I am hoping to get some advice based on people's experiences.
I have been diagnosed with Hashimoto's in 2007 and put on Levothyroxine in 2012 after the birth of my first child. My dose has been increasing consistently and I am currently on 225mcg. However, it seems that I need to keep increasing my dose every year as my results keep going the wrong way and I keep getting the same old fatigue symptoms.
My results in August of last year were (after the dose increase from 200 to 225):
TSH = 0.07 (0.27-4.20)
T4 = 25.4 (10.8-25.5)
T3 = unfortunately was not tested.
My results in May 2018 are (every day on 225):
TSH = 0.33 (0.27-4.20)
T4 = 17.5 (10.8-25.5)
T3 = 3.1 (3.1-6.8)
So it seems that my endo will probably say more levothyroxine; however, how much more can the body take? Should I try T3? My biggest issue is fatigue and pain in my muscles - I have two kids and work full time so it is pretty draining.
I just did the genetic test for T3 conversion gene and am awaiting results but was considering asking for T3 even if I do not have a faulty gene. Should I try it or should I go for higher dose of levothyroxine?
Thank you in advance for any advice.
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kromash
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Have you been tested for Hashimoto's thyroid autoimmune antibodies , or/and Vit D, B12, folate and ferritin levels? Both can produce fluctuating results; so both tests same dose for 6 plus weeks on 225 mcg levo? Your last test May 2018 has the only FT3 result which does indicate poor conversion but this might be due to low min/vit levels. Are you taking levo correctly - eg early morning with water and no food/ drink for an hour, or if eat/ drink then wait two plus hours before taking thyroxin; and not taking iron, VitD, calcium within 4 hours of levothyroxin? Get tested as priority I'd advise.
Thank you both! Yes, my Hashimoto's was identified back in 2007 (from memory) while I was in the US through presence of antibodies - they were around 200+ mark but I really cannot remember that far back.
I will ask GP to test for all of the above Vits and ferriting - in the past results were satisfactory - I had all tests done after giving birth to the 2nd child.
Judithdalston do you think it really makes a difference as to how the levo is taken - tbh I have not been adhering strictly lately. When I tried strict adherence (30 mins before food) in the past it did not really make a difference but I think I will try to do it again and then retest.
Vitamins need to be optimal, not just at bottom of range. Always get actual results and ranges at every test. You are legally entitled to printed copies of all your blood tests
Yes it makes an enormous difference how you take Levothyroxine . Many find taking at bedtime significantly better.
Always take Levo on empty stomach and then nothing apart from water for at least an hour after. Many take on waking, but it may be more convenient and possibly more effective taken at bedtime
Many people find Levothyroxine brands are not interchangeable. Once you find a brand that suits you, best to make sure to only get that one at each prescription. Watch out for brand change when dose is increased
All thyroid tests should be done as early as possible in morning and fasting and don't take Levo in the 24 hours prior to test, delay and take straight after. This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, GP will be unaware)
As you have Hashimoto's look at strictly gluten free diet
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
Thank you so much SlowDragon!!! Yes, I have had test for coeliac disease - it was negative. I also barely eat gluten but might try gluten free completely.
I guess I was just hoping for a magic bullet of T3, but I will try all the other methods first as my endo was saying that T3 dosing could be tricky.
My genetic tests came back showing that i do have one copy of the defective DIO2, so am definitely going to try T3. Would you be able to message me directly with the sites where I can get it in case the GP refuses to prescribe?
Thank you so much for the advice - will do. Seeing GP next week. Do you happen to have a list of Endos in London area or Southwest suburbs who encourage the T3/T4 combined approach? My private endo brushed me off with it being too expensive / too difficult last year so am looking for someone new.
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