Comments requested on my wife's test results

[Chrys]

My wife is currently on 25mcg Levo and 15mcg Liothyronine daily, but still not feeling great, and we have just received these results, and would welcome any comments.

THYROID STIMULATING HORMONE 4.08 mIU/L 0.27 - 4.20

FREE THYROXINE *7.610 pmol/L 12.00 - 22.00

FREE T3 4.06 pmol/L 3.10 - 6.80

REVERSE T3 *9.8 ng/dL 10.00 - 24.00

REVERSE T3 RATIO 26.97 15.01 - 75.00

HAEMATOLOGY

Vitamins

ACTIVE B12 131.000 pmol/L 25.10 - 165.00

FOLATE (SERUM) 19.98 ug/L 2.91 - 50.00

25 OH VITAMIN D 89.9 nmol/L 50.00 - 200.00

Inflammation Marker

CRP - HIGH SENSITIVITY 2.35 mg/l 0.00 - 5.00

Iron Status

FERRITIN 82.7 ug/L 13.00 - 150.00

[SeasideSusie Remembering]

Chrys

You're wife's not feeling great because she's undermedicated. Her TSH is far too high - what happened about the endo who said she likes to see very low TSH?

Her FT4 is way below range, I would say she needs more than the 25mcg Levo she's taking. How much did the endo reduce her Levo when T3 was introduced?

Her FT3 is too low also, one would expect to see that in the upper part of the range, especially when taking T3.

B12 and Ferritin are fine.

Folate is OK but recommended is at least half way through it's range (26.5 plus with that range). Is she supplementing with a good B Complex, if not it might be an idea to get Igennus Super B Complex or Thorne Basic B.

Vit D is a bit short of the level recommended by the Vit D Council, the Vit D Society and Grassroots Health -100-150nmol/L.

[Chrys in reply to SeasideSusie]

Thks Susie, two months ago she was on 75 T4 and 5 T3, the understanding endo, having been advised of DIO2 gene variation, (poor conversion) introduced current regime, stating that if TSH at next test was 0.3 or more, she should continue on T3 only. I'm wondering if the T3 should be increased somewhat. The problem is that GP's know nothing about

'T3 only' treatment, so we would need another endo referral.

[greygoose in reply to Chrys]

So your endo is assuming that T4 is just a storage hormone. But, what if it turned out to have other functions? If it's not doing any harm, I can't see the necessity to stop taking it altogether. He's not giving her much room to experiment to find her optimal doses, is he.

[Chrys in reply to greygoose]

I agree, I would prefer the combination, and feel more of each may be better.

[greygoose in reply to Chrys]

Then it should be discussed with your wife and the endo. Treatment should be by informed consent, not by the doctor dictating to the patient, as they so like to do.

[SeasideSusie Remembering in reply to Chrys]

Chrys

Did her Levo need lowering to 25mcg? That's a big reduction. Firstly it should be 25mcg at a time, and secondly her FT4 wasn't near the top of it's range it may not have needed lowering.

[Chrys in reply to SeasideSusie]

Probably as it is now accepted that she does not convert properly, and she did much better for a short time on T3 only. See my previous posts on this.

[Chrys in reply to SeasideSusie]

Forgot to say, she is on B50 complex from Natures Best.

[SeasideSusie Remembering in reply to Chrys]

Chrys

I don't like these B50, B100, type of complex as they aren't a particularly good balance. in the B50 there is 50mg B6 and the recommended amount is 10mg.

Also, it contains folic acid and the recommended form is methylfolate.

Personally, I would buy one with all bioavailable ingredients and a better balance, the 2 brands mentioned above come into this category.

[SlowDragon Administrator]

Having DIO2 gene usually means you need T3 in addition to T4, not instead of T3

It doesn't mean you can't convert, but that brain needs T3 to function well

Is she heterozygous or homozygous DIO2 ?

Her FT4 is far too low, as others have said

Suggest she tries increasing Levo by 25mcg. Retesting in 6 weeks. Likely to need further 25mcg increase (s)

I have heterozygous DIO2 gene.

[Chrys in reply to SlowDragon]

Heterozygous, or reduced ability to generate T3. ie as said a poor converter, thus I feel more T3 in addition to T4 is required given her results.

[SlowDragon Administrator]

Meant to add, my endo (erroneously) reduced my Levo by 25mcg (from 125mcg to 100mcg) when started on T3. After 3-4 months being much more actively on T3, FT4 was too low and feeling dreadful. Putting Levo back up resolved issues.

[Chrys in reply to SlowDragon]

Thks

[Chrys in reply to SlowDragon]

I have already done that, up to 50 T4 , and legalised it this AM with GP, and agreed with her to review in 6 weeks.

[SlowDragon Administrator in reply to Chrys]

Does she also have autoimmune thyroid disease (Hashimoto’s) diagnosed by high Thyroid antibodies or by ultrasound of thyroid

If not had TPO and TG Thyroid antibodies tested push GP to test or get tested via Medichecks or Blue Horizon

NHS refuses to test TG antibodies if TPO are negative

If she has Hashimoto’s is she on strictly gluten free diet?

Very very many with Hashimoto’s find it helps significantly or is essential

You don’t need any gut symptoms at all

[Chrys]

Yes to Hashimotos, yes to high antibodies, yes to low platelets, yes to gluten free, also lactose free.