T3

[Ava9]

New member going to reintroduce T3. Currently on 150mcg levothyroxine, how much to reduce this by please. Diagnosed hypothyroid 2014. Thankyou

OCT 17

TSH *5.8 (0.2 - 4.2)

Free T4 13.7 (12 - 22)

Free T3 3.8 (3.1 - 6.8)

[SeasideSusie Remembering]

Well, you're not really on enough Levo according to those results. Your TSH is over range, FT4 very low in range, FT4 and FT3 although low in range are balanced, you can't work out how well you're converting until your TSH is down to about 1 or below.

How come you're only on 150mcg Levo, why no increase with such a high TSH?

Are all your vitamins and minerals optimal? They need to be for thyroid hormone to work. Have they been tested:

Vit D

B12

Folate

Ferritin

Have you had thyroid antibodies tested - are they high - Hashimoto's?

[Ava9 in reply to SeasideSusie]

The GP reduced me from 150mcg levothyroxine to 100mcg and now I am back to 150mcg. I was meant to have an increase but because the endo does not know my GP reduced I haven't raised dose

[SeasideSusie Remembering in reply to Ava9]

I really think endos and GP should communicate and decide who is the one that is going to control dose.

Have you had T3 prescribed previously by endo?

[Ava9 in reply to SeasideSusie]

Yes

[SeasideSusie Remembering in reply to Ava9]

You might want to elaborate on 'Yes'.

How about some results. What were the results which prompted adding T3? What were the results when on T3? Why were you taken off T3 - reason and results? Is endo reintroducing T3 or are you planning to self source.

The more information we have, the more we can help.

[Ava9 in reply to SeasideSusie]

Results before T3 given

TSH 1.60 (0.2 - 4.2)

Free T4 19.8 (12 - 22)

Free T3 3.9 (3.1 - 6.8)

Taking 200mcg levo

Results when taken off

TSH 0.07 (0.2 - 4.2)

Free T4 22.6 (12 - 22)

Free T3 4.5 (3.1 - 6.8)

Taking 100mcg levo and 10mcg T3

Endo said overtreated

[SeasideSusie Remembering in reply to Ava9]

Ava

So here we have an endo who prescribes T3 but doesn't know how to treat with T3 or what it does.

The results which prompted the addition of T3, in the circumstances he was right to introduce it because your FT3 was low and your T4 to T3 conversion poor.

These results, when endo said you were overtreated:

TSH 0.07 (0.2 - 4.2)

Free T4 22.6 (12 - 22)

Free T3 4.5 (3.1 - 6.8)

Taking 100mcg levo and 10mcg T3

actually show that you weren't on enough T3.

Your endo ought to know that taking T3 will lower, or even suppress TSH so that result is of no consequence. Your FT4 was very slightly over range, he could have reduced your Levo by a small amount. Your FT3 was still low in range - in fact no much more than before you started taking T3 - so he should have increased your T3 to get your FT3 nearer the upper part of the range.

The problem is most endos are diabetes specialists and know very little about treating hypothyroidism. They play about with adding T3, taking it away because they don't understand how it works. Then leave the patient to suffer.

If you reintroduce the T3 you have left, once you've finished it what then? Are you going to tell your endo or GP that you're reintroducing it?

What you really need to do is gather all the information in the different replies in this thread. Realise that most doctors know nothing about how important optimal nutrient levels and good absorption is in treating hypothyroidism so do everything you can to help yourself get well, so:

* Address the Hashi's with a strict gluten free diet and supplementing with selenium.

* Address the gut/absorption problems by following the advice in the post by Slow Dragon I linked to.

* Optimise all your nutrients

When all these things have been sorted and all the building blocks are in place for thyroid hormone to work, check your levels and then see if you need T3 added, then decide which route you take - endo or self treat.

[Ava9 in reply to SeasideSusie]

Planning to use what I have left

[Ava9 in reply to SeasideSusie]

Results what I posted initially were after it was stopped

[SeasideSusie Remembering in reply to Ava9]

Ava

You currently need an increase in Levo while you are tackling all the issues mentioned.

[Ava9 in reply to SeasideSusie]

TPO antibody 503.5 (<34)

TG antibody 376.3 (<115)

I think this is Hashimotos

[SeasideSusie Remembering in reply to Ava9]

Ava

Yes, it is Hashi's and will be causing problems all round. Hashimoto's is where antibodies attack the thyroid and gradually destroy it. The antibody attacks cause fluctuations in symptoms and test results. Most doctors don't understand Hashi's and haven't a clue about dosing, so doses get increased/decreased/increased/stopped according to how the endo feels, whether he knows anything about it, sometimes the patient gets blamed for abusing meds, not taking meds, it's a minefield and a nightmare. And as most endos are diabetes specialists playing at pretending to know how to treat hypothyroidism, there's not much help forthcoming from them.

Read and learn, educate yourself so you can help yourself.

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_...

**

Hashi's and gut/absorption problems tend to go hand in hand and very often low nutrient levels are the result. It's very important to have them tested so ask for those listed above if not already done. And if ferritin is low then you need an iron panel and full blood count to see if there is any iron deficiency anaemia.

All nutrients need to be optimal for thyroid hormone to work. Hashi's trashes nutrients so it's important to address this.

[Ava9 in reply to SeasideSusie]

Thankyou I supplement but levels aren't improving

[SeasideSusie Remembering in reply to Ava9]

This is likely due to absorption problems. Would you like to post the details? Results before, what are you taking, latest results.

[Ava9 in reply to SeasideSusie]

Ferritin (before iron infusion 2016) 15 (15 - 150)

Ferritin (Feb 2017) 44 (15 - 150)

No iron

Vitamin D (2014) 27.2

Vitamin D (June 2017) 29.6

800iu vit D

Folate (Nov 2016) 2.3 (2.5 - 19.5)

Folate (June 2017) 2.1 (2.5 - 19.5)

Folic acid 5mg

Vitamin B12 (June 2017) 228 (190 - 900)

[SeasideSusie Remembering in reply to Ava9]

Ava

Ferritin (before iron infusion 2016) 15 (15 - 150)

Ferritin (Feb 2017) 44 (15 - 150)

Are you seeing a haematologist? Some ask for the patient to be referred back for another infusion if ferritin falls below 50.

As your level was so very low originally, you should have had an iron panel and full blood count. Ask for those now to see if you have iron deficiency anaemia.

Are you taking any iron tablets? You need something to raise your ferritin which needs to be at least 70 for thyroid hormone to work. You can help raise your level by eating liver regularly, maximum 200g per week due to it's high Vit A content, and including lots of iron rich foods in your diet apjcn.nhri.org.tw/server/in...

**

Vitamin D (2014) 27.2

Vitamin D (June 2017) 29.6

800iu vit D

I think you should ask your GP the following question:

"Considering I've been supplementing with D3 for 3 years, how come my level has only been raised by 2.4 points?"

He wont admit it but the answer is because you are on the wrong dose. You were 2.2 away from severe deficiency, are still 4.6 away from severe deficiency. You should be on loading doses and 800iu will never, ever raise your level - see 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 maintenace treatment of about 800 IU a day. Higher doses of up to 2000IU 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 regims 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 ask that he treats you according to the guidelines and prescribes the loading doses. Once these have been completed you will need a reduced amount (more than 800iu so post your new result as the time for members to suggest a dose) to bring your level up to what's recommended by the Vit D Council - which is 100-150nmol/L - and then you'll need a maintenance dose 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/

If your GP refuses the loading doses, come back and we can tell you what to buy.

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 helps D3 to work and 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.

As you are Hashi's, once you start buying your own D3 you should get an oral spray for better absorption, eg BetterYou. They do D3 alone or D3/L2-MK7 combo.

**

Folate (Nov 2016) 2.3 (2.5 - 19.5)

Folate (June 2017) 2.1 (2.5 - 19.5)

Folic acid 5mg

Vitamin B12 (June 2017) 228 (190 - 900)

Were you checked for signs of B12 deficiency before starting folic acid? You should have been, you can check here b12deficiency.info/signs-an... but be aware that taking folic acid masks B12 deficiency symptoms so you may need to think back.

You should take these results over to the Pernicious Anaemia Society forum for further advice healthunlocked.com/pasoc also quote your ferritin results and any signs of B12 deficiency you may have or are currently experiencing.

I have read (but not researched so don't have links) that BCSH, UKNEQAS and NICE guidelines recommend:

"In the presence of discordance between test results and strong clinical features of deficiency, treatment should not be delayed to avoid neurological impairment."

And an extract from the book, "Could it be B12?" by Sally M. Pacholok:

"We believe that the 'normal' serum B12 threshold needs to be raised from 200 pg/ml to at least 450 pg/ml because deficiencies begin to appear in the cerebrospinal fluid below 550".

"For brain and nervous system health and prevention of disease in older adults, serum B12 levels should be maintained near or above 1000 pg/ml."

**

Because Hashi's causes absorption problems, which has caused your dire nutrient levels, you need to address the absorption issue. Check out SlowDragon 's reply to this post for information and links to help healthunlocked.com/thyroidu...

[Ava9 in reply to SeasideSusie]

No longer under haematologist was discharged and MCV below range MCHC above range Haemoglobin under range iron under range thankyou

[SeasideSusie Remembering in reply to Ava9]

Ava

MCV below range MCHC above range Haemoglobin under range

So you are still iron deficient. It needs sorting. Either get your GP to do something or ask for a referral back to your haematologist.

[Ava9 in reply to SeasideSusie]

No longer taking iron tablets