Help with dosing please

[Julienew]

I’m on 2 grains of NDT (Thiroyd). I have tried increasing but seem to get more episodes of flushing and increase in pulse especially when v tired (I’ve had ME for over 20 years and well into menopause though). It may have nothing to do with the dose of NDT but I tend to panic and think of my GP’s raising of eyebrows as they disapprove of me self-medicating. They were no help and neither was endocrinologist. They gave up when I was diagnosed with Non-Hodgkin’s Lymphoma as they thought it was the cause of all my woes. But it wasn’t, so my battle continued.

I just got new blood test results –

THYROID STIMULATING HORMONE *0.038 mIU/L 0.27 - 4.20

FREE THYROXINE 12.600 pmol/L 12.00 - 22.00

FREE T3 3.96 pmol/L 3.10 - 6.80

THYROGLOBULIN ANTIBODY 79.100 IU/mL 0.00 - 115.00

THYROID PEROXIDASE ANTIBODIES 10.9 IU/mL 0.00 - 34.00

In January my antibodies spiked (271.00 0.00 - 115.00) and T’s dipped (Free T4 12.6 12.00 - 22.00 Free T3 3.44 3.10 - 6.80) So I was definitely hypo/ Hashi. Previously I’d thought I was over-medicating so had dropped from 1 and half grains, to 1 grain. I was wrong so gradually increased up to 2 grains once I’d had bloods checked and realised what was happening.

I’m gluten and dairy- free. Little, if any soya.

Rest of today’s results -

ACTIVE B12 *>300 pmol/L 25.10 - 165.00

FOLATE (SERUM) 7.22 ug/L 2.91 - 50.00

25 OH VITAMIN D 111 nmol/L 50.00 - 200.00 Interpretation of results:

Deficient <25 Insufficient 25 - 49 Normal Range 50 - 200 Consider reducing dose >200

CRP - HIGH SENSITIVITY 0.83 mg/l 0.00 - 5.00

FERRITIN 125 ug/L 13.00 - 150.00

I’m seeing a nutritionist who is helping with diet etc. On supplements to help methylation so expected folate to be higher. I was hoping to feel better by now but no sign of that happening. I should be absorbing nutrients better as digestion much improved and reflux is gone.

I still have loads of hypo symptoms – e. g. dry eyes, sore, dry mouth with enlarged tongue, totally exhausted with no energy (virtually housebound), heavy legs with pads of ‘fat’ (not fluid) around ankles despite losing weight (I’m size 8 or 10 now. Ok, a 9). Brain is a total fog. I just can’t retain info even though I’ve read about the subject for over 2 years, when I’ve been able.

My questions are

– do I try and increase NDT again? My pulse rate seems to be an unreliable way to monitor as it has always been a bit high for some reason and gets higher when I’m more exhausted and struggling. Something to do with adrenaline???? My temp was always a bit low but I just couldn’t get reliable readings when trying to monitor progress, even with a mercury thermometer. Can I monitor with resting pulse and ignore anything else/spikes in pulse rate?

-anything else I should be doing?

- also I need ‘ammunition’ as I see GP on tomorrow for an unrelated problem and I suspect she’s sneaked a TSH in with other blood tests. Can I say I’m definitely hypo/Hashi and my self-medicating when they ‘abandoned’ me prevented the situation becoming much worse? The TSH being so low is irrelevant?

Many thanks

[Sv_cy]

Did you check your cortisol? It can happen when there is Adrenal Fatigue.

drlam.com/blog/hormone-imba...

[Julienew in reply to Sv_cy]

Thank you for your reply.

I did check my cortisol last year and it was a bit high. My nutritionist put me on adrenal support capsules which I didn't feel made much difference until I stopped them. I re-started them a couple of weeks ago.

I really don't know if I get these episodes because I need more NDT or not. Tend to be worse at the end of the day. I crawl up to bed and have to lie down before I can clean my teeth because I can't stand for long and my heart is pounding.

It may be the ME.

No clue. I'll read the link. Thanks.

[Sv_cy in reply to Julienew]

As I see from results free thyroxine and free T3 are low. According to the results you need to increase the dose. T3 should be in a high range, thyroxine in the middle range. Adrenal fatigue can be the reason that the increasing of the dose make you feel bad. Also you have to take this dose 2-3 times a day

[Julienew in reply to Sv_cy]

Thank you

Last night I finished reading the OAT axis article you have the link to. I downloaded the Fatigued Put Of Life PDF which I will read today. It's very interesting and I feel the picture fits me. I think my oestrogen/progesterone were unbalanced as I had loads of breast cyst but they disappeared as soon as I hit the menopause. No idea what levels they are now.

The thyroid hormones (I take 1 grain early am and another early afternoon) don't seem to have helped me but the antibodies have come down into range. I know there are other things going on but I don't know what.

I'm working through various things with my nutritionist and am continuing to deal with digestive issues. I think I'm not sufficiently Paleo so need to address that.

Can I ask - have you been through this? And any advice on where to go from here? I saw a endocrinologist who was no help at all.

Thanks.

[Sv_cy in reply to Julienew]

There are seven stages of Adrenal Issues stopthethyroidmadness.com/s... You have to make SALIVA cortisol testing stopthethyroidmadness.com/s... Before to make the test please read this information stopthethyroidmadness.com/s... Two years before I wanted start to take NDT instead of euthyrox. I could not do that as I was feeling VERY bad. And after 3-4 weeks I stoped and continued to take euthyrox. In that time I did not know that before to take NDT I have to support adrenals and put up ferritin. Low cortisol and low ferritin will not let us to feel good. Now I take T4+T3. When I started to take T3 I had this problem but not as before as my ferritin was in normal range and cortisol little bit better. I hope it will be helpful for you.

[Julienew in reply to Sv_cy]

Thank you.

I contacted my nutritionist and I'm going to do a comprehensive Adrenal test.

The links to articles are useful - thank you.