Update on thyroid results and advice on hair loss

[cleo26]

I really want to get a handle on this, if there is indeed a thyroid problem that is causing hair loss. Never had hair loss until after menopause. My TSH and T4 numbers from seven years ago until I started measuring the full panel in the last three years always hovered around TSH 1-2 and T4 1.

Before taking thyroid medication:

Mar 2017

TSH 1.87 (.45 - 4.5)

FT4 1.2 (.82 – 1.77)

FT3 2.4 (2.0 – 4.4)

rT3 19.6 (9.2 -24.1)

TPO Ab 18 (0 - 34)

Tg Ab 7.9 (0 - .9)

After starting and taking thyroid meds:

T4 13 mcg and T3 10 mcg for two months

Beginning of Aug 2017, morning, fasted and meds taken at least 24 hours prior to testing

TSH .611 (.45 - 4.5)

FT4 .81 (.82 – 1.77)

FT3 2.0 (2.0 – 4.4)

rT3 14 (9.2 -24.1)

Antibodies were not measured.

Iodine (serum) 34.6 (40. - 92)

Vit D 83.8 (30-100)

Vit B12 2000 (211 – 946)

Folate 13.4 (> 3.0)

Ferritin 57 (15 -150) recent decline from 70 / 80

Iodine (serum) 40.3 (40. - 92)

I continue to experience hair loss, and in fact, it has accelerated. The only improvement I have experienced is digestive.

I also take a ton of supplements (maybe too many): vitamin B complex, D, K2, C, fish oil, curcumin, milk thistle, iodide, zinc, selenium, magnesium, collagen protein, iron, adrenal (ashwagandha, rhodiola, theanine), probiotics, glutamine. These are the one I remember! I’d like to take a few as possible since these contribute to higher liver enzymes.

Thoughts? Is there any need to take thyroid meds at all, and if so, what advice on dosage do you offer based on my numbers? I will be working with a new doctor who monitors me more frequently in the future. Thanks again.

[Clutter]

Cleo26,

Your thyroid levels were euthyroid (normal) in March and are better than the results in August after you were prescribed Levothyroxine and T3. Do you feel better or worse for taking Levothyroxine and T3?

Thyroid antibodies are negative for autoimmune thyroiditis (Hashimoto's).

VitD is replete but will drop without supplementation during the winter. I would supplement 1,000iu D3 daily Oct-Apr to maintain levels.

Ferritin is sub optimal and that may be why you are having hairloss. Ferritin is optimal halfway through range. Supplementing iron with 1,000mg vitamin C will raise ferritin.

B12 and folate are good.

Why are you taking so many supplements?

[cleo26 in reply to Clutter]

I was prescribed T3 because my doctor said my T3 levels were low, and because using T3 causes T4 to drop, she prescribed a little T4. As you noted, I had better numbers prior to the thyroid meds supplementation.

The only benefit I've noted is better digestion and somewhat better sleep, though the latter could be a coincidence and a result of something else I've done.

I have had ferritin at as high as 89 in the past, but it just recently declined as I stopped supplementing. Didn't want to risk too high iron levels.

All the supplements: iodide, adrenal, magnesium, zinc, and thyroid support were prescribed by the doctor. Vitamin B because I take metformin and supplement for B12.

Think I should stop the thyroid meds because I'm considering it?

[Clutter in reply to cleo26]

Cleo26,

FT4 may have dropped because you are taking proportionally more T3 than T4. What is strange is that your FT3 has also dropped. Your FT3 is even lower now so options are:

1. Stop supplementing Iodine which can reduce FT4 and FT3. It used to be given to hyperthyroid patients to reduce their thyroid levels, and

2. Stop taking Levothyroxine and T3.

Or:

3. Increase Levothyroxine to 37.5mcg and stay on 10mcg T3 which will raise FT4 and FT3. Or

4. Increase T3 to 20mcg.

Some people need to supplement a maintenance dose of iron to stop ferritin dropping too low. Ferritin is optimal between 75 -100.

[cleo26 in reply to Clutter]

Agree. I was shocked that my T3 was so low even though I was supplementing.

I take 400 mcg of iodide based on both a previous urinary and recent serum blood test indicating iodine insufficiency. I also have goiter and nodules. I was not taking iodine prior the tests. The vitamin levels are reflective of present day levels.

Yep, already started back on the iron.

In summary, you wrote that I was euthyroid. I understood that optimal levels were to be higher range, T3 and T4. Is Option 2 then viable?

Thanks, Clutter.

[Clutter in reply to cleo26]

Cleo26,

TSH, T3 and T4 were euthyroid in March because they were within normal range. Advice that T3 should be in the upper third of range is for patients taking T3 or NDT. It will rarely be that level in unmedicated patients or patients taking Levoothyroxine only. Results were euthyroid in July too because they were in range but they deteriorated and I suspect that is due to taking iodine.

As I see it you can stop taking iodine and see whether thyroid levels improve or continue taking iodine and increase the thyroid replacement you are taking. Increasing Levothyroxine or T3 may shrink the goitre and nodule a little. Option 2 alone doesn't seem viable.

[cleo26 in reply to Clutter]

Clutter, I am confused. I was not taking iodine at the time of any of these tests. As i mentioned the vitamin levels provided were recent, not indicative of levels at the time of the blood draws. To reiterate, I was not on iodine when I was taking thyroid meds.

If I understand your message: Supplement with iron, stabilize on 1000 mg of Vit D.

[Clutter in reply to cleo26]

Cleo26,

I misunderstood. I thought you were taking iodine between March and July.

In that case, I don't know why thyroid levels dropped after you began taking Levothyroxine and T3 and I would increase Levothyroxine dose to 37.5mcg along with the 10mcg T3 and retest in 6-8 weeks.

And yes, supplement iron with vitamin C and supplement vitamin D3.