T3 please

[jblue]

Hi I am new could someone please tell me where I can get T3 from. My endo told me I am a poor converter. Diagnosed 2013 with hypothyroidism and taking 150mcg levothyroxine. Thanks

TSH 10.3 (0.2 - 4.2)

FREE T4 13.6 (12 - 22)

FREE T3 2.5 (3.1 - 6.8)

[SeasideSusie Remembering]

jblue Can you give us a bit more information please. If your endo says you are a poor converter, why are you not being prescribed T3?

Can you post your latest thyroid test results, to include TSH, FT4 and FT3 all done at the same time. Members can then suggest how much T3 you should start with and if you need to adjust Levo.

Have you had vitamins and minerals tested? Have thyroid antibodies been tested? Are they high, do you have Hashimoto's?

Many recent posts asking for T3 have turned out to be Hashi's which has trashed nutrients which means thyroid hormone can't work. The first step is to optimise nutrients, get TSH to 1 or below so that thyroid hormone works, then we can see whether conversion is poor. Unfortunately, most doctors have had an information bypass where this is concerned.

[jblue in reply to SeasideSusie]

Different endo prescribed it for me. My latest results are

TSH 10.3 (0.2 - 4.2)

FREE T4 13.6 (12 - 22)

FREE T3 2.5 (3.1 - 6.8)

150mcg levothyroxine diagnosed 2013 thanks

[SeasideSusie Remembering in reply to jblue]

jblue So have you had T3 prescribed then taken away by a different endo?

Do you have any results from that time?

Did you do well on it? Did you show a clinical need for it and yet it was still removed? If so you can appeal to get it re-prescribed.

What about vitamins and minerals and thyroid antibodies? Do you have any results?

Your current results show that despite a decent amount of Levo you are still 'undermedicated' to have such a high TSH, but those results wont tell us if your conversion is poor because TSH needs to be very low, around 1. Which makes me think that either you may have Hashi's or your nutrients are trashed.

[jblue in reply to SeasideSusie]

Results from the time I was on T3

TSH <0.02 0.2 - 4.2)

FREE T4 20.6 (12 - 22)

FREE T3 5.5 (3.1 - 6.8)

TSH <0.02 (0.2 - 4.2)

FREE T4 20.3 (12 - 22)

FREE T3 5.2 (3.1 - 6.8)

I did well on it and I showed a clinical need for it and it was still removed. When on 175mcg levothyroxine I showed results of poor conversion

[SeasideSusie Remembering in reply to jblue]

jblue Well, those are pretty good results when you were on T3, although if you didn't feel perfectly well there was room to increase the T3 and reduce the Levo a little.

When you were on 175mcg Levo, was your TSH 1 or below?

From the information below about Hashi's and Vitamins/Minerals, they are a very big part of your problem and need addressing first, then once Levo is working and TSH is 1 or below you can see how well you convert.

[jblue in reply to SeasideSusie]

On 175mcg levothyroxine my TSH was just above 1

[jblue in reply to SeasideSusie]

THYROID PEROXIDASE ANTIBODIES 347.5 (<34)

THYROGLOBULIN ANTIBODIES >1500 (<115)

[SeasideSusie Remembering in reply to jblue]

jblue

Ah, so there we are. Has anyone bothered to tell you that you have autoimmune thyroid disease aka Hashimoto's as confirmed by your high antibodies? This is where antibodies attack the thyroid and gradually destroy it. The antibody attacks cause fluctuations in symptoms and test results.

Hashi's and gut/absorption problems tend to go hand in hand and very often nutrient deficiencies are the result. So do you have test results for those vitamins and minerals I mentioned?

[jblue in reply to SeasideSusie]

Do I post the vitamin and mineral levels here?

[SeasideSusie Remembering in reply to jblue]

Yes please, keeps it all together and saves members asking questions that are covered here.

[jblue in reply to SeasideSusie]

FERRITIN 41 (30 - 400)

FOLATE 2.0 (2.5 - 19.5)

VITAMIN B12 177 (180 - 900)

VITAMIN D TOTAL 28.3 (25 - 50 VITAMIN D DEFICIENCY)

Taking 800iu vitamin D only, had iron stopped in May 2016 due to iron deficiency correcting within 3 years of taking iron tablets and stopped folic acid until intrinsic factor has been tested thanks

[SeasideSusie Remembering in reply to jblue]

jblue

FERRITIN 41 (30 - 400) had iron stopped in May 2016 due to iron deficiency correcting within 3 years of taking iron tablets

So is your MCV/MCHC/haemoglobin now all nicely in range?

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. So you need to incease yours somehow. Some haematologists ask for patients to be rereferred and maybe get an iron infusion if ferritin falls below 50 again. Has anything been mentioned?

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...

You must get your ferritin up for thyroid hormone to work.

**

FOLATE 2.0 (2.5 - 19.5)

VITAMIN B12 177 (180 - 900) stopped folic acid until intrinsic factor has been tested

OK, so you need to wait until intrinsic factor has been tested, if you need B12 injections then they should be started and then start folic acid to treat the folate deficiency. Folate should be half way through it's range.

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."

**

VITAMIN D TOTAL 28.3 (25 - 50 VITAMIN D DEFICIENCY) Taking 800iu vitamin D only

Well, 800iu D3 isn't going to ever raise your level. It is hardly a maintenance dose for someone with a reasonable level. You need 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.

When you start buying your own D3, as you have Hashi's then for better absorption you would be best using an oral spray eg BetterYou.

**

As you can see, your nutrient levels are very poor and these need addressing. The fact that your T3 was removed has probably added to your nutrient problem, but the absorption problems caused by Hashi's will also play a big part.

Please see SlowDragon 's reply to this post on how to address absorption problems, there is much information and links to help healthunlocked.com/thyroidu...

As for Hashi's, 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_...

Once you've addressed the Hashi's, optimised your nutrient levels, then you can see how well Levo is working and you'll know whether you are converting and if T3 is needed. Such a shame that this fundamental information isn't understood by doctors. So many Hypo patients are treated incorrectly and never get well through this sort of ignorance.

[jblue in reply to SeasideSusie]

Thanks my MCV is below range and MCHC above range and nothing more is being done

[SeasideSusie Remembering in reply to jblue]

Below range MCV, above range MCHC suggests that iron deficiency anaemia is still present so you need to be discussing that with your GP, maybe a referral back to you haematologist (if you were under one) but it can't be ignored.

[SlowDragon Administrator]

Essential to improve vitamins, get Levo dose up so that TSH is around one and FT4 towards top of range and FT3 at least half way in range

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.

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

thyroidpharmacist.com/artic...

thyroidpharmacist.com/artic...

amymyersmd.com/2017/02/3-im...

chriskresser.com/the-gluten...

scdlifestyle.com/2014/08/th...

drknews.com/changing-your-d...

Low stomach acid can be an issue

Lots of posts on here about how to improve with Apple cider vinegar or Betaine HCL

thyroidpharmacist.com/artic...

drmyhill.co.uk/wiki/hypochl...

scdlifestyle.com/2012/03/3-...

healthunlocked.com/thyroidu...

Other things to help heal gut lining

Bone broth

thyroidpharmacist.com/artic...

Probiotics

carolinasthyroidinstitute.c...

Importance of magnesium

hypothyroidmom.com/two-vita...