Hashimoto's? Should I be taking T3?: Hi, I am a... - Thyroid UK

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Hashimoto's? Should I be taking T3?

selina_kohen
selina_kohen

Hi,

I am a 63 year old female and I'm new to this forum.

I have been hypothyroid for 22 years and still feeling unwell. I am always feeling tired and exhausted, with anxiety and feeling sleepy all the time. I have lost half of my hair on my scalp too, which worries me a lot. Sometimes my vision is also blurred and I feel breathless.

I’m currently taking 75mcg and 100mcg of Levothyroxine every other day. I also had palpitations and a new GP put me on 100mcg a day. At first, I had more energy on 100mcg, however, 8 weeks later the TSH on my blood test was 0.11 – down from 2.53 (Range 0.35 – 4.94mu/L). The GP then decided to change my dosage back to what it was (75/100mcg).

Last week I had a Medichecks – Thyroid check UltraVit blood test done and the Medichecks doctor report suggested that my thyroglobulin antibodies are positive and that this can be associated with auto-immune thyroid disease and in particular Hashimoto's disease.

I had my blood test last week at 8.30am on an empty stomach, fasting, and no thyroxine for 24 hours. Please see my blood test results below.

Free T4 - 19.9 pmol/L (Range: 12 pmol/L – 22 pmol/L)

TSH - 1.08 miu/L (Range: 0.27 miu/L – 4.2 miu/L)

Free T3 - 3.63 pmol/L (Range: 3.1 pmol/L – 6.8 pmol/L)

Vit. D - 57.6 nmol/L (Range: 50 nmol/L – 200 nmol/L)

Ferritin - 146 ug/L (Range: 13 ug/L – 150 ug/L)

B12 (Active) – 63.2 pmol/L (Range: 25.1 pmol/L – 165 pmol/L)

Folate – 8.27 ug/L (Range: 2.91 ug/L – 50 ug/L)

Thyroglobulin antibodies: 160 iu/mL (Range: 0 iu/mL – 115 iu/mL)

Thyroid Peroxidase Antibodies (TPOAB) < 9.0 iu/mL (Range: 0 iu/mL – 34 iu/mL)

CRP: High Sensitivity (CRP-HS) 1.17 C-Reactive Protein (CRP) (Range: 0 mg/L – 5 mg/L)

Any help and suggestions are much appreciated,

Thank you very much.

5 Replies

Yes, you do need T3. You are a poor converter. But it also sounds as if you have an ignorant doctor who doses by the TSH, so your chances of getting T3 are pretty low.

You do have Hashi's. So, a gluten-free diet might help you feel better. Have you tried that? And you also need your TSH suppressed, whatever your ignorant doctor might think!

Your vit D, folate and B12 are low, so taking vit D3, with vit K2 - MK7, and a B complex with methylcobalamin and methylfolate will raise your levels. Which might help your conversion a bit, but I think you'd still need T3.

Thank you for your quick response and advice. I started a gluten-free diet yesterday, and taking Vit.D3 20,000IU a week and will add the rest of the vitamins. Now my biggest problem is where to get the T3. Do you have any suggestions as to where I can buy T3 from?

Start a new post asking people to PM you their trusted on-line sources of T3, and I'm sure people will send you some links. :)

SlowDragon
SlowDragonAdministrator

Getting your vitamins optimal is first step

Vitamin D is far too low and needs improving to around 100nmol. Many with Hashimoto's find vitamin D mouth spray is good as avoids poor gut function

Perhaps try 2000iu or 3000iu daily and then retest in 2-3 months via vitamindtest.org.uk £29

Look at importance of magnesium and vitamin K2 Mk7 supplements as well when taking vitamin D. Lots of info on here

B12 and folate are very low. Both are common when we have Hashimoto's. Low B12 common as we get older too. You could ask GP to test for Pernicious Anaemia before starting supplements

Supplementing a good quality vitamin B complex daily. One with folate in, not folic acid. Plus you may also need sublingual B12 initially as well

If you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 3-5 days before any blood tests, as biotin can falsely affect test results

endo.confex.com/endo/2016en...

endocrinenews.endocrine.org...

Hashimoto's affects the gut and leads to low stomach acid and then low vitamin levels

Low vitamin levels affect Thyroid hormone working

Poor gut function can lead leaky gut (literally holes in gut wall) this can cause food intolerances. Most common by far is gluten.

According to Izabella Wentz the Thyroid Pharmacist approx 5% with Hashimoto's are coeliac, but over 80% find gluten free diet helps significantly. Either due to direct gluten intolerance (no test available) or due to leaky gut and gluten causing molecular mimicry (see Amy Myers link)

Changing to a strictly gluten free diet may help reduce symptoms, help gut heal and slowly lower TPO antibodies

Ideally ask GP for coeliac blood test first

amymyersmd.com/2017/02/3-im...

chriskresser.com/the-gluten...

thyroidpharmacist.com/artic...

scdlifestyle.com/2014/08/th...

drknews.com/changing-your-d...

thyroidpharmacist.com/artic...

As you improve vitamins you may find you can increase Levothyroxine dose

Retesting 2-3 months after doing all this.

If FT3 remains low then you will likely need a small dose of T3 added

Dr Toft, past president of the British Thyroid Association and leading endocrinologist, 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)."

You can obtain a copy of the articles from Thyroid UK email print it and highlight question 6 to show your doctor

 please email Dionne at

tukadmin@thyroiduk.org

Plus list of recommended thyroid specialists, some are T3 friendly

Professor Toft recent article saying, T3 may be necessary for many

rcpe.ac.uk/sites/default/fi...

Thank you very much for your quick response and advice. I will surely do all these. Thanks again.

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