Help needed :)

[Kittymeowmeow42]

Hi - Has anyone ever self medicated with Dithyron? My uncle managed to get me some in Greece and i wanted to try it. I'm currently on T4 only and feeling rubbish. My Gp doesn't want to know

[SeasideSusie Remembering]

Kittymeowmeow42

If you post your latest results members will help. Before you know if you need T3 added (in whatever form) then it would be best to get full thyroid panel and vitamins and minerals tested to see if there are any obvious problems that need addressing first. Ideally you need

TSH

T4

FT3

Thyroid Antibodies

Vit D

B12

Folate

Ferritin

If you post your results, with reference ranges, members can comment. Also tell us how much Levo you currently take.

[Kittymeowmeow42 in reply to SeasideSusie]

Thanks for replying SeasideSusie. I'm currently taking 50mg Levo

These are my last results. I'm currently still very sympomatic

TSH - 2.43 mIU/L (0.27 -4.20)

Free Thyroxine - 15.100 pmol/L (12.00 - 22.00)

T4 - 103.0 nmol/L (59.00 - 154.00)

Free T3 - 5.42 pmol/L (3.10 - 6.80)

Reverse T3 - 14 no/dL (10.00 - 24.00)

Reverse T3 Ratio - 25.2 (15.01 - 75.00)

Thyroglobulin Antibody - 81.800 IU/mL (0 - 115) Thyroid Peroxidase Antibodies - 11.6 IU/mL (0 -34)

B12 - 81.700 pmol/L (25.10 -165)

Folate - 7.35 ug/L (2.91 - 50)

Vitamin D - 29.1 nmol/L (50 -200)

CRP - 15.83 mg/l (0 - 5)

Ferritin - 74.8 ug/L (13 - 150)

[SeasideSusie Remembering in reply to Kittymeowmeow42]

Kitty

OK, so forget the Dithyron for now. You are undermedicated and have some poor nutrient levels there, this will be why you are symptomatic. I would also be rather suspicious about your Thyroglobulin antibody levels.

TSH - 2.43 mIU/L (0.27 -4.20)

Free Thyroxine - 15.100 pmol/L (12.00 - 22.00)

T4 - 103.0 nmol/L (59.00 - 154.00)

Free T3 - 5.42 pmol/L (3.10 - 6.80)

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 if that is where you feel well. So your TSH is far too high, your FT4 is only 31% through it's range, and your body is doing it's best to push out a decent amount of T3 at the moment.

50mcg Levo is a starter dose. How long have you been on it? When were you diagnosed? Have you ever been on a higher dose and had your dose changed?

You need to ask your GP for an increase in your Levo and to support this use the following information from thyroiduk.org/tuk/about_the... > Treatment Options:

Dr Toft states in Pulse Magazine, "The appropriate dose of levothyroxine is that which restores euthyroidism and serum TSH to the lower part of the reference range - 0.2-0.5mU/l.

In this case, free thyroxine is likely to be in the upper part of its reference range or even slightly elevated – 18-22pmol/l. Most patients will feel well in that circumstance.

But some need a higher dose of levothyroxine to suppress serum TSH and then the serum-free T4 concentration will be elevated at around 24-28pmol/l.

This 'exogenous subclinical hyperthyroidism' is not dangerous as long as serum T3 is unequivocally normal – that is, serum total around T3 1.7nmol/l (reference range 1.0-2.2nmol/l)."

Dr Toft is past president of the British Thyroid Association and leading endocrinologist.

You can obtain a copy of the article by emailing Dionne at [e-mail] print it and highlight question 6 to show your doctor.

Tell your GP that you have taken advice from NHS Choices recommended source of information about thyroid disorders (which is Thyroid UK) and they have advised that you need an increase (don't mention internet or forums, they don't like that).

Thyroglobulin Antibody - 81.800 IU/mL (0 - 115) Thyroid Peroxidase Antibodies - 11.6 IU/mL (0 -34)

Even though your antibodies are within range, your Thyroglobulin (TG) antibodies are rather high and I'm wondering if you might have autoimmune thyroid disease (aka Hashimoto's) which is where antibodies are raised and they attack the thyroid and gradually destroy it. Antibodies fluctuate so you could have tested at a time when they were in range, a further test could show them raised. As an example, I don't have Hashi's, I have tested my antibodies about 5 times over the years and both my TG and TPO antibodies come back usually below 10.

There is no cure for Hashi's, and the treatment is no different, but adopting a strict gluten free diet and supplementing with selenium l-selenomethionine 200mcg daily can also help reduce the antibodies.

Don't worry about your Reverse T3, that is fine, you don't have a problem and problems generally only exist when FT4 is high/over range.

**

B12 - 81.700 pmol/L (25.10 -165)

This is a little bit low for Active B12. Anything below 70 would suggest testing for B12 deficiency, and this is too close to 70 in my opinion. Do you have any signs of B12 deficiency - check here b12deficiency.info/signs-an... If not then you might want to supplement with some sublingual methylcobalamin lozenges to raise your level.

**

Folate - 7.35 ug/L (2.91 - 50)

Folate is low, it should be at least half way through it's range. Folate and B12 work together. I would consider supplementing with a good B Complex containing methylfolate (not folic acid), eg Thorne Basic B or Igennus Super B.

**

Vitamin D - 29.1 nmol/L (50 -200)

This really is dire. It is low enough for your GP to prescribe loading doses. See

NICE treatment summary for Vit D deficiency:

cks.nice.org.uk/vitamin-d-d...

"Treat for Vitamin D deficiency if serum 25-hydroxyvitamin D (25[OH]D) levels are less than 30 nmol/L.

For the treatment of vitamin D deficiency, the recommended treatment is based on fixed loading doses of vitamin D (up to a total of about 300,000 international units [IU] given either as weekly or daily split doses, followed by lifelong maintenace treatment of about 800 IU a day. Higher doses of up to 2000IU a day, occasionally up to 4000 IU a day, may be used for certain groups of people, for example those with malabsorption disorders. Several treatment regims are available, including 50,000 IU once a week for 6 weeks (300,000 IU in total), 20,000 IU twice a week for 7 weeks (280,000 IU in total), or 4000 IU daily for 10 weeks (280,000 IU in total)."

Each Health Authority has their own guidelines but they will be very similar. Go and see your GP and ask that he treats you according to the local guidelines or this summary and prescribes the loading doses. Once these have been completed you will need a reduced amount (more than 800iu so post your new result at the time for members to suggest a dose) to bring your level up to what's recommended by the Vit D Council - which is 100-150nmol/L - and then you'll need a maintenance dose which may be 2000iu daily, maybe more or less, maybe less in summer than winter, it's 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/

If your GP wont do anything, or only prescribes 800iu, come back and we can tell you what to buy and what dose to take.

There are important cofactors needed when taking D3 as recommended by the Vit D Council -

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.

**

CRP - 15.83 mg/l (0 - 5)

This is an inflammation market and yours is well over range. It's non-specific so it's just showing that there is some inflammation somewhere. Your GP should really look into this. If you do have Hashi's, it could very well be that it's linked to that.

**

Ferritin - 74.8 ug/L (13 - 150)

This is pretty good. Ferritin needs to be 70 for thyroid hormone to work properly so you should maintain this level. You could eat liver every couple of weeks and that will help.

**

So for now you need to get an increase in your dose of Levo and sort out those nutrient deficiencies. Once your TSH is down to around 1 you will know whether you convert T4 to T3 well enough and then you will know whether you need to add T3 or change to Dithyron, but nutrient levels need to be optimal first.

[Kittymeowmeow42 in reply to SeasideSusie]

Thanks SeasideSusie! You’ve given me a lot to take it x

[Kittymeowmeow42 in reply to SeasideSusie]

50mcg Levo is a starter dose. How long have you been on it? - About 4 months

When were you diagnosed? - about 6 months ago

Have you ever been on a higher dose and had your dose changed? - No. I was on 25mg for 2 months

[SeasideSusie Remembering in reply to Kittymeowmeow42]

Kitty

50mcg Levo is a starter dose. How long have you been on it? - About 4 months

Then your GP is not following protocol which is to retest/increase dose by 25mcg every 6 weeks until your levels are where they need to be for you to feel well. With your results, he should not have stopped at 50mcg, he should have retested 6 weeks after that increase. See

cks.nice.org.uk/hypothyroid...

Initiation and titration

•The dose of levothyroxine (LT4) should be individualized on the basis of clinical and biochemical (thyroid function tests) response. Treatment must be monitored regularly to determine an adequate dose and to avoid both under-treatment and over-treatment.

• The initial recommended dose is:

◦For most people: 50–100 micrograms once daily, preferably taken at least 30 minutes before breakfast, caffeine-containing liquids (such as coffee or tea), or other drugs.

◾This should be adjusted in increments of 25–50 micrograms every 3–4 weeks according to response. The usual maintenance dose is 100–200 micrograms once daily.

◦For people aged over 50 years and people with cardiac disease or severe hypothyroidism: 25 micrograms once daily, adjusted in increments of 25 micrograms every 4 weeks according to response.

•Once a stable thyroid-stimulating hormone (TSH) level is achieved and an adequate dose determined, arrange follow up to check thyroid function tests (TFTs) at 4–6 months and then annually.

You have the information from Dr Toft's Pulse article above, have you sent for it yet? Ask your GP to increase your dose in accordance with the information above and Dr Toft's article. Make sure you continue with retesting/increasing every 6 weeks until your TSH is about 1 or below and your Free Ts in the upper part of their ranges, if that is where you feel well.

[Kittymeowmeow42 in reply to SeasideSusie]

I have requested the article. I'm going to call and make an apt to see my GP as that will probably take about a month. My GP is very sweet but she doesn't ever fill me with any confidence. She's very wishy washy. Thank you so much for the information!

[humanbean]

The problem with dithyron is that it has a fixed ratio of T4 to T3. Each tablet, as far as I am aware, contains 50mcg L-Thyroxine Sodium and 12.5mcg L-Triiodothyronine Sodium,

Obviously if you want to increase the T4 component you can do, by adding some of the Levo your doctor prescribes. But if you want to increase the T3 component you're stuffed.

But it may be perfect for you. You'll just have to try it and see.

[shaws Administrator]

Dithyron is a combination tablet of T4 and T3 combined in the one tablet. I think it should work very well as it is a good combination (I haven't tried it). It has 50mg of levothyroxine and 12.5 mg. The effect will be around 100mcg of levothyroxine.

If you wish you could half a tablet and take half for a number of days, then every two weeks add 1/4 tablet. Take pulse/temp before beginning as both are usually low and if either go too high drop to previous dose. It is also by a good Pharma Company.

[Kittymeowmeow42 in reply to shaws]

My temperature is usually quite high. Would it be normal for me as the base temperature?

[shaws Administrator in reply to Kittymeowmeow42]

I think it if went higher than your usual 'normal' it might be a sign of a bit too much.