I am a 35 year old male. 72 kg, 6 ft. Hypothyroid for at least 15 years, probably most of my life but didn't know it. Living in New Zealand.
This is a long post, but in a nutshell, I'm taking Slow Release T3 (SRT3), but it is not working as expected. I think I need to improve how cells use it, specifically by getting on iron supplementation.
My latest blood tests are the following. Please note that I have done these early in the morning (7.30 am), fasting (water only), no supplements or hormones just before. Last T3 taken 12 hours before. So the results should be as accurate as they can be. I always do my blood tests like this.
Thyroid tests while currently on 30 mcg of compounded Slow Release T3 (SRT3) twice a day compared to 6 weeks ago on 37.5 mcg x 2 per day.
Now (30 mcg x 2 per day) | Before (37.5 mcg x 2 per day)
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TSH | 14 mlU/L ( 0.40 - 3.80 ) | 4.30 mlU/L ( 0.40 - 3.80 )
FT3 | 5.8 pmol/L ( 4.0 - 6.8 ) | 7.7 pmol/L ( 4.0 - 6.8 )
FT4 | 0.7 pmol/L ( 12.8 - 20.4 ) | >0.6 pmol/L ( 12.8 - 20.4 )
Just from this, you would think I would have been feeling better Before with my FT3 (7.7) quite a bit over the max vs now (5.8), which is not even in the upper quartile (6.1). However, I was all over the place with anxiety attacks and if possible, even more hypothyroid symptoms than now. Paradox. So just to give examples of those familiar hypo symptoms: heart rate (< 60 bpm), temperature (< 36.4 C orally), feeling freezing, slow thinking, bad memory, no motivation, dry skin you name it.
My (researched) theory is that my cells are not able to utilise T3. Which is why I did the following blood tests to identify what elements need to be more optimal.
As an aside. Having been on SRT3 it has eliminated poor conversion as part of the problem as well as Reverse T3 (RT3) as that clogging up the T3 cell receptors. But it hasn't made me any better than when I was on T4 only or NDT.
Iron Panel
Serum Iron: 15 umol/L ( 10 - 30 ) - Optimum: 21 - 24 (men 24)
Ferritin: 128 ug/L ( 30 - 500 ) - Optimum: 265
Transferrin: 2.4 g/L ( 2.0 - 3.2 ) - Optimum: N/A
Transferrin Saturation: 25 % ( 16 - 45 ) - Optimum: 35 - 45
To supplement this:
CRP : < 3 mg/L ( < 6 )
This is weird as a range. I'm guessing anything under 6 is good, mine was even under 3. I take it this inflammation marker is pretty good and shouldn't drive up Ferritin.
Haemoglobin : 149 g/L ( 130 - 175 )
Mid point is 152.5, which I'm very close to. So according to this I don't have terribly low Iron. So unfortunately it doesn't support the iron panel results, but may not need to?
For me right now, with what I have already done, I think Iron is the most important thing to get right. Based on this I need good iron supplementation. Any comments on the decision and/or best way to get my iron levels up to those optimal levels fastest but safe?
Other blood tests:
B12 : 1263 pmol/L ( 170 - 800 )
Unsurprisingly high as I have been supplementing with sublingual B12 and Folate for 6 months to bring low in range result up.
25-OH Vitamin D : 118 nmol/L ( 50 - 150 ) - Optimal
Serum Cortisol : 427 nmol/L ( 170 - 500 ) - Says over 300 excludes adrenal insufficiency.
I know saliva 4 point test is best and I have done it before. This was ordered by my doctor as another indicator. It did show low and so I have tried Hydrocortisone treatment from 32.5 mg spread through the day with no more than 10 mg at a time. Experimented down to 10 mg in the morning. Basically nothing helped. Sadly, it was not my magic solution to get T3 into my cells.
Plasma Aldosterone: < 103 pmol/L ( 103 - 859 )
This is a bit weird as I have been taking fludrocrtisone (Florinef), for this, but probably need to up the dose.
Other minerals:
Calcium: 2.52 mmol/L ( 2.15 - 2.55 )
Phosphate: 1.37 mmol/L ( 0.80 - 1.50 )
Albumin: 43 g/L ( 34 - 48 )
Adjusted Calcium: 2.48 mmol/L ( 2.15 - 2.55)
No real comment about these. If anyone has anything interesting to say, let me know!
Cholesterol. I wanted to know how I'm travelling with it. I know I have a bit too much LDL in the past, but good ratio though. The picture looks similar now too.
Fasting status: Fasting
Cholesterol: 4.4 mmol/L ( < 4 )
Triglyceride: 0.6 mmol/L ( < 1.7 )
HDL cholesterol: 1.72 mmol/L ( > 1 )
LDL cholesterol: 2.4 mmol/L ( < 1.8 )
Chol/HDL Ratio: 2.6 ( < 4 )
Based on this I have too much total cholesterol and LDL. But HDL is good and so the ratio is good. I do feel that my blood arteries/vessels are constricted as I have trouble every time doing the blood tests. Equally this could be just the hypothyroidism though.
Another reason to measure cholesterol is during my anxiety attacks that feel like I'm having a heart attack, I feel that I might need to get a measurement of my heart arteries. So do an angiogram. FYI I've done an echocardioagram, ECG and brain MRI, which were all good. Angiogram though, would show partial blockages that perhaps could be causing my chest pains and dizziness.
For reference, here is the last results, which is the rest of my Complete Blood Count (CBC):
RBC: 5.02 x 10e12/L ( 4.30 - 6.00 )
Hct: 0.45 ( 0.40 - 0.52 )
MCV: 90 fL ( 80 - 99 )
MCH: 30 pg ( 27 - 33 )
Platelets: 330 x 10e9/L ( 150 - 400 )
WBC: 7.0 x 10e9/L ( 4.0 - 11.0 )
Neutrophils: 2.7 x 10e9/L ( 1.9 - 7.5 )
Lymphocytes: 3.3 x 10e9/L ( 1.0 - 4.0 )
Monocytes: 0.7 x 10e9/L ( 0.2 - 1.0 )
Eosinophils: 0.2 x 10e9/L ( < 0.6 )
Basophils: 0.1 x 10e9/L ( < 0.3 )
Nucleated RBCs: 0.00 x 10e9/L
This has ended up being a massive post. I've put a short summary up the top and have hopefully made it as readable as possible with as much detail as I could. Please let me know your thoughts.