First blood test after starting t3, where should I go from here?

[Rkx212]

Once again, advice and direction would be greatly appreciated...

Earlier this year my endo suggested I increased my thyroxine from 100 to 125mg daily to try and increase my T3 levels... To no avail. This is when I posted my first private blood test results (please see my previous post). Since then with lots of great advice from this forum I have:

1. Supplemented my iron /vit d (with magnesium and vit K) / vit b complex

2. Sourced t3 and gradually increased my daily dose to 25mg (i find it much easier to take one daily dose in the morning)

3. Reduced my daily thyroxine from 125 to 100mg. I know that 25mg of t3 is roughly equivalent to 75mg of thyroxine.... But when I dropped from 125 to 100 I felt terrible and couldn't face what another drop in dose may do to me, so I stuck with 100 and waited for my next blood tests.

I've posted the thyroid blood test results below (I couldn't afford to do all the vitamin /iron levels again this month)

So, after 3 months of supplements and t3...

Pros: better energy / sleep, better mood (sometimes ;), better weight management (I've managed to lose 6kg with strict diet and exercise... Same regime as before t3 but back then it got me no where), better bladder control (I don't even know how that effects it, I'm just happy I don't need oxybutinin any more)

Cons: hideous night sweats across my chest & neck (it doesn't wake me every night, so not sure if it's just some nights or every night to varying degrees), my hair is still falling out - I know 3 months is early days buts there's zero improvement & now I'm starting to think it's worse (in my head?) this has been, by far, the worst part of my thyroid condition.

Questions and advice please...

1.My hair loss is really upsetting. It wasn't a presenting symptom though, could it be a side effect to the thyroxine meds rather than the condition itself? And if so, would it be reasonable to try and go t3 only? Or just reduce the dose to a minimum? (or ndt?.?? that just occurred to me.. hadn't even thought of that)

2. My free T4 dropped from 20 to 14 (range 12-22) just by reducing dose from 125 to 100. Was that to be expected? Or does that suggest I shouldn't lower the dose again? (or go back to 125??) Is optimising your T4 level as important when taking t3?

3. At 5.3 (3.1 - 6.8) is the t3 optimal now? Or is there room to adjust more? (considering symptoms)

4. Are the night sweats just because I'm adjusting or because I'm over medicated (when I theoretically should have reduced my thyroxine dose by more) or because I'm still under?

My biggest problem / fear is my hair loss. And any help /advice /comment would be greatly appreciated.

Thanks in advance x

[mistydog]

Hair loss could be due to low iron. Did they check your ferritin?

Low T4 doesn't matter, it's the T3 which you need to be aware of and it looks good.

Could night sweats be due to other hormonal changes?

I have the same issue and it's horrible. Venlafaxine is supposed to help.

[Rkx212 in reply to mistydog]

Thanks for the reply. My ferritin wasn't too bad, but I upped my supplement to make sure it's optimal. I'm sceptical about hormones being responsible for night sweats as it's gone from zero to 100 just as the changes in thyroid meds have kicked in (i remember something similar just after being diagnosed).

[mistydog in reply to Rkx212]

If you reduce again and the sweats stop, you'd know, I guess.

[Rkx212 in reply to mistydog]

Now that you mention low T4 isn't as important now that I've got decent T3, maybe it would be ok to start reducing the T4 and see if it helps.... (fingers crossed maybe help both Sweaty Betty & Baldy Betty!)

[SlowDragon Administrator]

Have you considered low zinc as possible connection to hair loss issue?

hypothyroidmom.com/my-favor...

ncbi.nlm.nih.gov/pmc/articl...

Do you supplement selenium?

Also you vitamin B complex might be helping as contains Biotin which is good for hair & nails. But did you remember to stop taking it, (or anything with biotin in) 4-5 days before any thyroid test

endocrinenews.endocrine.org...

Night seats can be linked to low B12. Perhaps you could try adding sublingual B12. Do you have other symptoms of low B12

b12deficiency.info/signs-an...

[Rkx212 in reply to SlowDragon]

Thanks for the reply.

The only zinc and selenium I take are in a multivit, so low amounts. The matching symptoms from that list are hair loss, raised antibodies, raised rt3 (but that was the blood rest before starting t3 meds). I'll be sure to try the liquid zinc test at home though.

I did remember to stop my vitB complex/biotin before my blood tests. I've been supplementing vitB (with a higher level of biotin included) for a couple years now (tried the sublingual too) and there's been no improvement in that time to the hair (much worse now) and I don't have any of the other signs of deficiency (especially now most of the brain fog, lethargy etc has been improved by the 3)

[SlowDragon Administrator in reply to Rkx212]

Multivitamins are not recommended on here, especially if it has iodine in, if you have Hashimoto's

greygoose is good on why multivitamins are not recommended

[Rkx212 in reply to SlowDragon]

Sorry, I had read that... I was just using them up 🙁 but they're done now and wasn't going to buy again. Looking at separate supps for the selenium and zinc, if required.