GP visit and conversation on T3 advice needed.

[Peanut31]

I’m looking for some advice.

As you know from my previous posts I have Hashimoto’s, I’m gluten and dairy free.

March I was started on Levothyroxine by my GP as my Endocrinologist refused to give me Levothyroxine and said no medication would help.

Thinking there was no hope and after one GP within my surgery told me it was anxiety, and I had been misinformed about Hashimoto’s, I resided that this was how life was going to be.

Anyway, after feeling very ill I went to my allocated GP, took bloods and immediately contacted me to see him.

Results below

TSH 12.2 (0.27-4.5)

Antibodies 160 (<34), had increased.

T3 4.12 (3.1-6.8)

T4 10.2 (11-23)

I was started on 50 mcg of Levothyroxine.

April results:

TSH 4.1 (0.27-4.5)

T3 4.51 (3.1-6.8)

T4 14.2 (11.0-23)

Increased to 75mcg of Levothyroxine

May results:

TSH 1.6 (0.27-4.5)

T3 4.58 (3.1-6.8)

T4 17.4 (11.0-23.0)

Now Upped to 100 mcg of Levothyroxine.

I went to see my GP yesterday to discuss my results and also the fact the I’ve had two kidney blood tests (one before I started Levothyroxine) that they came back borderline.

Having done further research about my kidney results, it’s appears it all to do with metabolism and thyroid function, I mentioned this to my GP.

He didn’t disregard what I was saying, but, said the results don’t take into account weight as I’m I am slim he isn’t worried.

I then got on the subject of my thyroid results, he started by saying they are in range, I interpreted him and reminded him that my TSH needs to be 1 or below and T4, T3 higher end, as per his words, he agreed.

I then asked him to look at all my results that my TSH and T4 was improving a lot faster than my T3.

I asked what his thoughts were on T3 and was it correct that IF I needed T3 he is not permitted to prescribe me this.

He said that was correct, that an Endocrinologist could only do this and all his patients that have seen an Endocrinologist have never needed to add T3.

He did say that T4 converts to T3 anyway.

He asked how I was feeling, and I explained that my anxiety was getting better, not brilliant, but, I am absolutely worn out in the mornings despite me having a good nights sleep with no broken sleep, I said I struggle in the morning (last week I couldn’t get out of bed) and in the evening I’m struggling.

My body temperature is still low in the morning ( I take it everyday) it was 36.0 degrees now 36.4/ 36.3 since increased to 100mcg.

I am still feeling cold, not like ice cold water running through my veins, but still cold.

He seemed to disregard the T3, I’m due another blood test in four weeks time to see how the 100mcg of Levothyroxine is doing, with a view to increase to 125mcg of Levothyroxine, but, I am convinced I need T3.

I’ve also noticed, I’m putting weight on, it’s creeping up a couple of pounds a week. I have done nothing different at all.

I’m not overweight but, I’ve struggled all my life with weight and lost a lot after my son was born through healthy eating.

I was also bullied at school for being overweight, so as you can appreciate I hate weight gain. I have not mentioned this to my GP.

I can’t seem to understand that Levothyroxine is suppose to increase metabolism but I’m gaining weight, my weight pattern is worse now on Levothyroxine.

feel like I’ve been up all night and freezing cold. I’m suffering with neck stiffness and muscle stiffness. I’ve been massaging coconut oil at night and this has helped, but still feel like a old woman in the morning.

I’m yawning constantly, which is embarrassing when your taking to people, it looks like your disinterested, and I sometimes can’t cope with normal situations, if I get busy at work.

Should I add some T3?, I’ve just got a copy of Paul Robinson book, started reading it last night, but I couldn’t keep my eyes open and nothing would register.

I’m stick of this feeling how long do I leave it.

Best Wishes

Peanut31

[greygoose]

Your FT4 is just slightly over mid-range, and your FT3 just slightly under. So, at the moment, you're not showing signs of poor conversion. Wait and see your results on 100 mcg before you make any decisions.

He did say that T4 converts to T3 anyway.

Pretty ignorant remark on behalf of your doctor. It would have been better to say T4 is supposed to convert to T3. And, it usually does. But, often not enough, leaving the person with good levels of T4, but low levels of T3. He should know that.

You have Hashi's. What do you know about Hashi's? Do you know that it often causes levels to jump around in a way that has nothing to do with your dose of hormone? Are you on a gluten-free diet and taking selenium to reduce antibodies? Have you have your nutrients tested? Hypos often have low stomach acid, causing nutritional deficiencies, and these will also cause symptoms and make you feel bad. Ask for vit d, vit B12, folate and ferritin to be tested.

[Peanut31 in reply to greygoose]

Hi greygoose

I was hoping you would reply.

Yes I know a bit about Hashimoto’s through books etc.

I’m gluten and dairy free, interestingly, my antibodies increased when the GP tested them back in March.

I have been gluten free since September 17 and dairy free since December 17.

I take 200mcg of selenium daily, I was thinking of increasing it to 400mcg as I see thyroid U.K. mentions it helps convert.

I take vitamin D, C , B12 and iron tablets. magnesium at night.

I take my Levothyroxine at 6am in the morning, breakfast at 7.30am with vitamins taken 4 hours after Levothyroxine.

I had vitamins tested in March

B12 1,091 (197-771)

Ferritin 72 (20-130)

Vitamin D 175 (<75)

GP phoned me and had a fit at me as B12 & vitamin D over range.

I’ve been still supplementing D & B12 but, low dosage since her fit.

I’ve just paid for medi checks blood test for vitamin levels to see where I’m at now.

The GP is aware of my Hashimoto’s as the consultant letters are on my records and the GP confirmed this with my March antibodies test.

I’m seeing a nutritionist to help, my leaky gut is better since GF and I’ve had further food allergy tests, which has flagged up several foods in the red zone.

She wants to test my reverse T3 as thinks it might give more insight, would this be a good idea?

I’m convinced I’ll need T3, maybe the GP will agree to increase my dosage by another 25mcg after my blood test in a few weeks.

Let’s hope.

Just can’t explain weight gain, tiredness, coldness if I’m an converting well?

Would a further increase benefit me?

Maybe it’s my vitamins level, iron in particular.

Best wishes

Peanut31

[greygoose in reply to Peanut31]

Your antibodies increasing means nothing. They fluctuate all the time. But, the important thing is, do you feel better on gluten and dairy free?

I would not double your selenium, if I were you. Too much is toxic. In fact, you ought to have a little pause between bottles. The 200 mcg will do both, reduce antibodies (possibly) and help with conversion. You don't have to take double.

Iron tablets should be taken 2 hours away from everything else except vit C, on its own. It will block absorption of your vitamins.

Your vit B12 is ok, just reduce your dose. Your vit D can't be over-range because there isn't a top to the range.

If she wants to test your rT3, let her go ahead, I'd be interested to know what she makes of the results. But, don't you pay for it. It won't give you any helpful information. It will tell you if there's a problem, but won't tell you where that problem is!

You're under-medicated, that's why you still have symptoms. You need an increase in dose.

[Peanut31 in reply to greygoose]

Hi greygoose

Yes I definitely feel better going gluten free, and dairy free.

She wants to charge me (nutritionist) for reverse T3, but reckons she can’t get a stand alone test and it will have to be a full thyroid test.

I’ve told her there’s no point at the moment as my GP is testing TSH, T4 & T3 at present, and medi checks due a reverse T3 test anyway.

What’s the ratio you use to know if you are converting well with T3?

I look forward to an increase soon.

Best wishes

Peanut31

[greygoose in reply to Peanut31]

I don't use ratios. I'm allergic to ratios! I just know by looking at the two results. Your FT4 and FT3 are more or less in equal places in their respective ranges, FT4 slightly higher. And, that's the way it should be.

[ShinyB in reply to Peanut31]

I'm not much use to man nor mouse at the moment as I'm so tired I can't think straight! but, I wondered if your ferritin could be higher? I've read on here that it needs to be 80+ for thyroid hormone to work well.

Recovering with T3 has a page on facebook which Paul answers questions to sometimes. Thought I'd mention that in case it's helpful.

Good luck x

[Peanut31 in reply to ShinyB]

You make perfect sense in your post to me ShinyB.

I’ve tested my iron recently, waiting for results.

I supplement with iron tablets and every evening meal I have a load of spinach. I can’t face liver, I’ve tried it and just reached every time.

I’ve just brought his book, it arrived yesterday.

I’m one of the few that’s not on Facebook, one of my friends calls it boast book.

Best Wishes

Peanut31

[ShinyB in reply to Peanut31]

yes I know what your friend means. There also seem to be an inordinate number of people who think people want to see a photo of what they're having for their tea. Bizarre! lol.

PR is pretty good too at answering emails and occasionally will do a skype consultation.

[Peanut31 in reply to ShinyB]

Lol, I’ve been busted, occasionally, I post photos of my dinner on the healthy eating section of this forum for ideas for other people, whoops.

No offence taken though, your posts always cheer me up.

Best wishes, take care

Peanut31

[ShinyB in reply to Peanut31]

ah, but that's a relevant forum to post them on! Why do people on facebook randomly think people want to see what they're eating each night though?! haha.

Thanks for the compliment

[greygoose in reply to Peanut31]

Sorry, Peanut, but you're not going to get much iron out of spinach. It contains loads, but human guts can't absorb it - Popeye is just a myth. So, you're eating the ghastly stuff for nothing!

[Peanut31 in reply to greygoose]

Thanks for the advice.

To be honest it just tasted of leaves, I kept eating it thinking I was doing well on the iron side.

Well it will be interesting how my iron levels are when my results are in.

Best wishes, thanks for your replies.

Peanut31

[greygoose in reply to Peanut31]

You're very welcome.

[Angel_of_the_North in reply to Peanut31]

I quite like spinach but it actually contains oxalic acid which can block iron absorption - usually OK cooked but don't juice it or eat it raw. Same with rhubarb (but who would even try to eat raw rhubarb?). That contains enough oxalic acid to clean copper.

[Peanut31 in reply to Angel_of_the_North]

Oh dear,

I was eating it raw, and loads of it.

Rhubarb I hate anyway.

I’m waiting for my iron results to come back so this will be interesting, as if the spinach is not brilliant to obtain the iron, and I’m only taking one iron tablet it could be my iron levels have dropped.

I do try and eat steak when I go out for meals, but I don’t go out often.

Thanks for that.

Best wishes

Peanut31

[Angel_of_the_North in reply to Peanut31]

Nettles, cooked, are quite good for iron (and free) and tasty if you want something leafy. Cooked spinach is OK.

[Peanut31 in reply to Angel_of_the_North]

Nettles,

when you said that I immediately thought of dogs and cats urinating up them.

Obviously, I would cook them first.

Best wishes

Peanut31

[Hillwoman in reply to Peanut31]

I have to agree with greygoose, Peanut. Give ghastly spinach the heave-ho and eat chicken liver pate, made with brandy and cream. It's easy to do. Chicken livers don't contain as much iron as livers from other animals, but they are the most palatable by far.

I made a frittata this evening, following a recipe from a book written by a nutritionist. It contained roughly half a hundredweight of spinach, plus lots of other greens. It was the most worthy and unpalatable frittata I've ever eaten. I'm trying to persuade my husband to take the rest to work with him.

[Hillwoman in reply to Hillwoman]

Oops! You're dairy free, I've noticed. Just add extra brandy to the liver pate instead.

[Peanut31 in reply to Hillwoman]

Oh hells bells, I was eating spinach with most of my meals thinking of all that iron I was having.

I don’t drink either, lol

I do like pate, but gave it up years again when I saw the calorie content. We revert back to it, or. I’ll just have to shove the liver in my mouth and think of chocolate.

Best Wishes

Peanut31

[greygoose in reply to Peanut31]

Lambs liver. Cut into small pieces and brushed with olive oil, sprinkled with sea salt and freshly ground pepper. Under the grill until cooked to taste. Then tossed in olive oil, lemon juice and chopped parsley. Eat with fresh crusty bread. Delicious!

And stop counting calories!!!

[Hillwoman in reply to greygoose]

That sounds delicious GG.

And agree absolutely, there's no point in counting calories.

[greygoose in reply to Hillwoman]

Had it in a Greek restaurant, once. Became one of my signature dishes.

[Peanut31 in reply to Hillwoman]

I hear what your saying about calorie counting, but as a child I was overweight and as a teenager overweight, I was badly bullied about it.

I’ve always struggled with my weight, looking back I think I’ve had a thyroid condition for a very long time and never made the connection or GP tested me.

Many years ago I suddenly went dizzy, this would happen at any time, then I would have ringing in my ears, and blocked ears. Went to an ENT said nothing wrong.

Since I met my hubby (22 years ago) I’ve always felt the cold, heavy periods lasting over a week. I’ve been unbearable to live with whilst on my period too. It’s like a red mist coming over me.

My nana has an underactive Thyroid and I believe my uncle suffered with this and was misdiagnosed with depression.

Sadly he couldn’t cope with life and ended it. I really believe he had a thyroid condition and if only they had checked this.

I lost two and a half stone with a slimming group, but my weight recently became unstable and has been for a while now.

if I eat something different, my body reacts by weight gain.

Many years ago when I was feeling awful

I did a well women’s test with BUPA, they put me on a bike for a fitness test, I wasn’t sweating and they did further test and said my metabolism wasn’t working properly, again I never made the connection with thyroid.

Since being on Levothyroxine it’s creeping up and it’s misbehaving, I hate it.

I do eat healthy and no longer have fizzy drinks etc, eat plenty of fish, protein and vegetables.

In fact I’m seeing a nutritionist and had to write my food diary, she also went food shopping with me and was impressed with my diet.

I don’t have microwave meals, I cook from scratch.

Lots of stir fry’s, homemade soups, salads, I love crab, scallops, prawns.

Hopefully it will stabilise and I long to feel warm!!!, and refreshed in the mornings, and not feel like I’ve been up all night, yawning away.

Best wishes

Peanut31

[Hillwoman in reply to Peanut31]

You've certainly been through the mill Peanut, and I can sympathise with all your symptoms, as well as the worries about weight gain. Struggles with weight affect a lot of us here, myself included. It's quite possible in your case that food intolerances may be prompting some of the weight increase, but that will mainly be caused by fluid retention.

Another possibility is that the increases in levo dosage are waking up your adrenal glands and prompting them to produce more cortisol, which can lead to temporary weight gain. I came across something about this in a book by Dr John Lowe, so I'll see if I can find the relevant passage again.

I am borderline Type 2 diabetic - actually diabetic by some measures - and the only way I can slow down my post-meno weight gain is by eating a very low carbohydrate diet. Protein intake has to be moderate, and my fat intake is high. Calories are not counted, and if you're interested in the whys and wherefores I can point you in the direction of some books on the subject, all of them based on sound science.

[Peanut31 in reply to Hillwoman]

Thanks I’ll google Dr John Lowe.

The nutritionist did food intolerance testing, and lots of food flagged up red. I been avoiding them now, but. introduced one the other day, banana.

On my word, after having it I was absolutely exhausted, headache and had to go to bed, who would of thought a banana could do that.

Didn’t think of fluid retention or the cortisol issue.

Thanks for your replies.

Greatly appreciated.

Best wishes

Peanut31

[Hillwoman in reply to Peanut31]

You're welcome. Eating something sugary has the same effect on me too, and it's a sign that glucose metabolism is not working correctly. Dr Myhill's book on diabetes is worth reading, even if you don't have a T2 diagnosis.

Dr Lowe's books have been out of print since he died in 2012, and second hand copies are now very expensive. I'll have a look for the passage I mentioned in my copy later today and let you know what I find out.

[Angel_of_the_North in reply to Peanut31]

"Many years ago I suddenly went dizzy, this would happen at any time, then I would have ringing in my ears, and blocked ears. " Look up Meniere's disease. You can go years between attacks

[Peanut31 in reply to Angel_of_the_North]

I’ve looked it up and can relate to those symptoms.

My ears always feel blocked and I can hear myself swallow.

Sometimes, I have to hold my nose and blow out to pop them, and sometimes I can hear my voice when speaking inside my ears really loud ( I don’t know how to describe it right).

I went to an ENT when it all started and they could find anything wrong, I had an MRI scan as well.

I had to have grommets when I was younger as my hearing was awful.

Best wishes

Peanut31

[FancyPants54 in reply to Peanut31]

Hi.

I would not dabble with T3 until you have exhausted every other avenue. a) it's really hard to get hold of and may well get harder once we leave the EU. b) it's hard to manage.

I have been on Paul's Recovering with T3 method in the past and it made me worse. It should be a last resort (as Paul himself says). At the moment you need a Levo. dose increase. You are not at last resort. I followed the T3 only protocol to the letter. It's very intrusive on your life and for me, the signs and symptoms did not guide me correctly. I had to stop it.

I would caution against T3 only unless you have no other options.

At the moment you just need more Levo.

[Peanut31 in reply to FancyPants54]

Thanks Fancypants54,

I will give Levothyroxine and the increases a go. Hopefully my GP will still increase my dosage.

I’m absolutely freezing cold today, yes it not brilliant weather, but I’ve got socks, vest top underneath my blouse and a cardigan and another jacket, plus my trousers.

I feel like a slab of marble.

Best wishes

Peanut31

[FancyPants54 in reply to Peanut31]

Which really does go to show that you are under dosed.

However, we all show different symptoms. I'm never cold. I'm only at the start of my thyroid Levothyroixine journey, being on 75mcg now and with plenty of symptoms. But cold and/or falling asleep are not on my radar. I'm in shorts, t-shirt and sandals.

T3 only is very hard to manage. It's one of those things that can save a person when nothing else works. But it takes over your life completely. You become a walking alarm clock to remember when to test and when to take. You have to take a blood pressure reader around with you and you are constantly taking your temperature. It's not for the feint hearted.

[Angel_of_the_North in reply to FancyPants54]

LOL. I'm still in long sleeves and a fleece. T3 only isn't that hard to do, if it is what works for you. NDT might be easier.

[Peanut31 in reply to Angel_of_the_North]

I’ve got some NDT already.

I ordered it incase my GP turned me away like my Endocrinologist and the first GP I saw.

I thought I would give Levothyroxine a try first and be under the NHS as this GP seems good at the moment.

I know he wouldn’t support me self medicating, as I sounded him out about T3 IF I needed it and getting it from a Endocrinologist or privately. He just said all his patients on Levothyroxine didn’t need T3.

He lost some of his credibility then.

The only concern I have is that if I decide to switch to NDT after giving Levothyroxine a go, will have to start on a low dosage again? As in start from the beginning?

I dread that if I do. Especially a very low dosage.

Best wishes

Peanut31