going to start cytomel with t4 need advice

[hypomomoffour]

I live at a place where endos would NEVER be convinced to prescribe t3 meds (teied hard)

I am attaching my latest results... in addition to that my vit d3(31) and vit b12(194) is also low

i am on 100mcg thyroxine.. this morning i took 25ug t3 too

i am experiencing a lil bit speedy heartbeat...not too out of control

question is shall i lower t3 to half? or lower just t4 and let t3 be 25or lower both?

and to raise b12 will mecobalamin 500mcg daily and to raise vit d 800 iu daily be ok dose?

any help is much much appreciated

Thank you in advance

[SeasideSusie Remembering]

hypomomoffour

You should check for signs and symptoms of B12 Deficiency here because your B12 is very low.

b12deficiency.info/signs-an...

Do you have a folate result? That is quite often low when B12 is that low.

You could do with posting on the Pernicious Anaemia Society forum here on Health Unlocked for further advice about your B12, mention your ferritin level too.

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What is the unit of measurement for your Vit D test? Is it Ng/ml or Nmol/L?

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Ferritin is very low, it needs to be half way through it's range.

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All those vitamins and minerals must be optimal for thyroid hormone to work. If you get them up to optimal levels then thyroid hormone can work properly and you may have no need for T3.

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Your high antibodies confirm autoimmune thyroid disease aka Hashimoto's. To reduce the antibodies you should try a strict Gluten-free diet and supplement with selenium L-selenomethionine 200mcg daily.

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Low and slow is the way to go with T3. It should be started at 6.25mcg and increases should be 6.25mcg each time with maybe 2 weeks between each increase. When you reach 25mcg you should retest. But as I said, if you optimise your vitamins and minerals you may not need T3.

[hypomomoffour in reply to SeasideSusie]

*vit d is ng/ml

*i do have forgetfulness and muscular pain

*my serum folic acid was 5ng/ml in jan 2017 when my b12 was 324

*selenomethionine 200mcg daily, will not interfere with 800 iu vit d , 500mcg vit b12, 100 mcg thyroxine and 12.5 ug t3 daily? plus i am on 25mg lamotrigine and citlaopram 30 mg DAILY for depression (WHICH i am sure was caused by my hypo and was never diagnosed) ??

*I have been told to get a retest of tpo antibodies after 6 months to confirm hashimoto's

thank you so much for your detailed reply, I will check out Pernicious Anaemia Society forum

Thanks a lot!

[SeasideSusie Remembering in reply to hypomomoffour]

hypomomoffour

Vit D 31ng/ml - according to the Vit D Council the recommended level is 40-60ng/ml. 800iu D3 isn't even a maintenance dose for someone with a reasonable level already. I think you should be taking more like 3000iu daily.

Check out the important cofactors needed when taking D3 and ensure you take those too vitamindcouncil.org/about-v... Take D3 four hours away from thyroid meds, and with the fattiest meal of the day.

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You haven't said what the range is for folate so I have no idea if it is low but if forgetfulness and muscle pain is on the list of signs of B12 deficiency then pop over to the PA forum with all the information for further advice

healthunlocked.com/pasoc

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Selenium is fine to take when taking thyroid meds (and supplements), but don't take them at the same time as your Levo and T3. As selenium is a mineral, minerals are generally advised to be taken in the evening.

As for interactions with your other medication, I would google for that information.

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You do not need Hashi's confirmed by another antibody test. They are high, that confirms Hashi's. Even if they are lower in 6 months' time, it doesn't matter, that would just be due to the normal fluctuation of antibodies. One positive result means Hashi's.

[humanbean]

The reference range for older adults for TSH is terrifying!

55 - 87 years 0.5 - 8.9

I'm in my late 50s. My TSH has never been as high as 8.9. I'm very hypothyroid. I treat myself.

One of these days I expect the rules to change and for me not to be able to buy my own thyroid meds through the post. I have no doubt I'll end up with a diagnosis of CFS, dementia and high cholesterol and I'll be left to rot and force-fed on statins.

[greygoose in reply to humanbean]

Yes, it is terrifying. And totally illogical. How can you have a higher range for 55 - 87, when the ranges for the Frees are the same? If my TSH were 8.9, my FT3 would be almost non-existant!

Well, there we are, it's official, after 55, we have to self-treat or die! Where is this, anyway? And, what is the meaning of the statement 'This is an electronic report and not to be used for any legal purposes'? That sounds very suspicious! Does it mean that 'if you sue us, we will change the results in our records, so you won't have a leg to stand on'?

[helvella Administrator in reply to greygoose]

If it cannot be used for any legal purposes that raises a few questions:

Can it be used for medical purposes? And if so, how come it is trustworthy for mere health but not for "justice"?

Does the placing of an automated "watermark" actually mean that it could not be presented as evidence in, say, a case malpractice or criminal acts?

Do GMC hearings count as "legal purposes"?

Do doctors have any right whatsoever to impose conditions on the use of information to which patients have a right of access enshrined in law? If they have no such right, on what basis are they printing a "frightener" right across the document?

Somewhat facetiously, does that mean it can be used for illegal purposes?

[greygoose in reply to helvella]

My thoughts exactly!

Although, for the life of me, I cannot think of any illegal purposes you could use it for!

But it is a little bit iffy, isn't it.

[hypomomoffour]

it is an electronic report , so it can be forged or photoshopped to alter results(people can have weird reasons)... the printed one done does not have any watermark or warning,these reports were emailed to me , will pick hard copy in a day or two

[Angel_of_the_North]

It's best to start on just a quarter of a T3 tablet. Then a quarter twice a day after a week or so, then half and a quarter (if you need it) and so on. Take temperature and be very aware of symptoms to make sure you aren't taking too much (you might need to lower levo).