Help needed please

[Praia]

Newbie here. Can I take T3. I am taking 150mcg Levo, diagnosed hypothyroid 2012 with no improvement in symptoms. Thankyou

TSH 5.2 (0.2 - 4.2)

FREE T4 13.2 (12 - 22)

FREE T3 3.1 (3.1 - 6.8)

TPO ANTIBODIES 803.5 (<34)

TG ANTIBODIES 256.3 (<115)

[SeasideSusie Remembering]

Praia What makes you ask? Have you been prescribed it before and had it taken away?

To know if you would benefit from T3 you would need to post your latest thyroid test results to include TSH, FT4 and FT3, all with their reference ranges.

Can you also tell us:

Have you had vitamins and minerals tested - Vit D, B12, Folate, Ferritin, maybe Iron Panel and Full Blood Count? If so please post results with their ranges, and say if you are supplementing and what dose.

Have you had thyroid antibodies tested - TPO and TG - were they high - Hashimoto's?

[Praia in reply to SeasideSusie]

I had it prescribed and taken away results added. Thankyou

[SeasideSusie Remembering in reply to Praia]

Praia

Why was it taken away?

What has your doctor said about your current results, they show you are undermedicated.

Did you know that you have autoimmune thyroiditis aka Hashimoto's as confirmed by your high antibodies? The antibody attacks cause fluctuations in symptoms and test results.

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 the result is low nutrient levels. You need those vitamins and minerals tested that I mentioned above to see if you have any problems there. All need to be optimal for thyroid hormone to work and if they're not optimal you need to address any absorption problem you might have.

[Praia in reply to SeasideSusie]

Thankyou it was taken away because of below results on 150mcg levothyroxine and T3 5mcg twice a day

TSH <0.02 (0.2 - 4.2)

FREE T4 21.3 (12 - 22)

FREE T3 4.7 (3.1 - 6.8)

No I didn't know I have Hashimotos

[SeasideSusie Remembering in reply to Praia]

Praia

You have a doctor who doesn't know what he's doing regarding treating hypothyroidism.

There is nothing wrong with those results and for a doctor who prescribes T3 he ought to know that taking it suppresses TSH (which is probably why he took it away).

Your FT4 and FT3 were in range so you were not overmedicated. In fact, you could have done with an increase in your T3 to bring it higher up in range, it was far too low considering where your FT4 level was. You can only be overmedicated when FT3 is over range.

So now you have been plunged into hypothyroidism with an over range TSH and very low FT4 with just at the bottom of range FT3. You could do with the reintroduction of T3 to get your FT3 up in range, I don't think there's much point in increasing your Levo as that will push your FT4 over range and possibly result in reverse T3.

[Praia in reply to SeasideSusie]

6000IU vitamin D since March 2015

5mg folic acid since November 2016

210mg ferrous fumarate since November 2013

B12 injections since August 2017

Latest results

FERRITIN 22 (30 - 400)

FOLATE 2.1 (2.5 - 19.5)

VITAMIN B12 242 (190 - 900)

TOTAL 25 OH VITAMIN D 28.3 (25 - 50 VITAMIN D DEFICIENCY. SUPPLEMENTATION IS INDICATED)

IRON 5.2 (6 - 26)

TRANSFERRIN SATURATION 13 (12 - 45)

Only things flagged up from complete blood count were

HAEMOGLOBIN ESTIMATION 112 (115 - 150)

MCV 76.1 (80 - 98)

MCHC 388 (310 - 350)

[SeasideSusie Remembering in reply to Praia]

Praia

As you are Hashi's it would appear that you have an absorption problem and this has trashed your nutrient levels.

TOTAL 25 OH VITAMIN D 28.3 (25 - 50 VITAMIN D DEFICIENCY. SUPPLEMENTATION IS INDICATED) 6000IU vitamin D since March 2015

You are very deficient and should actually be on loading doses - 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/

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.

Once you've finished the loading doses, when you buy your own supplement you would be better with an oral spray for better absorption. BetterYou does a D3 spray, also a De/K2-MK7 combined spray.

**

FERRITIN 22 (30 - 400)

HAEMOGLOBIN ESTIMATION 112 (115 - 150)

MCV 76.1 (80 - 98)

MCHC 388 (310 - 350)

IRON 5.2 (6 - 26)

TRANSFERRIN SATURATION 13 (12 - 45)

210mg ferrous fumarate since November 2013

How much ferrous fumarate are you taking? Is it 1 or 2 or maybe 3 a day.

Alll these results suggest iron deficiency anaemia. If you have had this diagnosis confirmed then your treatment should be 2 or 3 x ferrous fumarate daily and each iron tablet should be taken 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 are only taing 1 x ferrous fumarate daily, point out the appropriate treatment to your GP - see 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...

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.

For thyroid hormone to work (that's our own as well as replacement hormone) ferritin needs to be at least 70, preferably half way through range. As yours is below range you should ask for an iron infusion which will raise your level within 24-48 hours, tablets will take many months. You can also 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...

**

FOLATE 2.1 (2.5 - 19.5)

VITAMIN B12 242 (190 - 900)

5mg folic acid since November 2016

B12 injections since August 2017

B12 should have been started before the folic acid. You should go and post on the Pernicious Anaemia Society forum for further advice healthunlocked.com/pasoc

**

You need to address the absorption problem so that your nutrients can be absorbed, which should hopefully optimise your vitamin and mineral levels, and then your thyroid hormone should be able to work. See the reply by SlowDragon in this post on how to address gut/absorption problems with Hashi's healthunlocked.com/thyroidu...

[Praia in reply to SeasideSusie]

3 iron tablets a day since 2013 thankyou

[SeasideSusie Remembering in reply to Praia]

Praia

So you're having the correct treatment for iron deficiency anaemia.

So as all those results are current, and as you have been supplementing for such a long time and still have severe deficiencies, there is very obviously an absorption problem going on here.

You must ask your GP to investigate.