Please Help me :( - updated 19th Sept

[Jefner]

Just had my latest thyroid bloods through Looks like I need to go up to 100 T4, my T4 results looked much better in July and my T3 was steadily increasing until I upped to 15mcg t3 and pooled. T3 obviously isn't working for me. Now what? Still waiting for my Genova T3/T4 24hr urine collection test results to compare

***12 Sept**** - after being on 10mcg t3 for just over 3 weeks and still 75 Levo

TSH 13.69 (0.97 0.27 - 4.20 IU/L

Free T4 14.43 (12 - 22 pmol/L

Free T3 3.18 (3.1 - 6.8 pmol/L

****24th August**** - after 75mcg Levo, 2-3 days off 15mcg t3 and restarted on 5mcg on the 20th August then increased T3 to 10mcg 26th August

CRP 0.1 <5.0

Ferritin 97.1 (20-150)

FT4 12.45 (12-22)

FT3 2.43 (3.1 - 6.8)

TSH 13.46 (0.27 - 4.20)

T4 Total 85 (64.5 - 142.0)

Anti Thyroidperoxidase abs 365.60 <34

Anti Thyroidglobulin abs 245.40 <115

B12 961 Deficient <140

Serum Folate 11.65 (10.4-42.4)

***15th August**** - after being on 15mcg t3 and 75 Levo for just over 2 weeks

TSH 0.97 0.27 - 4.20 IU/L

Free T4 13.77 12 - 22 pmol/L

Free T3 H 9.34 3.1 - 6.8 pmol/L

2nd August - upped t3 from 10mcg to 15mcg and dropped Levo from 100mcg to 75

****26th July **** - after adding 10mcg t3 on 30th June with 100 Levo

CRP 0.2 <5.0

Ferritin 100.4 (20-150)

FT4 19.38 (12-22)

FT3 4.74 (3.1 - 6.8)

TSH 0.51 (0.27 - 4.20)

T4 Total 115.3 (64.5 - 142.0)

Anti Thyroidperoxidase abs 393.5 <34

Anti Thyroidglobulin abs 261.7 <115

B12 873 Deficient <140

Insufficent 140-250

Serum Folate 15.68 (10.4-42.4)

[greygoose]

Why do you think you need to increase your T4? Why don't you think T3 is working for you? Why do you get tested so often before things have had a chance to settle? Why do you keep chopping and changing doses when everyone explains that you need to stick to one dose for at least six weeks? I really don't understand your logic. Nothing is going to work if you don't take enough of it, and if you don't give it time to work. Why don't you wait until your get the urine test results back before jumping to hasty conclusion?

[Jefner in reply to greygoose]

greygoose

Looking at my July results they were quite reasonable. I need to increase my T4 surely because my TSH is high? It looked much better when I was on 100! Haven't chopped and changed hon, I worked my way back up to 10mcg t3 with the 75 Levo; been on the 10mcg t3 now for around 3 weeks. Have been on 75 since beginning of August.

I don't feel any better with the addition of t3 and have been on it now since the end of June

Won't be changing dosage until my urine results are back which should be soon I hope

[greygoose in reply to Jefner]

Your TSH is high because your FT3 is so low. It's right at the bottom of the range.

There is not point in increasing your T4 because you cannot convert it to T3, it just hangs around in the blood and converts to rT3. The rT3 blocks the receptors so that the T3 cannot get in. You know this. So, why would you contemplate increasing the T4 which will just increase your rT3?

Whether or not the T3 is getting into the cells or not at the moment, is a non-question. It doesn't even seem to be getting into the blood.

Your T3 probably pooled before because of the high rT3, but you over-reacted to the high level in the blood and came off it for several days, and then reduced your dose to 5 mcg. That set you back considerably. But, the answer is not to increase your T4. In your place, I would cut out the T4 completely until the rT3 has cleared, and just take T3. We discussed that before. I don't know why you think you absolutely have to have T4.

[Jefner in reply to greygoose]

greygoose

I didn't cut the t3 for several days hon when I pooled, just 2. If you look back at my July results they were pretty reasonable when I was on 100 Levo and 10 t3.

I can't cut out the t4 hon surely. I will just go even more hypo?

another reason it's not getting into the cells is because of my high cortisol levels, have been reading up on it

[greygoose in reply to Jefner]

Well, even two days was too much.

OK, so your July results were good and you were on 100 levo. That does not mean you should be on 100 levo now. You have Hashi's, things change.

Why would you go even more hypo by cutting out the T4 if you cannot convert it to T3? It is low T3 that makes you hypo, not low T4. If you increase the T3 at the same time as you reduce the levo, you will not go more hypo.

Look at the evidence in your blood tests : you are on T3, and your FT3 is low, but your FT4 is still up there at 14.43. You are not converting it, even though your FT3 is low. You don't need all that unconverted T4.

Yes, I realise your high cortisol is having a negative effect, but the answer is not to increase your T4.

[Jefner in reply to greygoose]

Greygoose

I see what you are saying. If i was converting t4 properly whilst taking t3, the results would have shown a high t3. Instead, even on t3 my levels are low which proves i am not converting and just highering my rt3?

[Jefner in reply to greygoose]

Greygoose

Phoned Genova and my results were released yesterday to TPAUK. Hopefully I should get them later

[shaws]

Why have you had so many blood tests. It takes about six weeks for your system to slowly absorb increases in thyroid hormones, particularly levothyroxine? That's why we have a blood test every six to eight weeks before reaching an optimum dose. who diagnosed 'pooling' of T3.

[Jefner in reply to shaws]

shaws

I wanted to do another test for comparable purposes as I am awaiting 24hr urine collection t4/t3 test results. I pooled when I went over range on my t3 at 15mcg as confirmed by my bloods. Clutter said to give the t3 a miss for a couple of days to wash out the excess and start back on it which I did and have been back up to 10mcg for just over 3 weeks.

Just so desperate to see a tiny bit of improvement somewhere because of feeling so ill for a year now. As I said to Goosey, my results looked quite promising in July on 100 Levo and 10 T3 but as soon as I cut to 75 Levo and went up to 15 t3 I pooled as shown on my results (all are in my profile). I am feeling no improvement anyway on the t3

[shaws in reply to Jefner]

I think it took me about 4 or 5 years, before I began to feel improvement and I had more symptoms on levo than before my diagnosis. As soon as T3 was added there was an immense difference for me (of course maybe not everyone)

This is an extract from a scientist/researcher and doctor - just for information:-

This past year, several Internet doctors, who give advice on thyroid hormone therapy, sired a false belief about the effects of plain T3 on the body—that it causes "physiological instability." These doctors must have a large audience. I say this because I’ve heard (through e-mails, letters, and phone calls) echoes of their false belief in almost every conceivable variation of words. Your doctor’s belief about plain T3 being "a very bumpy road" is an especially creative and graphic variation of the false belief.

Let me explain the error in the Internet doctors’ thinking. Within a couple of hours after a patient ingests a single daily dose of plain T3, the blood level of T3 peaks. The Internet doctors infer that because the blood level of T3 peaks, the metabolic reactions of body tissues also peak, resulting physiological instability. Their inference is wrong.

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

[Jefner in reply to shaws]

Shaws

Apart from wait for my urine tests i have no idea what to do. I am pretty sure my adrenals are hindering the t3 getting into my cells and despite asking on here no-one who is in the same situation has come back to me

[shaws in reply to Jefner]

I'm sorry you've not yet had a response from others. I am going to have a search to see if I can come up with something as your head must be spinning at present.

[Jefner in reply to shaws]

Shaws

It is hun, just took my levo for 10yrs and got on with it. Now i am on completely new territory. Damn brain fog doesnt help

[Jefner in reply to shaws]

Thank you xx

[shaws]

Did you leave a gap of approx 24 hours between your doses of thyroid hormones and your fasting blood tests?

[Jefner in reply to shaws]

Shaws

24hrs from levo and 15hrs from t3

[shaws]

All I can find at present is the following and it is the first answer on the first question. It is similar to the way doctors used to treat us before blood tests were introduced who took notice of clinical symptoms alone and then trials of NDT until symptoms were resolved.

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

[Jefner in reply to shaws]

Shaws

Thank you. Its tweaking meds with adrenal problems i was looking for help with from other members that i received little info on. I cant be the only one in this situation

[shaws in reply to Jefner]

No I have read members saying they were taking adrenal supplements etc. Maybe not so many on the forum at the present.

These are past posts and you might be able to suss something out.

healthunlocked.com/search/a...

[jacrjacr]

for me personally, testing b4 6 weeks will not show what my body is doing with change in dosage even when i was over medicated.......

[Jefner in reply to jacrjacr]

it can give pretty accurate results on what t3 is doing though and as I said I needed to get it done for comparable purposes with another test I had done

[Jefner]

received my urine test results today and they and my latest blood test pretty much correlate.

Urine Volume 2,350ml (600-2,500)

Triiodothyronine (T3) 1,090 pmol/24 (610-3380) normal range but low

Thyroxine (T4) 3,990 pmol/24 (1,030-8,240) normal and mid range

T3 : T4 Ratio 0.27L (0.50-2.00)

TSH H 13.69 0.27 - 4.20 IU/L

Free T4 14.43 12 - 22 pmol/L

Free T3 3.18 3.1 - 6.8 pmol/L

One of the mods on TPAUK where I had the test done says "Your last blood test t4 measurement was just under halfway up the scale. Your t4 measurement on the urine test is halfway up the scale. Your t3 measurement in the blood test was very low, so one would expect to see it just on the edge of the green in the urine test. As you are taking a bit of t3 it is slightly more into the green. So blood test and urine test correlate, which is good. I have done these tests and had a t4 of 17 in the blood test and in the urine test it has been right down in the red, which means that I was resisting t4, it wasn't going into my cells at all and it was pooling in my blood. It is going into your cells, which is good, you just don't convert it very well. However, you do need to take some more t4, but as you don't convert into it into t3 very well you need to take some more of that too. You are on 75mcg t4 aren't you? So if you up to 100mcg, you need to up the t3 to 15mcg and maybe to 20mcg.

You could stick to 75mcg levo and up the t3 but you said you went over range on the t3 when you went up to 15mcg t3, so you need to balance it out by increasing the levo too and see what happens. There is no quick and easy way out.

With this urine test and by comparing it to the blood test, you have established what is happening in your body and what you need to do next. There is no need to go on to t3 only. You don't convert very well and you need to fiddle around with the doses"

I can't see upping my T4 will help my high rt3 and when I was on 15mcg t3 I went over range (see profile for all results).

Please help me my good friends