New here endo says I can't have T3

[AlanaV]

So what do I do please? Taking 50mcg thyroxine diagnosed 2013.

TSH 6.10 (0.2 - 4.2)

Free T4 11.8 (12 - 22)

Free T3 2.1 (3.1 - 6.8)

Thank you

[SeasideSusie Remembering]

AlanaV It's not surprising your endo wont prescribe T3, it's being taken off patients left right and centre.

What you need is an increase in your Levo. Your TSH is way too high and free Ts far too low. Did your endo say anything about this?

The aim of a treated hypo patient generally is for TSH to be 1 or below or wherever it needs to be for Free T4 and Free T3 to be in the upper part of their respective reference ranges.

50mcg is a starter dose. Have you been on that since diagnosis in 2013? Or have you had changes in dose?

Do you have thyroid antibodies - Hashimoto's?

Have you had vitamins and minerals tested, if so please post results

Vit D

B12

Folate

Ferritin (and any iron/full blood count results)

[AlanaV1 in reply to SeasideSusie]

Sorry I lost my login, I was doing well on T3 and I have been told I can no longer have it. My results looked better on this too. My dose has been changed about a bit. Endo has said nothing about my latest results. I have raised antibodies and low vitamins and minerals which I don't know what to do about.

[SeasideSusie Remembering in reply to AlanaV1]

Alana

Your high antibodies mean that you are positive for autoimmune thyroid disease aka Hashimoto's which is where antibodies attack the thyroid and gradually destroy it.

The antibody attacks cause fluctuations in symptoms and test results. When the antibodies attack, the dying cells dump a load of thyroid hormone into the blood and this can cause TSH to become suppressed and Free T4 and Free T3 to be very high or over range. You may get symptoms of being overmedicated (hyper type symptoms) to go along with these results that look as though you are overmedicated. Unless a GP knows about Hashi's and these hyper swings, then they panic and reduce or stop your thyroid meds.

The hyper swings are temporary, and eventually things go back to normal. Test results settle back down and hypo symptoms may return. Thyroid meds should then be adjusted again, increased until you are stable again.

This probably explains why you've had your dose changed from time to time.

You can help reduce the antibodies by adopting a strict gluten free diet which has helped many members here. Gluten contains gliadin (a protein) which is thought to trigger autoimmune attacks so eliminating gluten can help reduce these attacks. You don't need to be gluten sensitive or have Coeliac disease for a gluten free diet to help.

Supplementing with selenium l-selenomethionine 200mcg daily can also help reduce the antibodies, as can keeping TSH suppressed.

stopthethyroidmadness.com/h...

stopthethyroidmadness.com/h...

hypothyroidmom.com/hashimot...

thyroiduk.org.uk/tuk/about_...

Gluten/thyroid connection: chriskresser.com/the-gluten...

**

If you were doing well on T3 then you shouldn't have had it stopped. Clutter posted links recently about the British Thyroid Association guidelines that state that patients who are doing well on T3 should not have their prescription removed. The BTA have issued this information british-thyroid-association...

If you can't open the PDF it states

Do I have to switch from T3 to thyroxine

If you are receiving T3 and are satisfied that you are deriving benefits from it then you do not have to stop it. You should let your GP know that you wish to continue taking T3. If the GP is not happy prescribing it they should seek the opinion of an endocrinologist

Please see Clutter's very helpful post here healthunlocked.com/thyroidu...

**

As for your current results, see Treatment Options here thyroiduk.org.uk/tuk/about_... which state

According to the BMA's booklet, "Understanding Thyroid Disorders", many people do not feel well unless their levels are at the bottom of the TSH range or below and at the top of the FT4 range or a little above.

Dr Anthony Toft wrote the booklet, he is past president of the British Thyroid Association and leading endocrinologist. The booklet is available from local pharmacies and Amazon for about £4.95.

Also -

Dr Toft states in Pulse Magazine, "The appropriate dose of levothyroxine is that which restores euthyroidism and serum TSH to the lower part of the reference range - 0.2-0.5mU/l.

In this case, free thyroxine is likely to be in the upper part of its reference range or even slightly elevated – 18-22pmol/l. Most patients will feel well in that circumstance.

But some need a higher dose of levothyroxine to suppress serum TSH and then the serum-free T4 concentration will be elevated at around 24-28pmol/l.

This 'exogenous subclinical hyperthyroidism' is not dangerous as long as serum T3 is unequivocally normal – that is, serum total around T3 1.7nmol/l (reference range 1.0-2.2nmol/l)."

If you would like a copy of the Pulse article, email [e-mail] print it and highlight question 6 to show your GP/endo and ask for an immediate increase in your Levo. Follow this 6 weeks later with a retest and another increase if necessary, and repeat until you feel well. Bear in mind the hyper/hypo swings that are part and parcel of Hashi's and be prepared to adjust dose when necessary.

**

Unfortunately, most endos are diabetes specialists and know very little about treating hypothyroidism, many GPs too. We have to read, learn and help ourselves, present evidence to our doctors to get the help we need.

You can tell your doctor that you have spoken to ThyroidUK who is NHS Choices recommended source of information for thyroid disorders.

**

Where are the results for your low vitamins and minerals? Post them for comment and suggestions.

[Clutter]

AlanaV,

You might not need T3 if you were optimally dosed on Levothyroxine. You are undermedicated on 50mcg to have TSH so high and FT4 and FT3 below range.

The goal of Levothyroxine is to restore the patient to euthyroid status. For most patients that will be when TSH is 0.2 - 1.0 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 and endo.