Hello, I am planning to use T3 since my endo does not support it and my symptoms when on this before very briefly were pretty much improved. I am age 31 and female and my results are
My endo wants my TSH between 1 and 2. I was diagnosed hypothyroid 2013 and I started Levothyroxine 50mcg 8 weeks ago.
Since being on this dose my legs have been feeling fizzy, I have more dry skin on my face and legs, gaining more weight, feeling breathless. Would this all go away if I add T3? Thank you
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Before adding T3 most find it essential to get vitamin levels very good first and to get on high enough dose of Levothyroxine to bring TSH down to around one
You should have bloods retested 6-8 weeks after any change in dose, so get tested this week.
All thyroid tests should be done as early as possible in morning and fasting and don't take Levo in the 24 hours prior to test, delay and take straight after. This gives highest TSH and most consistent results
Also have you had thyroid antibodies tested? Ideally TPO and TG antibodies. If not ask that they are
If results are above range then this is Hashimoto's (also known by medics here in UK more commonly as autoimmune thyroid disease).
About 90% of all hypothyroidism in Uk is due to Hashimoto's
With Hashimoto's, until it's under control, our gut can be badly affected. Low stomach acid can lead to poor absorption of vitamins. Low vitamin levels stop thyroid hormones working.
Essential to test vitamin D, folate, ferritin and B12. Always get actual results and ranges. Post results when you have them, members can advise
Breathless can be low iron
Pain in legs low vitamin D
Dizzy low B12
Ask GP to test
Poor gut function can lead leaky gut (literally holes in gut wall) this can cause food intolerances. Most common by far is gluten
According to Izabella Wentz the Thyroid Pharmacist approx 5% with Hashimoto's are coeliac, but over 80% find gluten free diet helps significantly. Either due to direct gluten intolerance (no test available) or due to leaky gut and gluten causing molecular mimicry (see Amy Myers link)
But don't be surprised that GP or endo never mention gut, gluten or low vitamins. Hashimoto's is very poorly understood
Changing to a strictly gluten free diet may help reduce symptoms, help gut heal and slowly lower TPO antibodies
Plus you need to try strictly gluten free diet for at least 3-6 months to see if it helps. Over 80% with Hashimoto's find noticeable or significant improvements
It should help reduce Hashi swings
But it must be alongside adequate Levothyroxine dose (TSH needs to be around one and FT4 towards top of range)
Vitamin D around 100nmol
Ferritin half way in range
B12 towards to of range
Folate good
Selenium supplements can help improve conversion
Vitamin c supports adrenals
Now endo is managing your case do NOT let GP alter dose
Dr Toft, past president of the British Thyroid Association and leading endocrinologist, 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 the article by emailing louise.roberts@thyroiduk.org print it and highlight question 6 to show your doctor.
Your GP was an idiot reducing the dose so drastically. Dose adjustments should be in 25mcg every six weeks.
You are undermedicated on 50mcg to have TSH 6.36 and endo will need to increase dose in 25mcg increments every 6-8 weeks until TSH is 0.27 - 1.0. Now you are seeing an endocrinologist don't let your GP interfere with the endo's treatment plan. Hold off self medicating T3 until your endo has you optimally dosed.
The goal of Levothyroxine is to restore the patient to euthyroid status. For most patients that will be when TSH is 0.3 - 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 louise.roberts@thyroiduk.org if you would like a copy of the Pulse article.
Thyroid peroxidase and thyroglobulin antibodies are positive for autoimmune thyroid disease (Hashimoto's). There is no cure for Hashimoto's which causes 90% of hypothyroidism. Levothyroxine treatment is for the low thyroid levels it causes. Many people have found that 100% gluten-free diet is helpful in reducing Hashi flares, symptoms and eventually antibodies.
Looks like GP dosing on TSH readings which aren't accurate one taking meds unlessshowing very high! My first thought was that you are undermedicated but I haven't looked at previous vitamins etc so if dire than itspssibly axtwo prong problem butvi would get vitamins sorted first and then retest.
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