Recently diagnosed as hypo. Investigations ongoing as to why. (Not Hashis. Maybe secondary/CH) GP prescribed Levo 50mcg. But my Iron levels are dire as are folate levels. Also b12 deficient (cause not yet established) and history of vitamin D deficiency (level good but not yet optimal)
My thoughts re starting on the Levo are
a) will it have any effect if my nutrients are shot? ie us it pointless until my levels are optimal
b) is it the case that using replacement thyroid hormones causes your own production to shut down?
c) can getting nutrient levels into optimal range "wake" the thyroid up again or is it usually the case that once it's struggling it stays struggling regardless of nutrients?
At the moment I've said to my gp that I'll hold off starting the Levo until investigations are complete. But this could mean several months. And not sure how much longer I can hold it together.
If I start levo I may feel better or it may not work until nutrients are addressed. But by trying it out I may also be committing myself to a lifelong medication and discarding the possibility that my thyroid may recover naturally if I address underlying deficiencies.
Basically having a crisis of confidence with my decision to hold off and would love to hear from anyone who's had a similar dilemma, what they decided,and what the outcome is. Or indeed what you would do.
Struggling.
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Portia1974
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Unfortunately, if we've been diagnosed it means the thyroid gland is already struggling. Also if we don't have sufficient coming from our thyroid gland and Free T4 and Free T3 is low, our body cannot function as it should particularly Brain and Heart which need the most T3. The gland doesn't usually 'recover'.
GP wont do FT3 and FT4 I believe as they seem to be instructed to only do TSH and T4.
Our vitamins/minerals should be optimum too. As levo is a hormone replacement is shouldn't affect nutrients but B12, Vit D, iron, ferritin and folate should be optimal as deficiences can also cause symptoms.
If you've been diagnosed as hypo, leaving off taking hormones means your heart/brain and other T3 receptor cells will not have sufficient to work at an optimum. I shall give you a list of symptoms and you may have some of them already. Thankfully we don't get all of them.
On the following you will see why FT4 and FT3 are important but rarely tested.
Thank you. So if my nutrients levels are not optimal (read dire in the case of iron and folate and sub optimal b12 and vit d) will the Levo even help? Or am I just pouring water in a bucket full of holes so to speak?
That was one of the main thrusts of my query.
Am pretty well versed now on symptoms, tests and what to (not) expect from the NHS. So not after that really (but appreciate your taking the time)
What I particularly am struggling with is that I read repeatedly on here that those particular nutrients HAVE to be optimal in order for Levo to be effective. Mine are not. So is there any point to taking Levo until they are, in your opinion? Will I get any benefit while my nutrient levels are so poor?
a) I see no reason why you shouldn't start levo whilst you're working on your nutrients. A starter dose of 50 mcg is probably not going to do much, anyway. And it could take a long time to optimise your nutrients. In the meantime, levo could be helping you feel better.
b) yes, it probably will shut your own production down. But that's not a problem. It's a myth that once you start thyroid hormone replacement, you're committed to it for life. If you should stop it, for whatever reason, your thyroid will just wake up and take up where it left off. It doesn't shut down for good.
c) I really don't think so, no. You haven't got Hashi's, you say - although I don't know how you can prove that. I would have thought it was obvious if you have Central hypo, and if you have, I really don't think improving your nutrients is going to improve the function of your pituitary or hypothalamus. If they aren't working properly, it's usually due to a blow to the head, massive bleeding, something like that. Nothing to do with nutrition. And, whilst it's true that anorexics (and I am NOT suggesting you are one!) usually end up hypo, I think that's more to do with the lack of calories than lack of nutrients. But, in any case, it tends to be irreversible.
Take the levo, I say, see if it helps. Why carry on suffering when it's not necessary?
Thank you greygoose 😊 I suppose the only way rule out Hashis is a scan of the thyroid that shows no physical damage coupled with negative antibodies? That and establishing an issue with the pituatary/hypothalamus instead I guess?
Should get some bloods back tomorrow that may shed light on that and whether scans etc are indicated.
So...
a) in your view I could still feel some benefits from Levo even while nutrients are deficient
b) I'm not losing the possibility of being med free at some point in the future but right now my thyroid needs the support
c) if it is CH, (which seems more likely anyway) I'll have to take the meds anyway so.....
I'm probably prolonging my "suffering" unnecessarily.
Is that the thrust of it?
(Dunno why I keep saying "thrust". Word of the day, lol!)
You can have Hashi's and Central hypo at the same time, of course. One doesn't rule out the other. And a scan of the thyroid wouldn't show any damage in the early days, only in the later stages.
a) you could possibly, yes. And, it would get your body used to taking the hormone.
b) nothing to do with support. Levo doesn't support your thyroid, it supports you, keeps you alive. You can't live without thyroid hormone. But, in the rare possibility that you didn't really need it, you could come off it, yes. It wouldn't harm your thyroid.
c) Absolutely. And I think you mean the gist of it.
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what are optimal levels on combined t4/t3 please?
Optimal TSH and T4 levels?
Is it possible to be deficient in nutrients, even if nutrient levels in your blood are optimal?
Low tsh levels 
Optimal Levels
