Help with latest results please

[E_lizab8]

I have Hashi and also celiac I was taking 100 Thyroxine up to 6 months ago when I reduced to 75 because of frequent hot flashes and occasional palpitations, and felt better. These are my latest results, endo seems content with them but still get some hot flashes and starting to feel tired again, almost dropping off to sleep at work in the afternoons, would like opinions please.

TSH 3.76 (0,3-4,2) (last time 0.13 when on 100 Thyroxine but felt worse than now)

FT4 1.35 (0,9-1,7)

FT3 2,44 (2,1-4,4)

Cortisol 18,32 (5 -23)

Adrenalin in Plasma 33 ( <84 )

Noradrenalin in Plasma 380 (< 420 )

Dopamin in Plasma <30 (< 85)

Corticoistimulant ACTH 17 (< 46 )

Paratohormona PTH 38 (10 - 65 )

B12 437 (206 - 678 )

D25OH 36,3 (30 - 100 )

[Clutter]

E_lizab8,

You are under medicated to have TSH >3.0 while taking Levothyroxine. Ask your endo to resume 100mcg or try 75/100mcg alternate days. The goal of Levothyroxine is to restore the patient to euthyroid status. For most patients that will be when TSH is 1.0 or lower with FT4 in the upper range. FT4 needs to be in the upper range in order that sufficient T3 is converted. Read Treatment Options in thyroiduk.org.uk/tuk/about_... Email [e-mail] if you would like a copy of the Pulse article to show your GP.

B12 looks fine.

VitD 40-50ng/ml is optimal so you need to get a lot of sun on your face and arms or supplement D3. 5,000iu alternate days for a couple of months should be good. You should also supplement Oct-April.

[E_lizab8 in reply to Clutter]

Thank you for your prompt reply, trouble with getting D3 from sun is that I work a 8 hour day 6 day wk inside from Feb thru to Nov so not much time for getting out in the sun. My endo gave me prescription for a 15960iu dose , once every three weeks, and says this is plenty, they are still following old guidelines here,(spain), it seems, I was taking this amount when these tests were done, I thought this wasn't enough so have started to take this amount once a week, maybe I should up it even more?

I also thought that my B12 could be a bit higher but maybe this is panicking because my son has been seriously ill with B12 deficiency.

As for the Levothyroxine, Endo recommended 100mcg 6 days and 75mcg 1 day but I still had heat problems, so I reduced it further, I have had two bouts of minor thyroid storm in the past which were quite frightening, I will try out alternate days and see how I get on.

I can see I could do with converting more T3, (I only converted 2.80 when I was taking 100mcg daily) maybe it would work for me to try a very small dose of T3, its not posible to try natural hormone in spain as it was removed from the permitted medicines list during the 1990's.

I'm lucky in that I have a simpathetic Endo and she is quite happy for me to suggest things, within reason of course, but she was adamant about not giving me more D3 on prescription.

[E_lizab8 in reply to E_lizab8]

Forgot to say that I was taking a combined B1,B6,B12 (500mg of B12) tab every day at the time of these tests.

[Clutter in reply to E_lizab8]

E_lizab8,

You can buy 5,000iu D3 softgel capsules on Amazon without prescription. The dose your endo is prescribing is fine as a 3 weekly maintenance dose once your vitD level is optimal. In the meantime I would increase dose to 5,000iu daily.

[E_lizab8]

Thank you