Not sure what to do next

[Venicefan]

I've just received my current Medichecks results.

Taking 75mcg Levothyroxine and 25mcg T3

TSH *0.112 (0.27 - 4.20)

Free T4 *11.9 (12.00 - 22.00)

Free T3 5.07 (3.10 - 6.80)

Still very low on energy and my hair is very thin. I've gained another 2kg in weight in the last 6 weeks.

I was previously on 100 mcg levo and 12.5 T3 and the private doctor said I had to reduce the levo to 75 mcg if I was going to increase the T3. He said to just take another 6.25 of T3 but I felt so weary after 2 weeks that I started taking 12.5 mcg T3 twice a day.

Before I started the T3, I was taking 125 mcg levo, but had severe hypothyroid symptoms and now I feel like all I'm doing is taking the same amount but in a different format.

I'm seeing the NHS endo next Tuesday and was hoping to persuade him to prescribe T3 if this trial was successful but if I'm not taking enough it won't work.

[SeasideSusie Remembering]

Venicefan I'm one who has added T3 myself to prescribed Levo and I've spent months tweaking doses. I found that if I went below a certain dose with my Levo it caused me dreadful fatigue and my FT4 plummeted to the bottom of the range, so I put my Levo back up. I couldn't cope with FT4 so low, I know from experimenting that I need it above half way, and I was best when it was 75% through the range with FT3 very close to the top of the range. TSH is irrelevant when taking replacement hormone, mine has been suppressed for donkeys years and was even suppressed when FT4 was 12.8 (12-22).

I think you need to do more tweaking to find the right dose for you.

Don't forget that you have Hashi's, according to the results in this thread healthunlocked.com/thyroidu..., and that complicates things anyway because of the fluctuations in symptoms and results that the antibodies can cause. Have you adopted a gluten free diet and are you supplementing with selenium to help reduce the antibodies?

[Venicefan in reply to SeasideSusie]

Hi. Thanks for responding. Yes, I've been gluten free for 18 months now and have been supplementing with selenium, zinc, magnesium and vit D. I was also prescribed DHEA and Adrenal glandular by the private dr after a saliva test.

I didn't want to reduce my levo because my FT4 was low in range last time but even the private dr is spooked by the suppressed TSH and he was adamant that I would come to harm if it stayed suppressed.

I know the endocrinologist won't be happy about it. I didn't want to see him in the first place. I asked for a referral to an immunologist because I've had so many bad experiences with endos but I got sent to him anyway!

[mischa]

Hi Maggie0652

I'm not entirely sure why you are taking adrenal glandulars with high cortisol. They are usually meant for very low levels of cortisol in order to bring levels up. For high cortisol Holy Basil is often used. When I had high cortisol this is what I used. There are other supplements/herbs available for high cortisol. Vitamin B5 (pantothenic acid) 500mg is often suggested twice a day; a.m. and p.m. High cortisol as well as low cortisol will prevent thyroid meds from working.

Another possible reason for continuing hypo symptoms could be low stomach acid. If this is the case then thyroid meds aren't being metabolised along with any other supplements you may be taking.

[mischa in reply to mischa]

Incidentally, how is your iron/ferritin?

[Venicefan in reply to mischa]

I haven't got all of my test results with me at the moment so can't give the numbers but the last time ferritin was checked it was high. Will look when I get home.

[Venicefan in reply to mischa]

The first cortisol test was high but it was done a few days after a short senacthen test when I was injected with ACTH. The second test a few weeks later showed my cortisol was extremely low.

[mischa in reply to Venicefan]

Oh I see - yes cortisol levels can and do fluctuate but it's extraordinary that they have changed so quickly. Of course, in that case glandulars would be appropriate.

[SlowDragon Administrator]

What about vitamin D, folate, ferritin and B12

Do you supplement any of these? If taking B12 then do you also take B complex

(Remember to stop this 3-5 days before any blood tests)

Your FT4 looks too low

What time was test and how long since taking T4 and T3

Do you take T3 in split dose

[Venicefan in reply to SlowDragon]

I take 3000iu vit D on alternate days as I've been getting plenty of sun during the summer also vit K with it, B12 and B complex. I didn't get vitamins tested this time. Ferritin was high last time I had it done. It was 170.5 (22-150) that was 4 months ago.

This test was done 8.30am. I took the last dose of T4 at 5.30am the day before and T3 at 4pm the day before.

I've been taking T3 in split dose 12.5mcg at 5.30am and 12.5mcg at 4pm.

[SlowDragon Administrator in reply to Venicefan]

Ferritin can apparently be high due to Hashimoto's. I know it's more commonn that it's low

Mine was always above range until started T3

[Venicefan in reply to SlowDragon]

I was worried when I first saw it but the dr wasn't because the CRP was well within range