Symptoms with normal results

[Amber4890]

Hi why do I have symptoms with normal results please. Taking 175mcg levothyroxine and 10mcg T3. I am tired and gaining weight and feeling low

Thank you

TSH 4.01 (0.2 - 4.2)

Free T4 13.2 (12 - 22)

Free T3 3.1 (3.1 - 6.8)

[Nanaedake]

A lot of people would not consider that normal results. NHS normal is not the same as making people feel well. Most people with thyroid conditions feel better with a TSH around 1.0 or what works for you. You FT3 is really low and so is FT4 which indicates you are undermedicated.

[SeasideSusie Remembering]

Amber - as Nana says, you are very undermedicated to have those results. Or another possibility is that you are not absorbing your thyroid meds.

Do you take your thyroid meds on an empty stomach, one hour before or two hours after food, and two hours away from any other medication and supplements?

Are you taking any other medication?

Do you have gut problems? Low stomach acid (self test here with baking soda scdlifestyle.com/2012/03/3-... )

Are your nutrient levels optimal? Have you had vitamins and minerals tested - Vit D, B12, folate, ferritin?

Do you have thyroid antibodies and have Hashimoto's?

[Amber4890 in reply to SeasideSusie]

Thanks I take meds on empty stomach away from meds and several hours before food and several hours away from supplements. No other medications but gut problems and low vits and mins and high antibodies.

TPO antibodies 582.5 (<34)

TG antibodies 368.3 (<115)

[Amber4890]

Feb 2017

Ferritin 63 (15 - 150) diagnosed iron deficient in 2013 and take iron tablet once a day

MCV 77.8 (80 - 98)

Folate 2.3 (2.5 - 19.5) given folic acid after result

Vitamin B12 201 (190 - 900)

Vitamin D 30.7 (>75 adequate) continuing D3 800iu since 2014

[SeasideSusie Remembering in reply to Amber4890]

Amber - MCV 77.8 (80 - 98) this can indicate iron deficiency anaemia and the treatment for that is one Ferrous Fumarate two or three times daily. Speak to your GP about this. Take your iron tablets with 1000mg Vit C to aid absorption and help prevent constipation, and four hours away from thyroid meds and two hours away from any other medication and supplements as it affects their absorption.

Ferritin needs to be at least 70 for thyroid hormone to work. Eating liver once a week, maximum 200g, can help, as can eating lots of iron rich foods apjcn.nhri.org.tw/server/in...

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Folate 2.3 (2.5 - 19.5) given folic acid after result

Vitamin B12 201 (190 - 900)

Were you checked for B12 Deficiency - check for signs and symptoms here b12deficiency.info/signs-an...

Then I would pop over to the Pernicious Anaemia Society forum here on Health Unlocked for further advice. You may need to be tested for Pernicious Anaemia.

From what I understand taking folic acid can mask symptoms of B12 Deficiency so it might be an idea stop that for now, post on the PA forum with these results, your iron/ferritin results and any signs of B12 Deficiency, then discuss what they say with your GP healthunlocked.com/pasoc

For us Hypos it's recommended that B12 be at the very top of it's range, and folate needs to be half way through it's range.

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Vitamin D 30.7 (>75 adequate) continuing D3 800iu since 2014

Your GP should have realised that after 3 years of supplementing you are still deficient. You really need loading doses to get your level up and then a decent maintenance dose which could be 1000-2000iu daily. 800iu will never raise your level.

The recommended level is 100-150nmol/L according to the Vit D Council.

Check out the NICE Clinical Knowledge Summary for Vit D Deficiency

cks.nice.org.uk/vitamin-d-d...

"Treat for vitamin D deficiency if serum 25-hydroxyvitamin D (25[OH]D) levels are less than 30 nmol/L."

Tell your GP that as you are only 0.7 over the limit, you wish to have the loading doses mentioned here:

"For the treatment of vitamin D deficiency, the recommended treatment is based on fixed loading doses of vitamin D (up to a total of about 300,000 international units [IU]) given either as weekly or daily split doses, followed by lifelong maintenance treatment of about 800 IU a day. Higher doses of up to 2000 IU a day, occasionally up to 4000 IU a day, may be used for certain groups of people, for example those with malabsorption disorders.

Several treatment regimens are available, including 50,000 IU once a week for 6 weeks (300,000 IU in total), 20,000 IU twice a week for 7 weeks (280,000 IU in total), or 4000 IU daily for 10 weeks (280,000 IU in total)."

When taking D3 there are important cofactors needed vitamindcouncil.org/about-v...

D3 aids absorption of calcium from food and K2-MK7 directs the calcium to bones and teeth where it is needed and away from arteries and soft tissues where it can be deposited and cause problems.

D3 and K2 are fat soluble so should be taken with the fattiest meal of the day, D3 four hours away from thyroid meds.

Magnesium comes in different forms, check to see which would suit you best and as it's calming it's best taken in the evening, four hours away from thyroid meds naturalnews.com/046401_magn...

Check out the other cofactors too.

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Optimising vitamins and minerals means that thyroid hormone has a good chance of working properly.

**

TPO antibodies 582.5 (<34)

TG antibodies 368.3 (<115)

These high antibodies confirm autoimmune thyroid disease aka Hashimoto's, which is where antibodies attack the thyroid and gradually destroy it. Unfortunately not many doctors think they're important but they can cause fluctuations in symptoms and results as the antibodies fluctuate.

You can help reduce the antibodies by adopting a strict gluten free diet which has helped many members here. Gluten contains gliadin which is a protein thought to trigger antibody attacks. Supplementing with selenium L-selenomethionine 200mcg daily and keeping TSH suppressed can also help reduce antibodies.

chriskresser.com/the-gluten...

stopthethyroidmadness.com/h...

stopthethyroidmadness.com/h...