My latest results - do I need T3?

[GraceB]

I apologize in advance for lengthy post but don’t want to miss anything important. I have Hashimoto and been on levothyroxine for last 4 years. Recently I increased my levothyroxine dose from 125mcg to 150mcg. Although increasing it was a nightmare, I have made it and am on 150mcg for last 3 months. At the same time, as advised by this forum, I also started taking supplements to address my vitD3, ferritin and vitBs deficiency and improve T4 to T3 conversion. My previous results can be seen here: healthunlocked.com/thyroidu...

Here are my latest thyroid results from December plus some more that my endo prescribed:

TSH 0.12 (0.35-5)

FT4 17 (9-19)

FT3 4.3 (2.6-5.7)

Vit D3 25OH 146.4

Serum B12 1794 (187-883)

Serum Folate 14,6 (3.1-20.5)

Iron 21 (12-26)

Haemoglobin 151 (115-165)

Haematocrit 0.467 (0.37-0.47)

Transferrin 2.8 (1.7-3.8)

TIBC 62 (45-70)

Calcium 2.42 (2.2-2.6)

Parathyroid hormone 4.0pmol/L

CRP <1 (<5)

Magnesium 0.8 (0.7-1.0)

Sodium 141 (132-144)

Potassium 4.1 (3.5-5.3)

IgG 9.8 (6-16)

IgA 1.15 (0.8-2.8)

IgM 1.31 (0.5-1.9)

Serum FSH 9IU/L

Serum LH 9IU/L

Serum oestradiol 209pmol/L

Serum prolactin 148mU/L

I must say I feel better than before, although sometimes suddenly I feel hot and a little shaky inside – is it a sign of overmedication? I’m definitely less tired and have more energy – though I’m still not what I used to be before Hashimoto.

I still have some hypo symptoms like difficulty to concentrate and focus, poor memory, cold hands and feet, very dry skin. The biggest problem however is weight gain in last 6 months despite eating healthy and homemade food in reasonable amounts. My arms became floppy, my stomach is bloating and I’m shocked with the speed I’m accumulating fat in my belly and thighs. I avoid anything what has sugar and gluten and I’m taking 40 billion active cultures daily but I’m not improving.

It looks like my TSH is suppressed and my FT4 is where it should be. Taking supplements have improved FT4 to FT3 conversion but studying this forum - precious source of knowledge and experience I’m grateful for- I guess it should be higher. Could anybody please advise how should I progress from here with my treatment? Do I need T3?

[Serendipity_28]

Hi, I also have hypothyroidism and have had a massive fight with my weight. I put abouthe 4 stone on in a matter ofor a few weeks. I have lost about 2 of it through hard work at the gym (which is agonising but worth) and very healthy diet, so no sugar, no gluten and no dairy products. This has helped so could help you? It is a very slow battle but I am starting to see progress 😀

[GraceB in reply to Serendipity_28]

I'm glad Serendipity your effort is bringing results. I described my weight gain problem in a separate post with more details that is available here: healthunlocked.com/thyroidu...

I know that's not easy for hypo people to lose weight and it will involve lots of determination which I have. My fight now is to stop gaining and I don't know how to achieve that.

I wish you best of luck with achieving your goals.

[GraceB in reply to Serendipity_28]

Serendipity_28 could you share more details on your diet and exercise? I mean whether you count calories, what sort of food do you eat, can you tell me your daily menu as an example and how much do you exercise daily, what sort of exercise is it?

[Serendipity_28 in reply to GraceB]

Hi, to be honest, I simply cut out all fast food and processed foods. Cut out gluten (both as it gave. Me gi problems and helps with weight). This alone for me kept my weight steady which was amazing. 3 small meals a day, normally a gluten free cereal for breakfast, then I might have something like a chicken wrap (again gluten free), the chicken just being lightly seasoned, not extra sauce etc, just veg. For dinner, I tend to have either a rice or pasta based dish with meat, with either chopped tomatos or something light, low calorie. I don't tend to strictly count my calories but I watch them, normally around 1500ish.

With this diet I can get away with a cheat meal but it does stop my weight loss, but no weight gain.

In terms of exercise, I will normally do around 15/20 minutes of cardio then will send around 40 minutes using the weights, alternate arms and legs.

I won't lie, it is hard to keep the weight loss, but it defo keeps the weight gain at bay. I have also found some simple yoga (I am not flexible at all, so I mean simple haha) a couple times a week helps with muscle aches and cramps.

Sorry for the length but I hope this helps you. Feel free to message for more info. 😊

[GraceB in reply to Serendipity_28]

Thanks Serendipity_28. I started writing down anything I eat every day to be sure I don't overeat. I must say it looks reasonably. For breakfast I usually have 6 tea spoons of sunflower/pumpkin seeds and baked apple with cinnamon or 1-2 boiled eggs. Lunch is always green salad with tomato, cucumber, onion, avocado +2 table spoons of oil olive/balsamic vinegar dressing and portion of chicken breast or turkey. Dinner is usually home-made soup or sometimes salad + chicken or fish. However, I have also 3-4 portions of fruits between meals: most often apples because I love them, kiwi, mango, banana.

I have been doing yoga now for couple of years and I love it. I used to do it 3 times a week but now I do only 2 because I have a lot of muscular pain after each session. Started doing Marie Windsor pilates at home this week that focus on belly and thighs - this is where all my fat goes. Will give myself more time and consideration. My endo was quite surprised I gained 3kg since last visit. Sent me for adrenal tests to check for Addison disease, although this is rather associated with weight loss. Thanks again for sharing your experience and good luck with your efforts.

[Serendipity_28 in reply to GraceB]

Sorry for the late reply, been really ill. I hope this works for you, the pilates should help you see a difference. One thing I forgot to mention is when I first started my diet I used a calorie counter on my phone, not so much for the calories but so I could monitor my food in take easier and see how much farsighted, sugar etc I was eating. Thus may help you too. Good luck, I hope you see progress 😀

[SeasideSusie Remembering]

Good conversion takes place when FT4: FT3 ratio is 4:1 or less (according to member Diogenes who is an advisor to Thyroid UK). Member Eljii frequently quotes 3:1 but I don't have a reference for that.

Your ratio is 3.95 : 1 so doesn't really scream that you need T3.

However, your results show that FT4 is 80% through range (upper third is considered best for most people so yours is good) and FT3 is 54% through range and upper quarter is considered best for most people so you fall short there.

If those were my results I would be looking to increase the FT3 a bit so would try adding a small amount of T3. This is not advice as I am not medically qualified, just what I would do in your circumstances.

[GraceB in reply to SeasideSusie]

Thank you SeasideSusie for analyzing my T4:T3 ratio, it looks like after 4 years I'm nearly where I should be. How much of T3 would you advise? Should it be taken along with 150mcg levo?

[SeasideSusie Remembering in reply to GraceB]

If it was me, and I presume you're talking about self-sourced T3 which are 25mcg tablets, I would take a quarter of a tablet, so 6.25mcg. When adding T3 you need to go low and slow. So I would leave it at 6.25mcg for 6-8 weeks and re-test, see where your levels lie and how you feel. It may be that's all you need.

At the moment I wouldn't reduce Levo, or if you do then only by 12.5mcg. The reason I say this is because when I added T3 my FT4 was very much over range and I needed to reduce that as well as increase my FT3. So I reduced Levo by 25mcg for every 6.25mcg T3. Your FT4 is in range but not too far from the top. You need to keep an eye on it but the addition of T3 could reduce it anyway. It may also reduce your TSH so your endo might (probably will) freak out.

As you are under the care of an endo, are you going to ask for T3 or is this a DIY thing? If DIY, how are you going to explain the change in your results? Just curious as I have dodged my GP and any discussion or testing of my thyroid since adding self-sourced T3.