Thyroid UK
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Results been told normal

TSH 4.60 (0.2 - 4.2)

FT4 14.7 (12 - 22)

FT3 3.0 (3.1 - 6.8)

Hiya, I am new and I have really crippling constipation pain in the left part of my gut. I was diagnosed with hypothyroidism in 2010. I take 50mcg levothyroxine, also been sleeping more during the day, making mistakes at work, feeling cold, thyroid swelling in my neck.

Currently waiting for my endo to get back to me but he's taking his time in contacting me. I can't afford to make mistakes at work all the time, it's getting me down.

Thyroid results I have been told by receptionist are all normal. Was taking T3 previously.

Thanks

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You are undermedicated. The aim of a treated hypo patient generally is for TSH to be 1 or below or wherever it needs to be for FT4 and FT3 to be in the upper part of their respective reference ranges when on Levo.

What happened with the T3? Why was it taken away? Do you have results from when it was decided you should have it prescribed, and again when it was removed? Who removed it - was it a different endo? Why was it removed?

Having T3 removed can have the effect of lowering nutrient levels. You need Vit D, B12, folate and ferritin tested.

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The T3 was prescribed in November 2015 by my first endo, it was taken away after the new one decided I was thyrotoxic on it and it was removed in June 2017.

Nov 2015 (150mcg levothyroxine)

TSH 1.08 (0.2 - 4.2)

FT4 19.2 (12 - 22)

FT3 4.1 (3.1 - 6.8)

June 2017 (150mcg levothyroxine and 10mcg T3)

TSH <0.02 (0.2 - 4.2)

FT4 22.8 (12 - 22)

FT3 4.5 (3.1 - 6.8)

Thanks

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You weren't thyrotoxic. The endo is probably a diabetes specialist who doesn't understand hypothyroidism and how to treat it. In June your FT3 was in range, quite low in range actually. Rather than take your T3 away, he should have lowered your Levo and increased your T3 to bring that further up in the range. You can only be overmedicated if FT3 is over range.

I also have TPO antibodies of 476 (<34) and TG antibodies of 255.8 (<115)

Your raised antibodies confirm autoimmune thyroiditis aka Hashimoto's which is where antibodies attack the thyroid and gradually destroy it. Most doctors know little or nothing about antibodies and dismiss them. You should read, learn and help yourself where this 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_...

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Having Hashi's generally causes gut/absorption problems and nutrient levels are often low or deficient. Taking away T3 will also have had an effect on your nutrient levels.

What was your Vit D level? 800iu wont be enough to raise your level because it's barely a maintenance dose for someone with a decent level to start with.

You also need ferritin, folate and B12 testing.

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No longer on iron since the GP isn't helping me with that anymore. B12 being taken care of since I am on B12 injections as well. Folic acid was taking but waiting on intrinsic factor antibody results before restarting it

Vitamin D total 55.6 (50 - 75 suboptimal) taking 800iu but thinking about taking 3000iu oral spray by Better You

Ferritin 64 (30 - 400) diagnosed iron deficient in 2011

Folate 2.1 (2.5 - 19.5)

Vitamin B12 235 (190 - 900)

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Yes, change to BetterYou spray and take at least 3000iu, possibly double dose for a couple of months then retest. The Vit D Council recommends a level of 100-150nmol/L.

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.

Ferritin 64 (30 - 400) diagnosed iron deficient in 2011

Are you still iron deficient?

You need to get your ferritin up to at least 70 for thyroid hormone to work. 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...

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I have MCHC over range 368 (310 - 350) and MCV 83.1 (83 - 98) so I think I'm iron deficient?

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If your MCV was 82.9 it would be iron deficiency anaemia - low MCV and high MCHC indicate iron deficiency anaemia. It might be worth mentioning these results to whichever doctor might be helpful.

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Also endo wants my ferritin about 70

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If your endo has suggested that, is he helping you with that considering your GP isn't?

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No he is not helping me with it at all

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I think you should do one of two things

1) Suggest to your endo that if he wants your ferritin at 70 he should do something about it

2) Tell your GP that endo wants your ferritin to be 70 so will s/he do something about it.

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Receptionists dont or shouldn't diagnose. See or talk to your doctor most people feel best when their tsh is 1.0 or below. Ask doctor for a dose increase. Your ft3 is below range no wonder you are ill.

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Hello Tokyokitty and welcome to the forum.

You are under medicated. 50mcg is a starter dose which most people take for six weeks. Have a blood test then raise a further 25mcg until their TSH IS 1.0 or slightly lower. Your T4 needs to be near the top of the range and T3 at least mid way upwards.

Your gut issues: are you taking any vitamins and if so which type. You should ask for another blood test to check for antibodies (TPO and TG) and too see what your ferritin and folate levels are.

Have the blood tests done at the earliest available appointment time Fast overnight - water is fine. Do not take your Levo that morning as it will shows a truer reflection of your levels. Take straight after with a full glass of water.

As for your Gp and Endo - I would change both and make a complaint as they are making you ill by holding back your meds.

You’ve done the best you can coming to this forum for advice.

Receptionists have not had medical training so s/he needs to let you speak to your Gp unless this was a message from your doctor.

Could you post your results from when you were taking T3. How long were you taking it for and why was it stopped.

Also can you phone your Endo as a reminder?

There’s more information but might get lost in the cross hair, so get the results as asked and post. So you can have proper guidance.

Chin up we’ll get you sorted.

Ebony

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The T3 was prescribed in November 2015 by my first endo, it was taken away after the new one decided I was thyrotoxic on it and it was removed in June 2017.

Nov 2015 (150mcg levothyroxine)

TSH 1.08 (0.2 - 4.2)

FT4 19.2 (12 - 22)

FT3 4.1 (3.1 - 6.8)

June 2017 (150mcg levothyroxine and 10mcg T3)

TSH <0.02 (0.2 - 4.2)

FT4 22.8 (12 - 22)

FT3 4.5 (3.1 - 6.8)

I also have TPO antibodies of 476 (<34) and TG antibodies of 255.8 (<115)

I take vitamin D only, cholecalciferol 800iu.

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Other results when on 50mcg levo and 10mcg T3, dose gradually moved up as TSH got higher.

Jan 2016 (50mcg levo and 10mcg T3)

TSH <0.02 (0.2 - 4.2)

FT4 20.6 (12 - 22)

FT3 5.4 (3.1 - 6.8)

Apr 2016 (50mcg levo and 10mcg T3)

TSH <0.02 (0.2 - 4.2)

FT4 20.4 (12 - 22)

FT3 5.3 (3.1 - 6.8)

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Tokyokitty,

TSH 4.6 is over range and FT3 3.0 is below range so your results are NOT normal. Ask your GP to increase dose to 75mcg if your endo isn't responding.

The goal of Levothyroxine is to restore the patient to euthyroid status. For most patients that will be when TSH is 0.3 - 1.0 with FT4 in the upper range. FT4 needs to be in the upper range in order that sufficient T3 is converted. Read Treatment Options in thyroiduk.org.uk/tuk/about_... Email dionne.fulcher@thyroiduk.org if you would like a copy of the Pulse article to show your GP.

Speak to your GP or pharmacise about the constipation as they can prescribe remedies depending on what sort of constipation you have.

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Ok thanks I am going to go back on T3 because I had no problems when on this.

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I appreciate you’ve made a decision. But would like to add that vitamins will help and also you have Hashimotos. Do you know how to help your system as Vit D is not sufficient for most Hypos. I’m assuming you self source your T3 as I doubt you’ll get it on prescription again for a while. And if you have time - will you be taking T4 in addition to your T3? Do you know how to start T3 again as returning to a dose larger than 6.25mcg might cause you problems.

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I haven't taken my T3 in a while, I want to tell my endo but worried about what he will say since he does not approve of it. I will be taking quarter of T3 in addition to the 50mcg levothyroxine.

Ferritin, folate etc been told all normal. No longer on iron since the GP isn't helping me with that anymore. B12 being taken care of since I am on B12 injections as well. Folic acid was taking but waiting on intrinsic factor antibody results before restarting it

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Sorry to be a pain but can you post those? You’ve been incorrectly informed about your T’s so let’s get you sorted properly?

You’ll get the support and help you need. And guidance. Just because your Gp isn’t helping doesn’t mean you can’t help yourself. You’re worried about work and how you feel. Your Gp is showing no signs of duty of care.

I think you’d be best to wait and see if the more experienced members of the forum think you should take T3 with an increase in Levo. I’m not as knowledgable as them but they may say to increase your T4 first in 25mcg and also you definitely need to get your building blocks in place. Ie your vitamin levels correct and up. I’d recommend Selenium to add to your list.

You’ll probably need to look into a strict 100% gluten free diet as you’ve got gut issues and high antibodies. Which indicates Hashimotos <—— research that.

If Endo doesn’t support you change Endo. You need to get better and s/he sounds like they are uneducated on the subject and holding your health care back.

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Vitamin D total 55.6 (50 - 75 suboptimal) taking 800iu but thinking about taking 3000iu oral spray by Better You

Ferritin 64 (30 - 400) diagnosed iron deficient in 2011

Folate 2.1 (2.5 - 19.5)

Vitamin B12 235 (190 - 900)

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Sod the endo they have probably got a nice healthy thyroid.

1 like
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Before you go back on T3 you must improve your low vitamins and increase Levo

Plus going absolutely strictly gluten free is likely essential

Your endo who removed T3 was probably a Diabetes specialist, plus they have been told to get numbers of patients off T3

But we do need vitamins optimal FIRST

Hashimoto's affects the gut and leads to low stomach acid and then low vitamin levels

Low vitamin levels affect 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

Ask GP for coeliac blood test first ideally

Persistent low vitamins with supplements suggests coeliac disease or gluten intolerance

gluten.org/resources/health...

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...

thyroidpharmacist.com/artic...

Selenium supplements can help improve conversion of T4 to T3

Detailed supplements advice on Low vitamins due to under medication

healthunlocked.com/thyroidu...

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When I had this same problem/symptom my endo had me start taking magnesium (400 mg) and a stool softener (250 mg) a day. This took care of the problem. I eventually was able to stop taking the stool softener, but kept taking the magnesium (but at a lower dose of just 200 mg per. day). Drinking lots of water helps as well. I hope you feel better soon :)

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Why do they have ranges and then ignore them? How can over range TSH and under range free T3 be normal? Your need an immediate dose increase.

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