I have just pick up my Blood results and I am a little surprised with the Free T4 results..
TSH 6.7 uU/ml (0.4-4.5)
Free T4 0.68 ng/dl (0.85-1.8)
Ferritin 50 ng/ml (15-150)
Folate 3.7 ng/ml (3.1-17.5)
B12 301 pg/ml (243-894)
I have Hashimotos, gluten free since 2 years ago, I have tried levo until 75mcg, then NTD and T3 only, I stopped the T3 only due to I have been having paranoid thoughts and really depressed.. my dose was 10 mcg in one go..
So in 2012 when I was diagnosed my Free T4 was 1.05 low but "high" now it means that my thyroid is really damaged, so I really need to be on medication yes or yes... I am thinking to start on T4 only 50 mcg but I am really scared to do it..
My hair is falling like hell and I am really depressed, I only want to sleep all day..
Any advise on what should I do? I can take any decision on my own at the moment I am like a zombie I can think, or drive, just eat and sleep..
Many thanks
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Cavalli13
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Why do you want to go back onto levo when you were on T3 only?
So many questions to be asked here...
How long did you stay on the 75 mcg levo before changing to NDT? Do you have any lab results from when you were on 75?
How long were you on NDT? What dose did you get up to? Why did you change to T3 only?
Yes, you obviously do need to be on something, now. But the question is, what? Impossible to tell how well you're converting without seeing FT4 and FT3 results when you were on T4 only. Even now, you don't have a T3 result.
Did you think the T3 was causing the paranoid thoughts and depression? Those are hypo symptoms, so the odds are that you weren't on a high enough dose. How much were you taking? How long were you on it? You really do not give us enough detail to be able to help.
Thank you very much for all your replies, I am working at the moment I have all my lab results at home, I will post it here too.
I am trying to get pregnant and my GP told me I can not stay with T3 only replacement due to the baby depends on my hormones the first three months, so he told me to stop all the hormones and re start with T4 only.
When I was taking Levo only I was fine the firs two months until I get to 50 mcg then I upped to 75 mcg and by TSH was really suppressed and T4 and T3 in the upper side... but feeling terrible... So I am thinking seriously to start something again,but not sure what to do.. I am really lost
It doesn't matter if your TSH is suppressed when you are on any form of thyroid hormone replacement.
OK, so you felt terrible even though your Frees were up near the top of the range. So, next question : did you feel any better on NDT or T3 only?
Doctors always say that about T4 and pregnancy. I really don't know how true it is.
Have you ever had your vit D, vit B12, folate and ferritin tested? If you have nutritional deficiencies, no form of thyroid hormone replacement is gong to work well for you. So, if you haven't already, best get them tested.
When I was on ntd I didnt feel any better so I move to t3 only I felt more energy my periods were regular but my mind was crazy!! My hair started to fall out and I had palpitations sometimes, but I didnt get diziness like when I was on t4 only.. Should I wait to improve my vitamins first or start a combo?? T3 plus t4??? Or try T4 only again??? Many thanks
It's so difficult to answer that question because you do not give enough information. And anybody that tries to answer it will just be making a wild guess. How much of thing were you on? And for how long?
I'm sure you know that where thyroid is concerned, it all takes a long time. You have to give things time to work and you have to take enough of them. And, keep chopping and changing things is counter-productive.
You didn't stay on T4 for very long, did you? You didn't give it long enough to work and you didn't take enough of it to know if it worked for you. And, I'll say it again, for anything to work, your nutrients have to be optimal - especially for NDT. They ground work has to be done, and the terrain prepared. And if you want to get pregnant, then it's even more important to make sure that your nutrients are optimal. So, before making any decisions, get them tested.
I havr been one year on T4 Tsh supresses and free t3 free t4 in the upper sides then i started to feel really ill with vertigo episodes and high blood pressure so I reduced to 50 but it was no difference, I sttopped the medication and I started with erfa 30 mg once day my antibodies increased and I felt nausea all day along with vertigo again I stayed on that for one year up and down in the dose the same my tsh suppresed and my frees ok but the diziness didnt stop. So finally I tried t3 only I was ok but not stable and I did not get any vertigo so I stayed on that six months until 10 mcg my tsh was 3 my free t4 was low, so probably was my fault not to increase a little bit due to I was afraid to do it.
In this test I have my ferritin my b12 and folate tested and I will start to supplement again I just want to give a try to t4 only because I think its easier for my future pregnancy but mentally I am not prepared to start with the vertigo again.. I will improve my vitamins and I will try again if not I can move to a combo again and see how it goes, many thanks for your reply
If you have Hashi's, NDT is often the wrong choice. And, if you have Hashi's, conversion is often compromised.
What do you mean by 'I was ok but not stable'?
Yes, you should have increased the T3. 10 mcg would not be enough on T3 only. But, when you are on T3 only, it doesn't matter about the FT4. It's obviously going to be low because you're not taking any. But it doesn't matter. The FT3 is the only important number, and the one to go by - plus symptoms, of course. Why were you afraid to increase?
So, it would seem, you have never actually tried T4/T3? Well, maybe worth a try, now. But, listen to your body, if you find that it doesn't suit you, then stop the T4. But, I think you ought to do some research into the necessity of taking T4 when pregnant.
What you could do is start out on T3 only, and then add in some T4. See how that works. But, once you're pregnant, you might find that the body accepts the T4 more easily. Things change when you're pregnant.
So, when did you have your nutrients tested? If it was more than six months ago, I think you should have them tested again before resuming the supplementation. Blind supplementing is not a good idea. And, once you've started taking B12 again, you won't get an accurate result.
Many many thanks for your reply greygoose, well I mean not stable because I started to have paranoid thoughts my mind was razy all day, depressed but I was able to do a "normal" life go working, home tasks....etc so I used to the feeling of being weird.. and my anger was awful, I was angry all day, so I thought it was because I was really undermedicate..
I was afraid to up my dose with the T3 beacuse I read a lot of bad things( I never will do that again and I was scared due to the palpitations..
My vitamins were tested one week ago, in this same blood test, so I really need to start with the B12 again, but I need a liquid b complex with methylfolate but I couldnt find it and keep taking the liquid iron to try to up my ferritin to 70 now is 50 so I am very close to the goal...
Many thanks, so I will start with the T3 again 5 mcg one week see how it goes, and then I will introduce 25 mcg of T4 and re test in 6 weeks.. maybe I will be lucky and I will find better now.. finger crossed... I will keep posting here many thanks again!
ahh and regardless my low T4, could it be due to I have been using T3 only for a loong time and my thyroid is not able to produce more T4 now? Because my free t4 was 1.05 before I started all this madness so I was in "normal" ranges but now is crazy is lower than the normal ranges.. I cant understand it..
It's nothing to do with your taking T3. Your thyroid just isn't working anymore. You had a sick thyroid, that's why you were put on thyroid hormone replacement. Now, it's sicker. That's what happens with Hashi's - although I perhaps shouldn't use the word 'sick'. The truth is, your thyroid is just being slowly destroyed. Eventually, there will be no thyroid producing tissue left.
With TSH 6.7 and FT4 below range you definitely need thyroid replacement. Hair loss, fatigue and low mood are symptoms of underactive thyroid. Symptoms are likely to become worse as your FT4 decreases if you don't take replacement. Most people will feel well when TSH is 1.0 or lower with FT4 in the upper quadrant of range but symptoms may lag behind good biochemistry by several months.
Your ferritin, folate and B12 levels are not great.
Ferritin needs to be around 80 - 100 ng/ml to be optimal.
Where do you live? In the US? The Free T4 reference range you quote looks like a US one and the units are not the ones commonly in use in Europe. So I don't know how much of what I write will be possible for you to follow.
To improve your ferritin (iron stores) level you need to take iron supplements. There are lots of different kinds available. The ones most commonly used on this forum are
1) Ferrous fumarate 210mg, 1 tablet, 2 or 3 times a day. Each tablet should be taken with a high dose of vitamin C (500mg - 1000mg) to try and avoid constipation.
2) Ferrous bisglycinate (also known as iron bisglycinate, also known as Gentle Iron). These usually come in a dose of 20mg or 25mg. With this dose, you would need to take 1 tablet/capsule 3 times a day. Take it with vitamin C as above.
Take one or the other of those given above - NOT both.
For information on vitamin B12 and folate please join the Pernicious Anaemia Society community here on HU and post your results there. They can give you the best info on B12 and folate deficiencies.
I think your dose of T3 was extremely low - only equivalent to about 30mcg levo so I think that may well be the reason you didn't feel well. Our brain contains the most receptor cells for T3 (the only active hormone) and we cannot function if it isn't optimal.
I take about 50mcg of T3 in one daily dose and am well but that's not to say everyone has the same response. Another doctor took his dose of 150mcg in the middle of the night and he could function and write books and articles and see patients etc.
Before the blood tests and levo were introduced we were given doses until symptoms were alleviated and that meant a dose of between 200 and 400mcg.
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