New member am I undermedicated?
TSH 6.2 (0.2 - 4.2)
Free T4 13.8 (12 - 22)
Free T3 4.0 (3.1 - 6.8)
Taking 50mcg diagnosed 2013 and I want to go into taking T3 thanks
Symptoms
Constipation with stool blocking toilet
Muscle cramps
Tiredness
Bone pain
Feeling cold
Low stamina with sweating
Periods bleeding through clothes
Kasha2
Yes you are undermedicated but your post is lacking in information for anyone to offer much help.
As you were diagnosed in 2013, have you always been on 50mcg Levo? If not, what other doses and what were the results at those times, and why were doses changed?
Have you had thyroid antibodies tested, were they high - Hashimoto's?
Have you had vitamins and minerals tested, these need to be optimal for thyroid hormone to work, if tested please post results, with ranges, and say if you are supplementing any of them:
Vit D
B12
Folate
Ferritin
Iron Panel
Full Blood Count
You may want to start taking T3 but you don't know, at the moment, if it's the correct thing to do. You need to know if you convert T4 to T3. But you need to have your TSH at 1 or below to see where your FT4 and FT3 lie and then you will know if you convert well enough.
So you need an increase in your Levo to start with to get your TSH down. You need optimal vitamins and minerals so that your Levo can work properly. If you have Hashi's then that can cause absorption problems so that would need addressing. Then when all those building blocks are in place you will then be able to see from your results whether you need T3.
Ask your GP for an immediate increase in Levo of 25mcg, retesting/increasing by 25mcg every 6 weeks until your TSH is 1 or below and free Ts in the upper part of their ranges. In support of this use the following information 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.
The booklet is written by Dr Anthony Toft, past president of the British Thyroid Association and leading endocrinologist. It's published by the British Medical Association for patients. Avalable on Amazon and from pharmacies for £4.95 and might be worth buying to highlight the appropriate part and show your doctor. However, I don't know if this is in the current edition as it has been reprinted a few times.
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 the article by emailing louise.roberts@thyroiduk.org print it and highlight question 6 to show your doctor.
No was on 175mcg levo before that and my free T4 was 19.3 and free T3 3.9
Well, if you can give us all the information asked for in my previous post, we can go further with this.
When were you on 175mcg Levo, what dose was it changed to and why? Just the one dose change or more? We can only help if we have the information, and at the moment you haven't given us very much I'm afraid.
Sep 2017 (175mcg levo) T3 taken away
TSH 0.03 (0.2 - 4.2)
Free T4 19.3 (12 - 22)
Free T3 3.9 (3.1 - 6.8)
Jan 2017 (175mcg levo and 10mcg T3)
TSH 1.66 (0.2 - 4.2)
Free T4 15.9 (12 - 22)
Free T3 4.5 (3.1 - 6.8)
Nov 2016 (175mcg levo and 10mcg T3) GP reluctant to change dose
TSH 3.89 (0.2 - 4.2)
Free T4 18.3 (12 - 22)
Free T3 5.0 (3.1 - 6.8)
Jun 2016 (75mcg levo)
TSH 3.30 (0.2 - 4.2)
Free T4 13.1 (12 - 22)
Free T3 4.6 (3.1 - 6.8)
Feb 2016 (25mcg levo) starting again with dose
TSH 6.80 (0.2 - 4.2)
Free T4 12.8 (12 - 22)
Free T3 4.2 (3.1 - 6.8)
Dec 2015 (100mcg levo and 10mcg T3) increased because still symptomatic
TSH 0.08 (0.2 - 4.2)
Free T4 22.9 (12 - 22)
Free T3 4.7 (3.1 - 6.8)
Oct 2015 (75mcg levo and 10mcg T3)
TSH <0.02 (0.2 - 4.2)
Free T4 20.5 (12 - 22)
Free T3 5.5 (3.1 - 6.8)
Sep 2015 (75mcg levo and 10mcg T3) T3 started because endo thought it would help
TSH <0.02 (0.2 - 4.2)
Free T4 20.8 (12 - 22)
Free T3 5.6 (3.1 - 6.8)
Jun 2015 (175mcg levo)
TSH 1.30 (0.2 - 4.2)
Free T4 19.8 (12 - 22)
Free T3 4.1 (3.1 - 6.8)
Mar 2015 (150mcg levo)
TSH 5.21 (0.2 - 4.2)
Free T4 23.2 (12 - 22)
Free T3 5.3 (3.1 - 6.8)
TPO antibodies 208.5 (<34)
TG antibodies >1200 (<115)
Nov 2014 (125mcg levo)
TSH 6.10 (0.2 - 4.2)
Free T4 15.8 (12 - 22)
Free T3 4.2 (3.1 - 6.8)
Aug 2014 (50mcg levo)
TSH 0.02 (0.2 - 4.2)
Free T4 20.3 (3.1 - 6.8)
Free T3 6.2 (3.1 - 6.8)
TPO antibody 191 (<34)
Kasha2
For a start, dose changes of Levo should be done in 25mcg increments, so to incease from 50mcg to 125mcg after your August 2014 result was madness.
To add T3 after your June 2015 result was correct because you showed signs of poor conversion and these results looked pretty good
Oct 2015 (75mcg levo and 10mcg T3):
TSH <0.02 (0.2 - 4.2)
Free T4 20.5 (12 - 22)
Free T3 5.5 (3.1 - 6.8)
How did you feel?
*
Presumably these results
Dec 2015 (100mcg levo and 10mcg T3) increased because still symptomatic:
TSH 0.08 (0.2 - 4.2)
Free T4 22.9 (12 - 22)
Free T3 4.7 (3.1 - 6.8)
prompted your doctor to start you off on 25mcg Levo again. Why? It was sheer madness and sadistic. You just don't decrease thyroid dose by the equivalent 105mcg (10mcg T3 is equivalent to 30mcg Levo)
*
So reducing you to 25mcg Levo gave you these results:
Feb 2016 (25mcg levo) starting again with dose
TSH 6.80 (0.2 - 4.2)
Free T4 12.8 (12 - 22)
Free T3 4.2 (3.1 - 6.8)
*
Then after your June results you had a massive increase from 75mcg Levo to 175mcg Levo plus 10mcg T3 - the equivalent of 130mcg Levo - sheer madness again!
What was wrong with these results:
Jan 2017 (175mcg levo and 10mcg T3)
TSH 1.66 (0.2 - 4.2)
Free T4 15.9 (12 - 22)
Free T3 4.5 (3.1 - 6.8)
that warranted the removal of your T3? You were undermedicated here.
*
And now on 175mcg Levo these results show that you need T3:
TSH 0.03 (0.2 - 4.2)
Free T4 19.3 (12 - 22)
Free T3 3.9 (3.1 - 6.8)
*
Best advice - sack this idiot doctor and find one who actually has a clue about treating hypothyroidism.
**
Also
TPO antibodies 208.5 (<34)
TG antibodies >1200 (<115)
Your high antibodies mean that you are positive for autoimmune thyroid disease aka Hashimoto's which is where antibodies attack the thyroid and gradually destroy it. The antibody attacks cause fluctuations in symptoms and test results.
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. These are called 'Hashi's flares' or 'swings'. 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 type swings, then they panic and reduce or stop your thyroid meds.
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.
It looks very much as though your results listed are frequently the result of these Hashi's flares. Pity your doctor doesn't understand what Hashi's does. Most of them don't, so read, learn and educate yourself because no-one else is going to help you here.
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_...
So now that we know that you have Hashi's, there's a very good chance that your nutrient levels are low, which is very often the result of Hashi's because it causes gut/absorption problems.
You need good nutrient levels for thyroid hormone to work, so you need to address absorption problems so that you can get your nutrient levels up.
So, post the results with ranges, tell us what you are supplementing and what dose, and for how long you've been supplementing, and we can take it from there.
With the October 2015 results I felt well and my puffy eyes had gone.
The December 2015 results were ones that confused my endo and she wanted me to start again
The January 2017 results were ones that were ordered by endo but acted on by the GP who told me to remove the T3
Kasha
Your October results were good, you felt good, you should have stayed on the doses you were on at the time.
Why was the GP acting on those results when the tests were ordered by the endo? The endo should have decided what to do.
You have been messed about by doctors who haven't a clue. Your endo is most likely a diabetes specialist, most of them are, and they pretend to know what they're doing but they're actually playing at treating hypothyroidism.
The best thing you can do is email louise.roberts@thyroiduk.org and ask for the list of thyroid friendly endos. Ask for feedback on the forum for any in your area, then ask to be referred.
If necessary, change your GP, but most of all you are going to have to learn about your condition so that you can help yourself.
Kasha2... Again... I am not a medical professional but it looks to me like you may have Hashimotos from your antibody numbers back in 2015. This is an autoimmune illness where the body attacks itself, in this case, your body is attacking your thyroid gland. This can result in large doses of thyroid hormone being released during attacks (feelings of being hyper) and feeling hypo when the thyroid is not being attacked.
You aren't going to like hearing this but.. if a blood test confirms that you still have high antibody numbers which will indicate hashis, you must go gluten free and start taking selenium, 200 - 400 mcg (that is micrograms, NOT milligrams) daily. This will help to start lowering those antibody numbers. Here is a good article on thyroid, hashis and selenium. I am sure there are good sources of information in the UK also (I am in the states). jeffreydachmd.com/hashimoto...
This is part I. There is a part II and part III (look at the top of the article). I would strongly suggest that you get labs to verify that you have hashis, also ck for Reverse T 3. This last test can indicate that you are storing your thyroid hormone instead of it getting into your cells. Pooling can also cause this. Get these tests even if you have to go private.
Flooding can also be a signal that your progesterone is low and your estrogen is high. Supplementing with over-the-counter natural progesterone cream for 10 - 12 days out of the month can help immensely with this problem and with sleep problems. If you need instructions, just let me know. A good reference book is "What Your Doctor May Not Tell You About Menopause" by Dr. John Lee. If you do get your sex hormones checked be sure to use saliva tests, not blood tests. The saliva tests are much more accurate.
Yes... by your numbers, you are woefully under-medicated. Your Free T 3 should be in the upper end of values and your Free T 4 should be mid-range. Your TSH should be 1+/-. I am not a medical professional but... I would think increasing your T 4 medication (Synthroid or levothyroxine) first before jumping on the T 3 supplementation bandwagon might be a more prudent move? If increasing your levo does NOT produce an improvement in your labs, then it might be time to think about going to T3 or NDT supplementation.
Have you had your D3, B12 and iron checked? If those numbers aren't optimal, it can make dosing thyroid meds problematic and difficult to stabilize.
Yes can post them I supplement but they're not improving at all
Been on levothyroxine since diagnosis with free T3 at the bottom and no improvement in symptoms thanks
Some questions about T3
A question about blood test timing 
T3 question about doing schedule 
Newbie with a question about NDT
