Newbie

[Maddy112]

Hi diagnosed hypothyroid 2012. Endo took my T3 away could someone pm me a supplier please current dose 175mcg levo thanks in advance

TSH 6.80 (0.2 - 4.2)

FT4 12.9 (12 - 22)

FT3 2.6 (3.1 - 6.8)

[SeasideSusie Remembering]

Hi Maddy112

We see lots of posts like yours, and usually there is a lot more to it when we've asked some questions and got a bit more background.

Your current results show that you are undermedicated, the aim of a treated hypo patient generally is for TSH to be 1 or below with free Ts in the upper part of their reference ranges when on just Levo.

However, taking your T3 away has not only affected your test results, and no doubt your symptoms, but it can also affect your nutrient levels and unless these are optimal thyroid hormone can't work and it would be useless reintroducing T3 at this staged.

Can you fill in some background.

Have you a proven clinical need for T3? Did you feel better and your results and symptoms show improvement? Then you should be able to continue having it prescribed.

Was it the endo who prescribed T3 who removed it, or a different endo?

When was it removed?

Have you had thyroid antibodies tested? If so were they high, do you have Hashimoto's?

Have you had vitamins and minerals tested? If so what are the results, do you supplement and with what dose?

[Maddy112 in reply to SeasideSusie]

I have a proven need for T3 and I felt better and my results and symptoms showed improvement

Different endo

Removed June 2017

Antibodies positive

TPO antibody 647 (<34)

TG antibody 779.3 (<115)

Ferritin 37 (30 - 400)

Folate 2.3 (2.5 - 19.5)

Vitamin B12 26 (190 - 900)

Vitamin D total 28.8 (25 - 50 deficiency)

Taking 800iu D3

Taking ferrous fumarate

Taking 5mg folic acid

[Nanaedake in reply to Maddy112]

Is your B12 result correct? If so you are terribly deficient

Who prescribed the folic acid? If GP, did he/she rule out pernicious anaemia by testing intrinsic factor?

[Maddy112 in reply to Nanaedake]

Yes B12 26 GP prescribed folic acid and pernicious anemia not ruled out

[SeasideSusie Remembering in reply to Maddy112]

Maddy

OK, so here is one of your problems:

Antibodies positive

So that confirms autoimmune thyroiditis aka Hashimoto's. Has anyone ever told you that? This is where antibodies attack the thyroid and gradually destroy it. The antibody attacks cause fluctuations in symptoms and test results. Most doctors dismiss antibodies as being of no importance and know little or nothing about Hashi's and how it affects the patient, test results and symptoms. You need to read, learn, understand and help yourself where Hashi's is concerned.

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 can very often result in low nutrient levels or deficiencies, and here is another of your problems.

Ferritin 37 (30 - 400) Taking ferrous fumarate

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. Ideally, because your level is so low, you do do with an iron infusion but I doubt you'll get one. 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...

How much ferrous fumarate are you taking? Low ferritin can suggest iron deficiency anaemia - have you had an iron panel and full blood count? Has iron deficiency anaemia been confirmed? If so, are you taking the appropriate amount of ferrous fumarate which is 3 tablets daily.

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.

**

Folate 2.3 (2.5 - 19.5)

Vitamin B12 26 (190 - 900) Taking 5mg folic acid

I am hoping your B12 result is a typo, maybe it is 226? Were you checked for signs of B12 deficiency before starting the folic acid? Check here b12deficiency.info/signs-an... (be aware that taking folic acid masks signs of B12 deficiency so think back to before you started taking it)and, if your B12 is as low as 226, you might want to post on the Pernicious Anaemia Society forum for further advice healthunlocked.com/pasoc

You may need intrinsic factor antibodies testing, you may have Pernicious Anaemia, you may need B12 injections. All this should be done before starting folic acid.

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."

**

Vitamin D total 28.8 (25 - 50 deficiency) Taking 800iu D3

800iu D3 is inappropriate for your level of Vit D. You should have been given 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.

As you have Hashi's, when you buy your own D3 you will be best getting an oral spray for better absorption. BetterYou do a D3 spray and a D3/K2-MK7 combined spray.

**

Your malabsorption means that even supplementing wont optimise your nutrient levels, and thyroid hormone can't work unless nutrients are optimal. You need to work on the absorption problem, check out SlowDragon 's reply to this post for information and links to help healthunlocked.com/thyroidu...

So at the moment there are things to address before reintroducing T3. It's just a shame that doctors don't understand all that is involved with hypothyroidism and Hashi's.

**

There are replies in this thread that explain how to go about getting T3 reinstated, but at the moment the other factors need work before the T3 will be of much help healthunlocked.com/thyroidu...

[Maddy112 in reply to SeasideSusie]

Iron deficiency diagnosed 2013 was severe enough to need iron infusion and I take one iron tablet now. B12 is 26 and I haven't been checked for B12 deficiency

[SeasideSusie Remembering in reply to Maddy112]

Maddy

1 x ferrous fumarate is insufficient for iron deficiency - 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.

Discuss your treatment with your GP or haematologist, whoever is in charge of this aspect of your health.

**

B12 is 26

Well, I am surprised you are still functioning! That has to be the very lowest result we have ever seen. If your GP has ignored this result then he has been extremely negligent and needs reporting, not just to the Practice Manager but to the GMC.

Please go straight over to the Pernicious Anaemia Society forum for further advice as detailed in my previous reply.

**

I am deadly serious about making a formal complaint for negligence about this GP, if you want to know what can happen when B12 deficiency is ignored, start watching the first film in this link b12deficiency.info/films/ You wont need to watch it all to understand how serious this GP's negligence is.

[silverfox7]

Talk about 'Your life in their hands' ! Yet another frightening post showing doctors haven't a clue!

Good advice given but how doctors can test and then ignore under range and low in range readings is frightening. Get you minerals and vitamins sorted and see a different doctor in the practice in the future if you can. The T3 was probably just papering over the. Racks before as so many other things need to be optimal to make medication work.

Hope you soon start feeling better though it can take time to build up to optimal doses