Test results after 8 weeks on T3 - advice on next steps please?

[stevenotts]

Hello all,

I started self-medicating with T3 8 weeks ago, and have just had the results back from my recent Medichecks Thyroid Check UltraVit test. The comparison with the same tests taken back in October is as follows:

October 2017 to February 2018

TSH: 0.589 to 0.46 [0.27-4.20]

Free T4: 20.2 to 16.9 [12-22]

Total T4: 113.0 to 91.6 [59-154]

Free T3: 3.84 to 3.75 [3.10-6.80]

Thyroglobulin antibodies: <10 to <10 [0-115]

Thyroid Peroxide antibodies: 96.2 to 135 [0-34]

Active B12: 64.1 to 128 [25.10-165]

Folate: 6.38 to 15.97 [2.91-50]

Vitamin D: 68 to 83 [50-200]

Inflammation CRP: 6.6 to 2.1 [0-5]

Ferritin: 339 to 217 [30-400]

Medication and supplements between test dates:

Reduce levothyroxine from 225 mcg to 200 mcg

Introduced T3 (6.25 mcg for 2 weeks then increased to 12.5 mcg)

40 mg Omeprazole (for acid reflux and Barrett's Oesophagus)

Better You DLux 3000 Vitamin D oral spray

Vitamin K2 MK-7 100 mcg

Thorne Basic B Complex (contains 400 mcg folate)

Jarrow Methyl B-12 lozenges 1000 mcg

Vitamin C 1000 mg

Strictly gluten-free since May 2017

After initially feeling worse when I started the T3, things did improve after a couple of weeks. My brain fog is now slightly improved and I find that my memory is a little better, I can retain information better and I generally feel a bit more "with it".

I was quite surprised that the T3 result actually went down rather than up, but, after doing some research om here just now, I realise that I probably should have taken my last dose of T3 12 hours before the test rather than 24 hours! Should I get the T3 tested again, or wait until I next have a full retest?

Given the above results, what do you recommend my next steps should be? I would imagine that I should be looking to at least increase T3, Vitamin D and folate as a minimum?

Many thanks in advance!

Steve

[Clutter]

Stevenotts,

TSH is low-normal and FT4 is mid-range.

Having left 24 hours between last dose and blood draw you can extrapolate FT3 result +20% so an estimate of normal circulating T3 is 4.5. There is scope to add another 6.25mcg T3 if you feel you need it.

Thyroid peroxidase antibodies are positive for autoimmune thyroid disease (Hashimoto's). There is no cure for Hashimoto's which causes 90% of hypothyroidism. Levothyroxine treatment is for the low thyroid levels it causes. Many people have found that 100% gluten-free diet is helpful in reducing Hashi flares, symptoms and eventually antibodies.

chriskresser.com/the-gluten...

thyroiduk.org.uk/tuk/about_...

Folate has improved. Eating more leafy green veg will lift it to optimal half way through range.

B12 is high in range. You could reduce dose to 1,000mcg 2 or 3 times a week to maintain level.

VitD 83 is replete >75. You could continue supplementing until April when ultraviolet light is high enough to stimulate natural vitD.

CRP and ferritin have dropped which indicates the inflammation or infection you had has cleared.

[stevenotts in reply to Clutter]

Thank you Clutter for your advice. I think I'll try adding in the extra 6.12 mcg. As I said in my original post, my brain fog does feel slightly better, but I'm far from OK still, so I'm finding this is all rather frustrating, But at least things seem to be moving in the right direction!

When do you think I should next restest? 6-8 weeks?

[Clutter in reply to stevenotts]

Stevenotts,

Yes, you should test 6-8 weeks after each dose adjustment.

[stevenotts in reply to Clutter]

Clutter,

Thanks, I'll do that then. But can you please just remind me... the last dose of T3 should be 12 hours before the test, rather than 24 hours before?

[Clutter in reply to stevenotts]

Stevenotts,

12 hours. No need to reduce 200mcg Levothyroxine, FT4 is within range.

[stevenotts in reply to Clutter]

Sorry, I forgot...

Should I keep levo at 200 mcg or drop it a little?

Many thanks!

[SlowDragon Administrator]

If you are not already strictly gluten free , then would suggest you try it

Vitamins are improving nicely and CRP falling

I would stick on current vitamin regime

As Clutter suggested, perhaps increase T3 to 3 x 1/4 tablet per day. But you could hold at current dose for further 6 weeks

I find it best to take in divided dose - 3 x per day - about 6 am, then 8 hours later and at bedtime.

Always on empty stomach and nothing but water for hour after

T3 helps some people sleep, but some find it keeps them awake

You may find after several months gluten free and on current improvements you can experiment with lowering omeprazole (but don't rush)

[stevenotts in reply to SlowDragon]

Thank you SlowDragon for responding. Yes, I am already strictly gluten free and things do seem to be moving in the right direction, though my brain fog is only ever so slightly better, so I'm wondering what it's going to take for the fog to completely clear.

I've decided to increase T3 by 1/4 of a tablet to see how it goes. Do I need to reduce my levo at the same time too?

[SlowDragon Administrator in reply to stevenotts]

I would personally leave Levo at same dose. It's not high in range and dropping would probably take FT4 below range.

Personally I found below range FT4 causes problems, even when on T3

But obviously we are all different

[stevenotts in reply to SlowDragon]

Thank you SlowDragon... as always!