T3

[Mandy2007]

Hello All, I read a lot about adding T3 in alongside Levothyroxine. As I am still trying to get to a point of “wellness” I would consider anything that may help. I am looking at what supplements are needed following my blood results and where to get the best quality, and what dose. To take. What would my results need to look like to consider adding in some T3? As always ....thank you. Mandy

[Clutter]

Mandy2007,

If TSH is low, FT4 high in range and FT3 low adding T3 can be beneficial.

[Mandy2007 in reply to Clutter]

Thanks Clutter.

My TSH is low 0.10 (0.27-4.20)

My FT3 is low end of the scale 3.76 (3.1-6.8)

My FT4 is 17.9 (12-22), where would that be considered in the scale? Thanks Mandy

[Clutter in reply to Mandy2007]

Mandy2007,

Yes, I think the addition of some T3 would be helpful but it will further suppress your TSH which may be a problem for your GP.

[Mandy2007 in reply to Clutter]

Hi.....when you say suppress, do you mean the 0.10 would drop lower?

Would adding some T3 and increasing the T4 (Levo) slightly, work? Excuse me as I’m just punching in the dark here. That may be a nonsense idea!

Thoughts please, thanks...

[Clutter in reply to Mandy2007]

Mandy007,

Yes, TSH would drop lower.

Increasing Levothyroxine dose would increase FT4 and FT3 but would also suppress TSH lower. You should either increase T4 or add T3. Not both at the same time.

[Mandy2007 in reply to Clutter]

Ok. I am going to address the supplement situation also. Would you recommend I do that first for a few weeks OR address the T3/T4 need first? I do have an NHS blood form here to get my annual Thyroid levels checked, but due to the snow I haven’t had my bloods taken as yet. I will go next week. If this shows a low TSH reading again (as you know it won’t show much else) should I be asking my GP to consider increasing my T4?

[Clutter in reply to Mandy2007]

Mandy007,

I doubt your GP will increase dose if TSH is still 0.10 but you can ask and point out T4 can be higher. Read Treatment Options in thyroiduk.org.uk/tuk/about_... Email [e-mail] if you would like a copy of the Pulse article to show your GP.

I don't see why you can't supplement and address T3/T4 at the same time.

[Mandy2007 in reply to Clutter]

Ok, I think then I will add a small amount of T3 in either before or after my plan of adding supplements to keep it separate. Do you have any recommendations on suppliers for T3? Also, what dose would you think to start at? Thank you....

[Clutter in reply to Mandy2007]

Mandy2007,

Start with a quarter tablet 6.25mcg to see how you tolerate it. If you need to, add a second 6.25mcg dose at bedtime after a couple of weeks. Hold at 12.5mcg plus Levothyroxine for 6-8 weeks and have a thyroid test including FT3 before increasing further.

[Mandy2007 in reply to Clutter]

Thank you. Anything I should be looking out for when searching for a supplier? Thanks

[SeasideSusie Remembering]

As for supplements, post your vitamin and mineral test results, with reference ranges, for suggestions of what to take.

[Mandy2007 in reply to SeasideSusie]

Serum Folate 8.90 (8.83-60.8)

Vitamin B12 268 (140-250 insufficient)

Vitamin D (25OH) 44 (25-50 insufficient)

Ferritin 69.6 (20-150)

My anti bodies are high. This is the first time ever in 24 yrs that I have been tested for them (I went private) they are:

Anti-Thyroidperoxidase 164 (<34)

Anti- Thyroglobulin 467 (<115)

Thank you......

[SeasideSusie Remembering]

Mandy

Vitamin B12 268 (140-250 insufficient)

Do you have any signs of B12 deficiency - b12deficiency.info/signs-an...

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."

So if you have any signs or symptoms of deficiency you need to see your GP for further testing and possibly B12 injections. If not then you could supplement with sublingual methylcobalamin - Jarrows is a good brand.

Serum Folate 8.90 (8.83-60.8)

This is right at the bottom of the range. B12 and folate work together. It's recommended for folate to be at least half way through it's range. When taking B12 we need a good B Complex to balance all the B vitamins, I like Thorne Basic B - it contains 400mcg methylfolate which will help raise your folate level.

Vitamin D (25OH) 44 (25-50 insufficient)

The Vit D Council recommends a level of 100-150nmol/L. As you have Hashi's then for best absorption an oral spray is better than capsules or softgels. BetterYou is very popular with Hashi's members here.

I suggest you get the 3000iu dose spray and take 6000iu daily for 6-8 weeks then reduce to 3000iu daily. Retest in 3 months. When you've reached the recommended level you'll need to maintain it and need to find your maintenance dose by 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.

Ferritin 69.6 (20-150)

This is just about OK, minimum of 70 is needed for thyroid hormone to work, preferable is half way through range. You should maintain this level by eating liver occasionally and other iron rich foods.

Anti-Thyroidperoxidase 164 (<34)

Anti- Thyroglobulin 467 (<115)

As you have 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_...

[Mandy2007]

You guys are amazing. Not only your knowledge, but your willingness to take the time to reply.....and swiftly too! Thank you.

I have started a gluten free “life”, but just two weeks ago, so I don’t know if I will be feeling the benefits of that yet?

I have resisted (just going for it) with adding in supplements because I worry I am not qualified to know what is best or how much to take. But, I have been on this journey now for too long of looking, reading, searching, asking, that I am just going to take that leap of faith and get going with it!

I will order up what I need and get a plan in place.

I have noted that D3 is to be taken with the fattiest meal and 4 hours away from Thyroid meds. Apart from that, is it ok to factor the other supplements in throughout the day what ever works best for me?

I really do appreciate you taking the time out of your day to respond. In a long time I actually feel that I am taking control of my health with the help of you all on this site. 😊👊

[SeasideSusie Remembering in reply to Mandy2007]

Mandy

I have no experience of a gluten free diet but I think it can take months to notice a difference, but not necessarily, everyone is different.

With the supplements, don't start them all at once. Start with one, wait a week or two and if no adverse reaction add in the second one, wait another week or two then again if no adverse reaction then add in the next one, etc. That's so that if you do have a reaction you will know what caused it.

It's normally said to take vitamins in the morning and minerals in the evening.

B vitamins can be stimulating so they're best taken no later than lunchtime. I take mine after breakfast.

I take D3 either lunchtime or with evening meal. I take K2-MK7 at the same time. I forgot to mention that a good brand of K2-MK7 is Healthy Origins - just the K2 and olive oil to help absorption as it's a fat soluble vitamin like D3.

Selenium I take after evening meal.

Magnesium I take an hour or so before bed. Make sure that you take magnesium at least 4 hours away from thyroid meds. I take my thyroid meds early morning when I need a visit to the bathroom, then go back to sleep, so it can be anything from around 3am to 6am, well away from any supplements.

Always ask questions if you want advice or suggestions, members are happy to help

[Mandy2007 in reply to SeasideSusie]

I think I need a dosset box!! 🤓 while we are talking about supplements what are your thoughts on milk thistle to support the liver? I didn’t realise until recently the connection between the liver and the Thyroid.....

[SeasideSusie Remembering in reply to Mandy2007]

Sorry Mandy, I've never had to do anything about supporting liver so don't know anything about milk thistle. I know my liver results are good as I have 3-monthly liver function tests due to taking a medication that can cause problems with the liver, at least I can keep my eye on that and it's about the only thing that's good LOL!

Pill dispensers can be very helpful. When I started taking supplements I made a spreadsheet and marked them off when I took each one. Now I just have my bottles lined up on the kitchen worktop and know which ones to take when. Thyroid tablets I put on a little tray when I go to bed, with a glass of water, and just take them when I visit the loo.

[Mandy2007 in reply to SeasideSusie]

Gosh it’s madness isn’t it that we, (me included) are up during the night and can rely on that to take medicine!

Do you feel a big degree of benefit from the supplements you are taking? I know everyone of us are unique....but it’s good to get feedback from anyone that is on a road to recovery or that has got there, and how they did it.

[SeasideSusie Remembering in reply to Mandy2007]

It's very hard to say what supplements made me feel any different. There was so much going on with nutrient deficiencies, adrenal problem, virtually non-existent sex hormones, poor conversion of T4-T3 and that had all been going on for a very long time. I can't pinpoint what I noticed when. All I can say is that my vitamins and minerals all became optimised and still are and the addition of T3 makes my thyroid results look very different! How I actually feel doesn't reflect what the test results show!