Advice please - starting T3 and high TPO antibodies

[Lou89]

HI I have just joined, I have hypothyroidism diagnosed 2011 and also TPO antibodies of 804.5 IU/mL (<34). I take 75mcg levothyroxine however I have started 10mcg T3 this morning and I am wondering when I will notice the full benefit of T3? I have symptoms of tiredness, constipation, cold intolerance, hair loss, heavy periods, weight gain, joint and muscle pain. Thankyou

OCT-2017 (results on 75mcg levothyroxine only)

TSH 7.1 mIU/L (0.27 - 4.20)

Free T4 13.9 pmol/L (12.0 - 22.0)

Free T3 2.6 pmol/L (3.10 - 6.80)

[Clutter]

Welcome to the forum, Lou89.

You are very undermedicated to have TSH 7.1 and FT3 so far below range. I think you will probably need more than 10mcg T3 to improve levels and symptoms. You should have a thyroid function test and FT3 checked 6-8 weeks after starting T3 as you will almost certainly need an increase in T3 or Levothyroxine. Arrange the blood test early in the morning when TSH is highest, and fast (water only) as TSH drops after eating and drinking. Take Levothyroxine and T3 after your blood test.

Ask your GP to check ferritin, vitamin D, B12 and folate which are commonly low/deficient in hypothyroid patients and may be causing some of the symptoms you are experiencing.

[SlowDragon Administrator]

Neither T4 or T3 will work if your vitamins are too low

You are very under medicated to have TSH so high. GP should have increased Levo by 25mcg steps retesting each time after 6-8 weeks until TSH is around one and FT4 towards top of range

Essential to test vitamin D, folate, ferritin and B12.

Always get actual results and ranges. Post results when you have them, members can advise

Low vitamin levels stop Thyroid hormone 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...

With Hashimoto's it's very likely you may be gluten intolerant and find benefit or essential to be strictly gluten free

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 articles from Thyroid UK email [e-mail]. print it and highlight question 6 to show your doctor.