10 weeks on Erfa - endo appt tomorrow - has it worked?! Results below.

[Annie8ell]

After being on levothyroxine since 2008, I've switched to NDT and following phased introduction since Feb, now on 60mg twice a day. Got endo appointment tomorrow armed with following blood test results. How do they look? I've put my pre-switch results below too. In general, I feel better! I've also been monitoring my B12, ferritin, Vit D and folate and they're now all above range (so probably need to cut back on supplements?). When tested in Feb before beginning Erfa, I was massively Vit D deficient (19.39, range was 50-200) and I'm now at 84.63; B12 was also a bit low (385), it's now 1083. I also took ferrous sulphate for ages as stores were low, but now they're above range. I do feel better - do the results suggest dose needs tweaking?

May 2017

TSH - 0.189 (0.27-4.2)

Free Thyroxine - 11.11 (12.00-22.0)

Total Thyroxine (T4) - 61.5 (59-154)

Free T3 - 4.55 (3.10 to 6.8)

Thyroglobulin antibody - 196.4 (0.0 - 115)

Throid Peroxidase - 27.4 (00-34.0)

Feb 2017

TSH - 0.576 (0.27-4.2)

Free Thyroxine - 18.58 (12.00-22.0)

Total Thyroxine (T4) - 90.9 (59-154)

Free T3 - 4.02 (3.10 to 6.8)

Thyroglobulin antibody - 216.4 (0.0 - 115)

Throid Peroxidase - 23.2 (00-34.0)

So I'm cautiously optimistic , just hoping someone can advise on whether I should carry on embracing erfa and the faff involved in private prescriptions/monitoring or go back. Thank you!

[Hidden]

The most important thing is how you feel!

I won't comment on your total Thyroxine as I have no idea what it should look like (no doctor has ever tested mine).

The TSH does not matter once you are on thyroid hormone replacement. Especially T3 will tend to suppress it, so if you raise Erfa further, your TSH is bound to end up suppressed (below 0). If that happens, no need to panic.

Your FT4 levels are just below range, but FT4 has a tendency to drop when on NDT because of the T4:T3 proportions in the latter (pigs produce slightly more T3 and less T4 than humans).

So, when on NDT, you need to go by your free T3 levels as T3 is the truly active hormone.

If you feel OK, you can keep taking your current dose. If you feel there is room for improvement, your FT3 levels are still well in range, so you can raise your current dose without problem.

120 mg daily is not that high a dose; many NDT users take 180 mg daily or more. It's all about how it affects you and how you feel.

So: how do you feel? Still some lingering hypo symptoms?

[silverfox7]

Your vitamins D is going in the right direction. It I've heard that 100-120 the range to aim for. I would want my FT3 reading to be higher so I would suggest to endo that a slight increase would help particularly if still have any symptoms. At this stage I would only increase by a quarter grain at a time.

[humanbean]

If your ferritin is above the range you should stop supplementing it immediately. It isn't a good idea to go overboard with iron because the body has no obvious mechanism for getting rid of the excess.

The optimal that is usually suggested for ferritin is mid-range or perhaps just a little bit higher.

[Katepots]

If you feel better stick with it. Took me a few months but I'm sooo much better on NDT.

I'd say other stuff going on that you need to address re inflammation. Are you gluten, dairy free? Looking at your antibodies it suggests that your Hashimotos is quite active.

Vit D looks ok, B12 you tend to pee out what you don't need. Ferritin id stop supplementing for a bit and keep monitoring.

You could increase Erfa.

[SilverAvocado]

Blood tests don't necessarily show a difference between NDT and synthetic hormones. It's only in symptoms that you can judge the difference.

It looks like your NDT dose is now very similar to your previous dose, as the blood tests have become quite similar. As others have said, you've got plenty of room for a raise if you want one.

The most important number to look at for dosing is freeT3. The rule of thumb is you want that in the top third of the range. At the moment yours is in the bottom third.

There's a chance your Endo will not be so good, and will give you poor advice, so its good to go in there knowing that raising is an option. Endos love to reduce doses rather than raise them

[Annie8ell]

Thanks all - you've been invaluable guides! Will report back - but feel happy to be armed with info. Yes, I stopped taking ferritin back in Feb as levels were high - GP had me on them for 18 months. I do feel better, but room for improvement - esp in regard to hair thinning (which was the reason that took me on the Endo route in the first place). Did anyone's hair thicken at the front on Erfa and how long did it take?!

[Heloise]

Hi Anna, Your Antibodies for Thyroglobulin are still high. This man explains and feels mercury has something to do with it.

youtube.com/watch?v=Z5SaM0R...(Not working as expected?)