamin B tablets containing folic acid. It is totally up to you.

For vitamin D I do fine with a generic no-name brand brought from one of my local pharmacies. Others use online brands. Others stick to Solgar or Jarrows.

[HyHashi in reply to bluebug]

super helpful. I'm going back to my solgar vit D then- and will add the ferrous fumarate... but also need K and selenium! helpful to know which brands are good, but it is indeed a lot of pills to buy and take.

[bluebug in reply to HyHashi]

It's not really.

Once your levels are up the iron and vitamin D will be maintenance doses which you don't have to take everyday.

[puncturedbicycle]

Sorry to hear you're not well. My first thought re swollen breasts is that levo is often responsible for swelling. I was unbelievably bloated on levo alone, which went away w the addition of t3. Since you're already taking t3, I wonder if maybe levo isn't for you. Of course if you just need a slightly higher dose that could sort it out.

My next thought is that your t4 is higher than I'd expect for someone on both meds, and maybe you're not getting much out of levo because it isn't converting efficiently. It may just be making you more symptomatic.

I'd begin to tweak the ratios - maybe reduce levo and raise t3 - and eventually you could try t3 alone if you fancy it. Paul Robinson's book Recovering w T3 is v helpful if you want to try that. Then if you have no joy I'd try ndt. It's just easier (imo) to tweak what you're doing, then you know you've done what you can w that specific treatment and you can put it behind you.

And I agree w other replies re iron and vit d. You could also raise your b12 a bit. If you're supplementing I'd expect your results to be higher.

[HyHashi in reply to puncturedbicycle]

Thank you pucturedbicyle, that's really helpful. I have noticed a direct relationship between ballooning breasts and t4, so yes i'll try raising my dose of t3, would 5mcg be a good start? and what would be a good range t4 to aim for, are there any indication on how to calculate that? thank you!!!!!