Looking to get T3

[Amberjk]

Hi new here looking to get T3 since it helped me feel better. Could I please have advice about where to source it please. Thanks

[SeasideSusie Remembering]

Amberjk Members are more likely to share their source of supply when a new member gives some background information about their thyroid journey and current dose of Levo. And if you post your latest thyroid results with reference ranges then suggestions can be made about adding T3 and if Levo needs reducing.

[Amberjk in reply to SeasideSusie]

Diagnosed 2013 with hypothyroid and taking 75mcg levothyroxine. Was taking T3 before it was stopped

[SeasideSusie Remembering in reply to Amberjk]

What are your latest results (include the reference ranges)?

Do you have high antibodies - Hashimoto's?

Are your vitamins and minerals at optimal levels -

Vit D - 100-150nmol/L

B12 - very top of range

Folate - at least half way through range

Ferritin - half way through range

[Amberjk in reply to SeasideSusie]

TSH <0.02 (0.2 - 4.2)

Free T4 20.6 (12 - 22)

Free T3 5.2 (3.1 - 6.8)

TPO antibodies 803.5 (<34)

TG antibodies >1000 (<115)

Before T3 was stopped

[SeasideSusie Remembering in reply to Amberjk]

Amberjk Has anyone told you that you have autoimmune thyroid disease aka Hashimoto's as confirmed by your high antibodies? This is where antibodies attack the thyroid and gradually destroy it. The antibody attacks cause fluctuations in symptoms and test results.

Have you had dose changes based on results and/or symptoms?

If you haven't been told about Hashi's and haven't researched it, 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.

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

stopthethyroidmadness.com/h...

stopthethyroidmadness.com/h...

hypothyroidmom.com/hashimot...

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

[Amberjk in reply to SeasideSusie]

Hi I thought I had Hashimotos but the endo I have been seeing just scrolled past the antibody results and didn't say anything. Dose has been adjusted based on results and also on symptoms.

[SeasideSusie Remembering in reply to Amberjk]

OK Amber, your endo either doesn't know about Hashi's and how antibodies affect you and didn't want to show his ignorance, or he's one of the majority that thinks they're not important. They are to you because they can make such a difference to how you feel. And if you understand what Hashi's does then can deal with it better.

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.

This may be what happened when your dose was adjusted.

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.

The aim of a treated hypo patient generally is for TSH to be 1 or below or wherever it is needed for FT4 and FT3 to be in the upper part of their respective reference ranges when on Levo only. Add T3 into the mix and TSH may well be suppressed, FT4 can lower and FT3 should be nearer the top of it's range.

It's also possible that with these results, when you were also taking T3

TSH <0.02 (0.2 - 4.2)

Free T4 20.6 (12 - 22)

Free T3 5.2 (3.1 - 6.8)

your endo saw your suppressed TSH and panicked. However, if you were feeling well at that time, there was no reason to change your dose of anything. Taking T3 usually suppresses TSH or causes it to be very low. Your FT4 is well within range as is your FT3. In fact, there was even room to increase your T3 a little. You can only be overmedicated if FT3 is over range.

I think your endo is a diabetes specialist (most of them are) and he really doesn't know how to treat hypothyroidism, doesn't have a clue about Hashi's, and doesn't know how to dose with T3. And you, unfortunately, suffer for his ignorance.

Do you have your results now that you're on 75mcg Levo only? If we can see where your levels lie now we can suggest what thyroid meds you probably should be taking.

[Amberjk in reply to SeasideSusie]

Ok thanks

Levels are currently

TSH 3.80 (0.2 - 4.2)

Free T4 14.1 (12 - 22)

Free T3 4.0 (3.1 - 6.8)

[SeasideSusie Remembering in reply to Amberjk]

So, Amber, these show that you are currently undermedicated. For now an increase in Levo will do. Your FT3 isn't too bad. Your FT4 is 21% through it's range and FT3 is 24% through it's range, so they're actually nicely balanced at the moment. By increasing your Levo, your TSH will lower and free Ts will increase, and if conversion is good enough the FT3 will increase too, hopefully staying in balance with the FT4.

To help get an increase from your doctor, this might help

From thyroiduk.org.uk/tuk/about_... > Treatment Options

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.

That booklet is written by Dr Anthony Toft, past president of the British Thyroid Association and leading endocrinologist, and is published by the British Medical Association for patients. You can get it from 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)."

You can obtain a copy of this article by emailing [e-mail] , print it and highlight question 6 to show your doctor.

Hopefully this evidence will allow you to get an increase in Levo.

Jeez, I'm so cross on your behalf that you've been treated so poorly and let down so much by your doctors.

[Amberjk]

Ferritin 17 (30 - 400)

Folate 1.8 (2.5 - 19.5)

Vitamin B12 158 (190 - 900)

Total 25 OH vitamin D 22.6 (<25 severe deficiency)

[SeasideSusie Remembering in reply to Amberjk]

Amberjk All your vitamins and minerals are dire, no thyroid hormone can work with these levels. Is anything being done about them?

[Amberjk in reply to SeasideSusie]

No nothing being done about the results

[SeasideSusie Remembering in reply to Amberjk]

Amber - whoever has ignored these results should find another job, they're not fit to be a doctor.

Ferritin 17 (30 - 400)

Did you have an iron panel and full blood count done as well? If not you need to ask for one to see if you have iron deficiency anaemia.

Ferritin needs to be at least 70 for thyroid hormone to work, and half way through range is best, although I have seen it said that for females it should be 100-130.

Ideally, because of your below range ferritin, you need an iron infusion so ask for one, but you may only be prescribed tablets which will take months to raise your level whereas an infusion will raise your level within 24-48 hours.

If you are given iron tablets then take each iron tablet with 1000mg Vitamin C to aid absorption and help prevent constipaton. Always take iron 4 hours away from thyroid meds and two hours away from other medication and supplements as it will affect absorption.

If you have been diagnosed with iron deficiency, the treatment is for Ferrous Fumarate 1 tablet 2 or 3 times a day. For low ferritin it is 1 tablet once or twice a day, but try and get the iron infusion first.

**

Folate 1.8 (2.5 - 19.5) Vitamin B12 158 (190 - 900)

This is appalling. Please go over to the Pernicious Anaemia Society forum here on Health Unlocked for further advice.

Do you have any signs of B12 deficiency b12deficiency.info/signs-an... (I would be very surprised if you haven't)

You are folate deficient with below range B12. I'm guessing you need testing for Pernicious Anaemia and you might very well need B12 injections. Please post on the PA forum and quote your Folate, B12 and Ferritin results, iron deficiency information if that has been diagnosed, also any signs of B12 deficiency. Don't wait, do it now healthunlocked.com/pasoc

This is so bad that once you've had their advice and sorted out treatment, you should seriously consider making a formal complaint against the doctor who has ignored these results (and the others here). This is serious negligence on the part of this doctor.

**

Total 25 OH vitamin D 22.6 (<25 severe deficiency)

As you can see you have severe Vit D Deficiency. Again, you need to speak to your doctor and point this out to him.

NICE treatment 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.

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)."

Each Health Authority has their own guidelines but they will be very similar. Go and see your GP and demand that he treats you according to the guidelines and prescribes the loading doses. Once these have been completed you will need a reduced amount to bring your level up to what's recommended by the Vit D Council - 100-150nmol/L - and then you'll need a sensible maintenance dose (not the 800iu you will be prescribed) which may be 2000iu daily, it's trial and error so it's recommended to retest once or twice a year to keep within the recommended range. You can do this with a private fingerprick blood spot test with City Assays vitamindtest.org.uk/

There are important cofactors needed when taking D3

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.

**

I know this hasn't answered your original question about obtaining T3, but honestly there's no point at the moment.

You must sort out these vitamins and minerals and get them to optimal levels. Without that nothing will work, and they must be optimal for T4 to T3 conversion to take place. It could very well be that if your deficiencies had been addressed before, your Levo would have worked properly and you may not have needed T3 in the first place.

So get these deficiencies sorted, address the Hashi's with a gluten free diet and supplementing with selenium (that helps conversion too), then a bit further down the line you'll know if you need T3 and you can go from there.

By the way, Hashi's causes gut and absorption problems and that could be part of why your nutrient levels are so bad. SlowDragon has info about this and she will come along and offer more information and links to help.

Please let us know how it goes with your doctor about these deficiencies.

[Amberjk in reply to SeasideSusie]

Complete blood count showed

MCV 77.5 (80 - 98)

MCHC 386 (310 - 350)

Haemoglobin 124 (115 - 150)

Iron 7.4 (6.0 - 26.0)

Transferrin saturation 12 (10 - 30)

Will go to the pernicious anaemia forum now thanks

[SeasideSusie Remembering in reply to Amberjk]

OMG Amber, I can't believe they've ignored this too. Your low MCV suggests iron deficiency.

Do you have someone who can go to your appointment with you because someone - maybe you yourself - needs to give it to this doctor with both barrels!

NICE Clinical Knowledge Summary for iron deficiency anaemia treatment (which will be very similar to your local area guidelines)

cks.nice.org.uk/anaemia-iro...

Have a read through but this is the treatment:

How should I treat iron deficiency anaemia?

•Address underlying causes as necessary (for example treat menorrhagia or stop nonsteroidal anti-inflammatory drugs, if possible).

•Treat with oral ferrous sulphate 200 mg tablets two or three times a day.

◦If ferrous sulphate is not tolerated, consider oral ferrous fumarate tablets or ferrous gluconate tablets.

◦Do not wait for investigations to be carried out before prescribing iron supplements.

•If dietary deficiency of iron is thought to be a contributory cause of iron deficiency anaemia, advise the person to maintain an adequate balanced intake of iron-rich foods (for example dark green vegetables, iron-fortified bread, meat, apricots, prunes, and raisins) and consider referral to a dietitian.

• Monitor the person to ensure that there is an adequate response to iron treatment.

The iron deficiency alone will make your feel cr*p, add in the Vit D and B12 deficiency plus being undermedicated with Levo, I'm not sure how you're functioning.

I know there's a lot of reading, links, etc. All of it will help you get the proper treatment you need. Read through it all again, and again if necessary, and make notes.

Please come back and let us know how you get on with your doctor and what he's going to do about all this.

[Amberjk in reply to SeasideSusie]

I think I'm just getting by on adrenaline because I feel wired and on edge and alert when at work but when I get home after work I feel burned out. I will take my partner with me

[SeasideSusie Remembering in reply to Amberjk]

Amber - just to add to all the misery, your adrenals will probably be stressed by what's been happening with your thyroid and your nutrients. They may need supporting.

Vit C helps support adrenals - take as much as you want (to bowel tolerance!), take in divided doses throughout the day. It doesn't need to be tablets, if you are OK with ascorbic acid form of Vit C then you can make it into a drink with orange juice (drink through a straw to protect tooth enamel).

It might be an idea to do a 24 hour saliva adrenal stress test, that will show whether you need more support than just Vit C.

[Amberjk in reply to SeasideSusie]

I did a private adrenal saliva test sorry, I can post if it can be interpreted.

[SeasideSusie Remembering in reply to Amberjk]

I can point you in the right direction

[humanbean in reply to Amberjk]

I might be able to help a bit with adrenal saliva results, if you want to post them.

[Amberjk in reply to humanbean]

Thanks for offering to help me I have results, do I post on a new thread? Just in case this one gets missed.

[humanbean in reply to Amberjk]

You could do. I won't be able to reply until later this evening though.

[Heloise in reply to SeasideSusie]

Such wonderful comprehensive responses, SS. Disgraceful, isn't it? I assume they are taught to order tests but totally ignorant when it comes to analyzing them.

[shaws Administrator]

If you had been prescribed T3 and T4 on the NHS the doctor should not withdraw your T3 if you have a clinical need as per the British Thyroid Associations Guidelines

You can also sign the pinned post on the right hand column protesting about the withdrawal.

[Amberjk in reply to shaws]

Hi I had T3 given to me on the NHS and I felt a benefit on it but not straight away. The endo I was seeing at the time advocated my taking of it. The current endo I now see has said he wants me to discontinue the T3 and go back to levothyroxine only because he said relief of symptoms is not evidence enough to convince him I need T3. I have 2 months of it left and I am tempted to continue with what I have but without a specialist's help I don't feel able to.

[shaws Administrator in reply to Amberjk]

I think you are warranted a longer trial but sometimes they prescribe too low a dose on the combination T4/T3. Research I have read shows that a 3:1 is best ie T4:T3. Go to page 80 on following link:

tpauk.com/images/docs/reduc...

It's not up to the medical profession to decide whether or not we have sufficient relief of clinical symptoms, it is up to the patient to decide as it is those who are experiencing them, not the doctors.

You can also send him a link highlighting the research that many improve with a combination. We, the patients, know better than the doctors as they cannot experience what we do with regard to symptoms. All they refer to, mainly, is a dot on a piece of paper showing results unless they are extra-special doctors who care and do everything in their power to help. It may not always be successful but I think it many cases it would be.

[Heloise in reply to Amberjk]

Yes, you will be able to.