Requesting advice for Hashimoto's

[CCJC]

Hello, I stumbled across your website while looking for something else! I have Hashimoto's and was diagnosed with low thyroid back in 1984 while attending an infertility clinic; otherwise I may never have been diagnosed. I have been on synthroid ever since then but have still got many of the Hashimoto's symptoms. The most annoying being constant fatigue and inability to lose weight no matter what. I have read Dr. Isabella Wentz's book and since found a GP who is willing to work with me (after getting fired by my endo who refused to work with me because I asked too many questions and refused to see him as god, and have tried LDN (but after 6 months gave it up because I didn't feel any different) and am now on 75 mcg Synthroid and 5 mcg Cytomel. Again, I don't feel any different, but my blood tests are beginning to show an improvement. I am in Canada and it is almost impossible to get a full range of tests through the GP. I have had tests done through a Naturopath because the ones through the GP do not test for both antibodies, ( just the one that for me is in the normal range - just) I will give you the results of my latest test in January 2018 and a previous test in 2015 that I will put in () for comparison. TSH 0.968 ulU/mL (0.45); FT4 0.98 ng/dL (1.22); FT3 2.2 pg/mL (2.37); Anti-Thyroglobulin 115 IU/mL (61.2) rT3 (31.37 ng/dL the 2018 test was from a different lab that did not test rT3). There seems to be a very slight improvement in FT4 but FT3 has gone down and the antibodies have gone up. I am alarmed because I have started getting symptoms of arthritis in my neck, wrist and lower back and was not expecting this in addition to Hashimoto's. I guess I am determined to try and get it under control so would appreciate any advice. My doctor has no idea how to control the numbers. He just looks at the TSH and says all is fine. I did find a compounding pharmacist who was the one who recommended LDN and Cytomel but they are both extremely expensive and we are soon to lose our health coverage. I saw on one of the posts that the recommended ratio of Synthroid to Cytomel was 3:1 should I start to up my dose of Cytomel? And if so, how long should I be at each increase? Would I increase by 5 mcg at a time? I seem to remember Isabella Wentz saying the ratio was 11:1 but maybe that was for compounding. How often should I be getting my blood tested? every 6 weeks or three months or?? Thanks for any advice.

[Hellonwheels]

Hi. Without reference ranges, it's hard to tell what your test results mean. Believe it or not, Hashi's can cause the "arthritis" symptoms you are having. T3 makes your TSH very low, and is not a good indicator---now your doctor should rely on symptoms to treat you. T3 is actually 4:1 ratio. If you DO increase, do it slowly, maybe adding another 5mcg mid-day. After 2-3 weeks you might up it again by 5, but you should really be tested at around 6 weeks before you continue to increase. It might be worth your time and money to seek private testing for all of your Hashi's numbers such as TSH, FT4, FT3, RT3 and antibodies, and all your vitamin levels such as B12, Ferritin, Folate, D, etc. Hope this helps.